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Message: <blockquote data-quote="Alexandra100" data-source="post: 1866823" data-attributes="member: 429870">Warning: this is my totally unscientific understanding of the A1c test. It measures how much glucose is sticking to your red blood cells. Red blood cells live for between 2 and 4 months before they are replaced, so the test shows very roughly what has been happening over that time, how much glucose has accumulated. There is lots of scope for inaccuracy. As far as I know, there is no way of knowing if YOUR personal red blood cells are longer or shorter lived, but anaemia or too much iron in your blood will definitely skew the results. This quote will give you an idea of the scale of the problem:"Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. However, reports on the effects of iron deficiency anemia on HbA1c levels are inconsistent."From:  <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255499/" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255499/</a>In addition, it is widely said that although the test is supposed to reflect your bg levels for the past 3 months, actually the last 3 weeks have more effect. I have some evidence of this, as a diabetic friend of mine went on the razzle just before his A1c test, scored a high reading and was threatened with insulin. He explained the situation to his nice GP, who allowed him to have another test  one or two weeks later. By then his bg had dropped to a more acceptable level.The A1c reading is also an average over 24 hours that can mask unhealthy spikes and troughs, so IMO it should always be supplemented by home finger prick or Libre / CGM readings.</blockquote>

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