Hi ,awarningv to various groups,---ethnic heritage; women;and certain drugs
we may be in a mulyiculural society such as UK;Australia; Europe,and USA
BUT WE ARE ALL NOT EQUAL AS FAR AS RED BLOOD LIFESPAN IS CONCERNED!!
as a Scot living in Australi,and a type 2 diabetic since 1986, I went for over 20yrs without being medicated based on this HbA1c test
Why?
I discovered that the test (12 fast) was actually 2 tests in 1 Page 1 ,Aic results ,page 2,blood chemistry data
I was never given any results for my a1c just comments like "great control" or ironically A1!!
It turned out that GPs were only looking at 1 screen on their computer! by sheer luck ,i could see the GPs computer with many **
and asked"was that part of my test" it turned out to be the blood chemisry (it was explained this is why you fast not for a1c?)
as a retired QA engineer and accreditation stds teacher, my training helped me uncover the reasons why I had not been medicated
Gps were only calling up page 1 (I had asked to see a pathology a1c report from2001 when I was very ill) on their computer!!
my readings were 2001 4.0 2002 4,1
underneath this , was a generic table ----7% the goal < 6 non diabetic level ?????
On asking for a copy of my blood chemistry ,page 2 I was horrified to find --fasring glucose 15.5 mmols/L
On Asking why I was,nt medicated based on this, I realised that I had NEVER seen GPs opening up 2 screens!!
On Contacting the Pathology Lab involved,--A1c is done in one lab section ,and blood chemistry in another,so goes out to the GP at different times as pages 1 & 2. When I asked if they (the Lab )compared fasting glucose and a1c for discordantr results.
Iwas told "Its up to the GP to read BOTH PAGES. i SUGGESTED THEY put Fasting glucose and A1c "On The Same Page"
not rocket science.!
Groups that can be affected by these "systemic errors
" CALD (Cultoral And Linguistically Diversepopulations) ie smediterranean(Greek;Italian; Turkish heritage etc Chinease;Middle East;SE Asian ;Indian Sub continent;Blacks African and American;Laqtin American;Pacific Islanders;Maori and indigenous comunnities--these come under the umbrella Genetic Mutations (over 1200 most clinicallt /Silent!!) causing False Lows or Highs in the HbA1c test
Women---common conditions that can give false A1c s are Heavy menstruation,/iron;Vit B12 and folate deficiences can give false highs and if GP or patient is unaware of these, the diabetic women can be over medicated
I had originally been tokld that I had a hemoglobinopathy but 5 yrs later found I haqd a low grade Hemolytic anemia!!!
another confounder whic h c an develope as we age
Simple soloution
A DIABETIC'S HEALTH IS ONLY AS GOOD AS HIS OR HER SELF MANAGEMENT SKILLS ALLOW
ALWA\YS write down your A1c data , use a simple math rule 2xA1c-6 = BG meter averages trends or take 3 consecutive fasting Glucose readings (before breakfast) and they should roughly be trensing with your a1c Data..
Note some people of the older ethnic heritage groups may not speak or read english so it encumbent on younger english speaking menmber of the family and remember it can be inherited
I now get a Fructosamine Test for my Management
hope this info helps.
QA suggestion- Path Labs Should put Fasring glucose and a1c ONTHE SAME PAGE (this is now happening here
ALL Path Labs be certified to World NGSP (google)
on youtube seaech engine put a1c--up will come various video stills most expain a1c with no interfering factors!!
go to video-2 large red disec with small biue discs representing haemoglobin with glucose binding--half wa y thro, watch for "interfering factors!!!!
hope this helps those who think HbA1c is a Gold Standard with NO exceptions
Angusmac
soory for any errors old eyes
we may be in a mulyiculural society such as UK;Australia; Europe,and USA
BUT WE ARE ALL NOT EQUAL AS FAR AS RED BLOOD LIFESPAN IS CONCERNED!!
as a Scot living in Australi,and a type 2 diabetic since 1986, I went for over 20yrs without being medicated based on this HbA1c test
Why?
I discovered that the test (12 fast) was actually 2 tests in 1 Page 1 ,Aic results ,page 2,blood chemistry data
I was never given any results for my a1c just comments like "great control" or ironically A1!!
It turned out that GPs were only looking at 1 screen on their computer! by sheer luck ,i could see the GPs computer with many **
and asked"was that part of my test" it turned out to be the blood chemisry (it was explained this is why you fast not for a1c?)
as a retired QA engineer and accreditation stds teacher, my training helped me uncover the reasons why I had not been medicated
Gps were only calling up page 1 (I had asked to see a pathology a1c report from2001 when I was very ill) on their computer!!
my readings were 2001 4.0 2002 4,1
underneath this , was a generic table ----7% the goal < 6 non diabetic level ?????
On asking for a copy of my blood chemistry ,page 2 I was horrified to find --fasring glucose 15.5 mmols/L
On Asking why I was,nt medicated based on this, I realised that I had NEVER seen GPs opening up 2 screens!!
On Contacting the Pathology Lab involved,--A1c is done in one lab section ,and blood chemistry in another,so goes out to the GP at different times as pages 1 & 2. When I asked if they (the Lab )compared fasting glucose and a1c for discordantr results.
Iwas told "Its up to the GP to read BOTH PAGES. i SUGGESTED THEY put Fasting glucose and A1c "On The Same Page"
not rocket science.!
Groups that can be affected by these "systemic errors
" CALD (Cultoral And Linguistically Diversepopulations) ie smediterranean(Greek;Italian; Turkish heritage etc Chinease;Middle East;SE Asian ;Indian Sub continent;Blacks African and American;Laqtin American;Pacific Islanders;Maori and indigenous comunnities--these come under the umbrella Genetic Mutations (over 1200 most clinicallt /Silent!!) causing False Lows or Highs in the HbA1c test
Women---common conditions that can give false A1c s are Heavy menstruation,/iron;Vit B12 and folate deficiences can give false highs and if GP or patient is unaware of these, the diabetic women can be over medicated
I had originally been tokld that I had a hemoglobinopathy but 5 yrs later found I haqd a low grade Hemolytic anemia!!!
another confounder whic h c an develope as we age
Simple soloution
A DIABETIC'S HEALTH IS ONLY AS GOOD AS HIS OR HER SELF MANAGEMENT SKILLS ALLOW
ALWA\YS write down your A1c data , use a simple math rule 2xA1c-6 = BG meter averages trends or take 3 consecutive fasting Glucose readings (before breakfast) and they should roughly be trensing with your a1c Data..
Note some people of the older ethnic heritage groups may not speak or read english so it encumbent on younger english speaking menmber of the family and remember it can be inherited
I now get a Fructosamine Test for my Management
hope this info helps.
QA suggestion- Path Labs Should put Fasring glucose and a1c ONTHE SAME PAGE (this is now happening here
ALL Path Labs be certified to World NGSP (google)
on youtube seaech engine put a1c--up will come various video stills most expain a1c with no interfering factors!!
go to video-2 large red disec with small biue discs representing haemoglobin with glucose binding--half wa y thro, watch for "interfering factors!!!!
hope this helps those who think HbA1c is a Gold Standard with NO exceptions
Angusmac
soory for any errors old eyes
I also disagree with the fasting numbers, based on my major liver dumps in the morning my A1c would be much higher than it actually is. I can hit the high 7's first thing and after I eat be in the 4's and 5's all day.