http://care.diabetesjournals.org/content/33/2/273.fullIt is tempting to speculate that higher LA1C could serve as a temporary intracellular storage compartment for glucose and/or some of its intracellular metabolites. Temporary sequestering of glucose or glucose metabolites as LA1C would prevent these substances from entering pathways that produce toxic metabolites when blood glucose levels are elevated
phoenix said:Red blood cells last on average 3 months, new cells are being added all the time. There will be more newer blood cells than the oldest ones so HbA1c is weighted towards more recent levels.
It would seem (from this study) that, contary to the normally state the 90-120 day average, the HbA1c test is 'an exponentially weighted average of blood glucose levels from the preceding 4 weeks, with the most recent 2 weeks being by far the most important'.
so until we get a true weighted average of the damage high b.g. can cause over time it is merely an indicator.
it leads one to be sceptical of the hard and fast 42 and 48 thresholds!
It also commends R.H. and says nothing about the problems of low b.g.
I'd put it another way. We have a lot of evidence that an Hba1C below 40 results in little damage, and similarly that Hba1Cs above 50 result in damage. As a result, we know that elevated Hba1C is an inidcator of damage.
We also know that swinging highs and lows are the major cause of retinopathy and that any swinging high in a T2 is a cause of Hyperinsulinemia, which leads to other issues such as Atherosclerosis and non-alcoholic fatty liver disease.
Therefore, given what we do know, it seems to me that it is worth keeping your Hba1C and blood glucose levels within what is considered normal, given the very real issues that are already identified.
I never had one eitherI've never had an OGTT and I suspect many other T2s haven't either.
They sound like a horrific shock to the system. Couldn't one just test levels before and at regular levels after eating?
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