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This article talks about the use of A1C blood tests to predict potential for diabetes and hear disease.  According to the article, this had not previously been considered a good tool for this but the study referenced is changing that.  I think it may be worth checking with your doctor to monitor this if you are prediabetic or have other reasons to be concerned about developing diabetes or heart disease, such as having sleep apnea, family history, etc. 

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I have a borderline A1C result -- i believe it was 5.6. but my fasting blood glucose levels are consistently elevated: 101-117. should I get the glucose tolerance test? yes, right?
I think yes, but make sure your PCP is aware of the new evidence supporting the use of the A1C in diagnosis as well as monitoring. I think that rechecking with A1C tests over months and years can help you know your status and help in making choices about the steps you are taking to get better numbers and know if what you are doing is working, or more changes are needed. Maybe it is also good for making your own goals, as long as you don't get over stressed worrying about it in too much detail. It is another way to view the meaning of the results than was previously accepted in the medical world. I don't think they were doing A1C tests on people before they were diagnosed as Diabetic with the fasting blood glucose test.

As the article states: "Those with an A1C of less than 5 percent had a 48 percent reduced risk of diabetes, while people whose A1Cs were between 5 and 5.5 percent had a normal risk of diabetes. From there, however, the risk quickly went up. Those with an A1C of 5.5 to 6 percent had an 86 percent increased risk of diabetes. For those between 6 and 6.5 percent, the risk more than quadrupled. For people with levels above 6.5 percent, the odds of being diagnosed were more than 16 times higher than for someone with levels under 5.5 percent. These results were similar to those for fasting glucose levels, the study authors noted."

So the A1C result you had, Mike, would suggest you are at an elevated risk range for Diabetes, supported by your elevated fasting blood glucose which represents the shorter time of the overnight bodily reaction. I, of course, am not a medical professional, and you should discuss this with your PCP, but it sounds to me like your numbers, while a bit of a red flag, can be improved much easier now, possibly preventing serious complications in the future, if you can make some lifestyle changes now. It would definitely be worth keeping an eye on both the tests results over the next few years. My understanding is that lifestyle changes like this are best handled gradually, so as to make them permanent, and not go crazy doing too much at once, out of fear or panic. Knowing where you are with this is an opportunity to make a difference and prevent big problems down the road. Figure out what is reasonable for you to work on right now, in moderation, and add more changes as you learn more and see what helps get your numbers a little lower or at least keeps them from increasing. Even if things get out of range, you can use that info to adjust and make different choices. New habits are always harder at first. Think long term, know your tools and how to use them. Learn ways to manage and reduce stress. If this sounds familiar, I think it is like getting used to CPAP therapy in some ways, so you have some experience to draw on. Your daughter is really going to know how to live healthy, growing up with you as an example!

I'm going to reread this to myself to remember what I need to do too!


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