lukkymik said:
Hana.. Now i'm really confused by your figures. You say Bernstein equates 85 to 4.7 yet when I was told my HBA1c was 8.3 that equated to 79 on the new guidlines. Does this mean we might all be confusing each other with our figures?? This might explain why so many people on here, justifiably, get confused by the information available from so many different sources. ??????
Mike
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Dr Bernstein who Hana was quoting is in the US. They use mg/dl for blood glucose readings using a meter. The 85mg/dl is the reading that he claims normal people have most of the time (I think he says he tested representatives when they came into his office and that's what they were. 85mg/dl equates to 4.7 on your blood glucose meter.
To change mg/dl to mmol/l as in the UK then divide by 18
Normal blood glucose levels vary just as diabetics do and they will go up after meals. This graph show (in mg/dl) the blood glucose od young people who had 'passed' and OGTT wearing a continuous monitor. The level in between meals for the average person here (blue line) is indeed in the low 80s but rose to an average maximum 132mg/dl (7.33mg/dl) after breakfast. ( see chart 25 ) The brown lines show that some subjects were considerably higher/lower. These were all 'normal'.
http://www.diabetes-symposium.org/index ... 2&chart=20
Hb A1c is the laboratory measurement that reflects your glucose levels over the last 2-3 months. In the UK this is now expressed in mmol/mol but until recently was expressed as a percentage.
(to change HbA1c expressed as a percent to mmol/mol use the converter here .
http://www.diabetes.co.uk/hba1c-units-converter.html0 )
The claim that normal people have HbA1cs ranging from 4.2%-4.6% also seems to derive from Dr Bernstein.
David Mendosa investigated how true this claim was and contacted the National Glycohemoglobin Standardization Program (which forms part of the international standardisation procedures)
Curt told me that every three or four years his lab at the university studies a group of people who don’t have diabetes to scientifically determine what a normal A1C level is. The results from one study to the next are always close, Curt told me. In their most recent study they tested 29 people who lived nearby in central Missouri.
I asked how they knew if the people they tested didn’t have diabetes. “Because we did fasting glucose tests on them, they had no prior history of diabetes, and none of them were obese,” Curt replied.
So what were their levels? They ranged from 4.5 to 6, Curt replied. That’s at plus or minus 3 standard deviations.
I am certainly no statistician. But Curt tells me that it includes about 99 percent of the values
The range is narrower — 4.7 to 5.7 — at plus or minus 2 standard deviations. This includes about 95 percent of the values.
“The upper limit is the more important one,” Curt explained further. “The lower limit doesn’t convey as much meaning.”
They also see “a little skew toward the high end of the range, a bit of tailing at the high side,” Curt continued. In fact, levels below 4.5 are “quite unusual,” and usually are only when people have anemia or other abnormalities of the red blood cells
http://www.mendosa.com/blog/?p=366
The non diabetic reference range for HbA1c using the 'new units ' is considered to be 20 mmol/mol to 42 mmol/mol (4-6%)
As to hypos. In T1 (
this is a T1 forum) it is important to be aware of glucose levels that are at or below 4 since unlike in non diabetics the insulin that we have injected can't be stopped. (OK this figure may vary a bit between countries but most don't suggest lower than 65mg/dl which is 4.6mmoll)
In the UK the DVLA considers 4mmol/l to be hypoglycaemic and you shouldn't be driving at this level or below (indeed they say 5mmol/l for when you start driving)
