I found something very interesting. Labs can differ a bit from one to the next, but in the US I never found much of a difference. Have you? Well, there’s certainly a difference between the usual lab value in Germany versus the one in the US. In fact, there’s a major global problem with lab standardization, yet everyone is still running with the “under 7.0%” target. Under 7.0, though, means something different depending on where in the world you are.
If you search online you’ll find that many medical sites give you a chart of approximate average glucose levels that correspond to whichever hba1c%. They may or may not be the same as your lab, but I bet they’re not much different. Well, many German websites have the same type of chart, but the numbers are NOT the same as on the American charts! Here’s an example from my old lab in America, the most common chart found on US websites and the most commonly found one in Germany. For each a1c, the corresonding average blood glucose:
6.0% a1c
America: 125 (most commonly listed as 135)
Germany: 120
6.5% a1c
America: 142 (most commonly listed as 151)
Germany: 136
7.0% a1c
America: 160 (most commonly listed as 170)
Germany: 151
So, accordingly, a blood sugar average of 140 might be an a1c of 6.3% at an American lab, but in Germany that exact same average would get you a 6.7%! Taking the most common charts found on medical websites alone, there is usually a .5% difference between Germany and the US for the same bg average.
I asked the docs at ChildrenWithDiabetes.com about this, received a good answer, then did my own research. It is true that different countries may use a different standard lab assay. For instance, Sweden just suddenly decided a while back to standardize to one test within its borders and most everyone’s a1c jumped up about 1/2 a percent overnight. So if you were tested in Sweden you’d get a 7.5, but a 7.0 next door in Norway.
Ok, right? Different lab assays, different lab ranges, right? Not really! The problem is that the whole world now (thanks mostly to the huge DCCT study) has set the standard for glucose control at “under 7.0% a1c” (preferably 6.5 or less). But just what does 7.0 mean??? Does it mean an average of 170? Or 151? Or 147? Or 172? If your blood sugar is 150 and in an average lab on one continent it means you’re at 6.9, but on another you’re at 7.5, doesn’t that matter? I mean, who’s right then? What should we actually strive for? If your a1c is 6.9% here but 6.4% there, are you doing great, or just ok?
Well, a major agreement was reached just last month between the US, Canadian, European and Asian organizations in an effort to standardize the a1c test globablly. We will all be shifted to a new calculation method “as soon as possible” (2 years? just a guess) that will be the same no matter where you are, albeit lower than what we’re used to (like if you’re at 7.0 now, it will say 5.8 then, so all targets will have to be changed accordingly). Hallelujah! But before that, just know that if the DCCT said you need to be at 6.5%, that means you only have to hit 6.9% in Germany, as crazy as it may be.
About the new a1c calculation coming (seem to need to register to read the article, unfortunately. Probably many more articles to be found, though…) https://profreg.medscape.com/px/getlogin.do?urlCache=aHR0cDovL3d3dy5tZWRzY2FwZS5jb20vdmlld2FydGljbGUvNTYxODEzP3NyYz1tcA==
This is really interesting… thanks for posting!
It would be nice to have it universal. Most websites are US based and I don’t understand the US A1C as they are totally different then Canadian, which are mmol. It make it hard to understand what being said some times. I was searching the web for a comparison, when I came across this info. Thanks for the update
Am I off here ??..the blood glucose reading in the US mg/dl , different from the CAN mmol/l divide US by 18 to get the Canadian number …A1C results comparable
Thanks for your help Nel
– After I posted this I went to the internet and found a widget that converts them. It had the following message from " manny hernandez said… Jenny: I just installed the widget in the Diabetes Video Blog and in the TuDiabetes Blog that feeds our iTunes podcast. Thanks for contributing something so useful! 10:40 PM, June 24, 2008 "
Now all I have to do is find where it is on this site.
You got me Gail …you could e-mail one of the Administrators with your question .Would that work for you ?
Hi Gail!
Here is the link to a TuDiabetes application that you can use to convert blood sugar readings between mmol/L and mg/dl.
I don’t think that there is an A1c converter that you can add to your TuDiabetes page, but I will check that. There is one available on Jenny’s website, to view that click here.
Thanks Nel & Kristin - you’re both right – that link took me to the converter and I added it to my page. And my reading this morning was 10.6 mmol/l which when multiplied by 18 = 190.8 mg/dl exactly the same as the converter. I appreciate your help. It will make it easier for me to understand when people are talking American measurements. One day since I joined this site and I’ve already found out lots of information through blogs here and links to other sites.