Hi,
Correct me if I am wrong. HbA1c does not distinguish between the high glycators or low glycators.
Some could therefore be prediabetic and be diagnosed as diabetic?
Also some could be diabetic and be diagnosed as prediabetic?
Surely HbA1c is merely a tool that indicates integrated glucose levels for normal glycators?
Yes.
By the way Phoenix, ......
I think in my original answer I was pointing out that we will may miss times when we are higher so our real average may be higher than our meter average. (and if you are hypo aware you tend to correct quickly so don't stay low for long periods but will usually have the low recorded on your meter)
] Does equal time above/below the average count act as an exact counterbalance in terms of glycation ? That to me raises questions that I don't have the answers to!
Not every cell is glycated when it's exposed to glucose only some, yet even people with very low glucose levels have some glycated cells. I don't know what determines the number of cells that are glycated ,apart from reading various vague statements about it being to do with the amount of glucose and length of time exposed (what's the effect of 20min at 3mmol/l compared with 20min at 9mmol/l ? ). I also believe that glycation is initially reversible. (under what conditions does it become permanent?)
You need a specialist to answer these questions... and even then I suspect that no-one really knows
BTW I use two different blood glucose meters and get the same results from similar GI foods.
I find my HbA1c of 50 difficult to equate to AG.
A reading of 9.0mmol/l as a EAG seems way too high! I only go over 9.0 if I deliberately abuse the bread and potatoes to see what happens to my blood glucose.
I shall have to get a private Fructosamine test (c.£140) to investigate the possibility I am a high glycator.
The UK has refused to use the eAg at the moment for 3 reasons.
1)the group studied were not randomly selected and included people without diabetes.
2) didn't include some ethnic groups.
3) and I'll quote because it is relevant to your concerns
there is uncertainty associated with the eAG value itself, acknowledged by the authors but not evident in the formula promulgated on the ADA Web site. That uncertainty is such that two patients with the same true mean glucose level of 170 mg/dl(ie 9.3mmol/l) could have an A1C value anywhere from 6.5% (which is as low as the A1C values of the intervention groups of the VA and ACCORD [Action to Control Cardiovascular Risk in Diabetes] studies) to 9.0% (which was adversely high in the Diabetes Control and Complications Trial) (2). Clinicians are already aware of ways to reconcile this degree of uncertainty, but we—as a diabetes community—are now planning to offload this task onto our patients. As a result, based on possible conversions of A1C to eAG, patients with the same true mean glucose level of 170 mg/dl could be told that their eAG is anywhere between 140 and 212 mg/dl—with predictable consequences when they try to compare this laboratory measurement with their own meter readings.
http://care.diabetesjournals.org/content/32/1/e11.full
Of course previous formulas were just as problematic.. ( and had even less evidence for their use)
regards
Derek