I had a question about the reliability of the home A1C kits, both in terms of official information and my own situation. I remember reading something like 97% but can't remember where I found that and it's not listed in the kit. It just says it's certified by the NGSP and the ADA. and that "all results may vary"
I did my first home test last December and got 5.7 which of course thrilled me. In the last couple months I've been struggling with a couple factors that I've just been getting under control. I was stalling on doing the test but my doctor is pressuring me so I just did. It was 5.7 again!! That seemed way lower than I expected and also a bit of a coincidence that it's the same exact number! So I checked my averages in my meter/remote and they are 125 for 30 days, 126 for 60 days and 126 for 90 days so really the 5.7 is only a tad lower than would be expected for those averages and I'm guessing that for better or worse the lows and highs averaged themselves out. I'm definitely getting less of both so I'm not concerned.
So do you think the A1C is more or less correct? I was expecting it to be higher. I'm waiting for my clinic to say that the home tests are no good and it can't still be 5.7! (They are not too knowledgeable - my doctor didn't know that the recent 30 days are 50% of the average (the last 30- 60 25% and the 60-90 25%! Should I be mean and bring the brochure that states that? LOL
Oh the joys of numbers and doctors - hopefully this is not the first bump in the road with my new doctor! (Him saying I need to get a lab test). Just in case, lab A1C's don't need to be fasting, right?
Yes, that is a bit unclear. Anyway, I delivered my A1C info to my doctor's office and hopefully won't hear any protests about it. If I do I'll research, print, and deluge him with data!
I did include a note saying that the A1c represented too many highs and too many lows which problem I've corrected. I also put "fyi" next to the info about percentage of the different timeframes distributed across the average. You gotta teach these doctors!
I run a medical laboratory and I did some paralell testing on A1c last year. Some of the kits have been improved likely since then,
There are several methods to doing the test in the lab but 2 are most common. 1. Latex method
2. Column method.
I tested 3 home kits and all 3 came within 10% of the LATEX method. So if the target was 5%, the kits gave me between 4.5 % and 5.5% .
It seems like a lot of variance, but the variance in methods is even higher, 12% between laboratory methods.
It does not matter what method you use, home or laboratory as long as you use the same test every time. If you go back and forth you could get a false sense of your A1c going up or down.
Bottom line he kits are accurate enough to use. I think they are expensive though.
You fasting blood sugars are not supposed to effect the a1c, but it does, in a big way. SO we should always try to aim for the same fasting number as close as we can get each time we get the test done, I aim for 100 mg/dl.
A1c is an average so there is no way to determine the range of results with this test. There are limitations to any test.
Red blood cells are glycated or glycosilated when produced. and they live for 3 months, That is how we get a 3 month average.
Red cells are produced mostly at night so your night time glucose effects the a1c much more than the daytime.
So you aren't saying that we should always have an A1C done in a fasting state, but that the day we do the test, we should have a consistent number?
I'm starting to accept (based on the averages in my meter) that my second 5.7 was accurate, but I don't feel as good as I did about the first one because I know this one was derived by averaging too many highs with too many lows.
Yes that is the limitation of the test. I say pick a number and go with it.
The higher your glucose is, the higher the a1c will reflect. It does not matter if you are fasting or not. It matters what the number is.
If you are at say 200mg/dl when you get the test drawn, the blood sits in that high state until it is tested, and for what ever reason it throws the test higher. The same happens when you are low, it lowers the A1c.
It is quite opposite from the info that the doctors give about preparing for the test, they usually say "It does not matter". It is my experience that it matters a lot.
I checked this myself a year ago. I tested normally at 100mg/dl and I got a 6.3% Then I ate and allowed my sugar to go to 220mg/dl and I tested again using the same laboratory method and my a1c came back at 7.0%
Then I took insulin and brought my sugar to 63mg.dl and tested again after 2 hours and it came 5.9%
There is a huge difference between 5.9% and 7.2 % but those tests were done just 4 hours apart.
We all know the reality of our sugars. Highs and lows. We should not put too much emphasis on this test or any specific test.
A1c was invented to give the doctors a heads up on diabetics who did not accurately report sugars, and for paitents who did not know weather they even had the disease.
Your log book and how you feel are much more important indicators.
Yikes, that's crazy! I didn't even think about my blood sugar before doing the A1C but checking my logs, I think it was around 80. That variation makes it even more amazing that I came out with the same exact 5.7 when the first one was from nice stable numbers and the second one an averaging of highs and lows!
Great thread. A little over a year ago, I got an 8.1 from a home A1c test, then a 7.8 from the Dr's office. Was told that home tests aren't accurate. It always seemed to me that BG at time of test affected A1C results.
Relion (walmart) home test kits are inexpensive-- about 9 dollars each. They are mailed in to Heritage labs and the results are emailed or mailed to you. I sent one in a week before getting mine tested at clinic--- The relion came in .4 higher, which is exactly where I would have expected it to given the rate that my a1c has been coming down if both tests were exactly accurate... therefore I think it was pretty accurate. Not exactly a scientific analysis but good enough for me. The relion test is somewhat difficult to use though as you are supposed to totally saturate two different test patches in one shot--which takes a fair amount of blood at once.
Ok, this is off topic, but then it's my topic so I have the right..lol
I just looked at the lab work I got back from the doctor for various things and it has "glucose - 133 - lab range 70-110" and he has it checked and marked high. Huh?
1. What value does one random blood sugar have for a Type 1 diabetic (or anyone already diagnosed? None! 2. My fasting before leaving the house to do labs was 85 and on returning pre-breakfast was 112 so where did they even get 133?
3. Uh...did I say I'm a type 1 diabetic? Ok, lab ranges are made for non-diabetics. How many of us have gotten a blood sugar or A1C and it says "at risk for diabetes"? But he actually checked it himself.
Ok, rant over
I did the Bayer home a1c test and it was a point lower than the doctors office. A friend of mine did the same home test and he too was a point lower than it was at the doctors office.
The fasting glucose tests are done even on diabetics just in case you are very high or very low and the test is cheap to do, so they always do it. It also explains why a person would have an A1c that is higher than expected and also why your trig might be higher than expected.
Pretty much If you are over 200 mg /dl Your A1c, Triglicerides and Hemaglobin are not reliable.
A good doc will have lipids and A1c redone if he or she sees it.
My lab has special ranges for conditions. That is if the doctor sends that info to the lab. Even so a 133 is abnormal weather or not you are diabetic, and should be flagged. The at risk comment could be eliminated, I agree.
There are also different ranges for lipids in men and women. It is a good idea to check to see your sex is marked, because if it is not the ranges default to the ranges for men most of the time.
I have a Type 1 friend named Mico and she is marked as Male all the time, just going by her name I expect. Ranges for Blood counts are more of a issue, as they are quite a bit different for men and women, ( that monthly bloodletting somehow effects women that way :)
AND wow $9 for A1c test?? I just looked at the pharmacy and it was $27.
Thanks for your input, Timothy. The fasting didn't have a "at risk" just a check and marked "high". I don't think my doctor has many type 1 patients if he thinks we can stay between 70 and 110 all the time! But I guess he is a good doctor (he's new to me) since he did ask for an A1c.
Yes, I think they're $29 at CVS but that's for two tests. I assume the $9 is only one, but still it's cheaper. I'm still happy not to have a Walmart near me!
