High BGs and A1C

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High BGs and A1C


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Old 02-03-2020, 16:54   #1
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Default High BGs and A1C

Got a hemoglobin A1C question.

Here's the scenario first. Occasionally my BGs will go sky high. I usually know the cause. Sometimes it's because I have a head cold, sometimes it's something I have eaten that has more carbs and sugars than anticipated, sometimes I forget to take a shot or for whatever reason I didn't seem to get the full dose of insulin. Because I test frequently and always wake up at night if my BGs are high or low - my elevated BGs don't stay elevated for very long - at most 1 - 3 hours.

While A1Cs measure prolonged BG control here's the question.

Hitting let's say 360 - 450 mg/dl for about an hour or two - then getting it down again afterwards (this doesn't happen often). Anyone know how much of an impact hitting a high for a short duration will do to ones A1C?

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Old 02-03-2020, 21:22   #2
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Interesting question, so I did a bit of Web research. I didn't find much out there, except for the reminder that A1c tends to be weighted more toward recent history than the beginning of the three-month period that it measures. That alone would have a slight effect on an A1c measurement.

But it strikes me that a BG around 400 (just to hit the middle of the range you specified) and the "shoulder" time when it is above 100, both coming up and going down, are but a few hours in the scheme of three months.

Three months works out to be around 2,180 hours. Let's say the spike lasted 12 hours between onset (that always happens quickly!) and return to normal. (It might not even be that long for a T1 who tests, notices the reading, and injects some insulin.) 12/2180 is about 1/2 of 1%. While the hemoglobin that A1c counts exists long after the spike is down and is additive (that is, a second episode of a 400 BG reading within three months will add more hemoglobin to the existing count), it seems to me there would just be too little time "high" to be reflected in an A1c in any way that you could point to that instance.

Does that thinking seem reasonable?

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Old 02-04-2020, 14:06   #3
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Quote:
Originally Posted by itissteve View Post
Interesting question, so I did a bit of Web research. I didn't find much out there, except for the reminder that A1c tends to be weighted more toward recent history than the beginning of the three-month period that it measures. That alone would have a slight effect on an A1c measurement.

But it strikes me that a BG around 400 (just to hit the middle of the range you specified) and the "shoulder" time when it is above 100, both coming up and going down, are but a few hours in the scheme of three months.

Three months works out to be around 2,180 hours. Let's say the spike lasted 12 hours between onset (that always happens quickly!) and return to normal. (It might not even be that long for a T1 who tests, notices the reading, and injects some insulin.) 12/2180 is about 1/2 of 1%. While the hemoglobin that A1c counts exists long after the spike is down and is additive (that is, a second episode of a 400 BG reading within three months will add more hemoglobin to the existing count), it seems to me there would just be too little time "high" to be reflected in an A1c in any way that you could point to that instance.

Does that thinking seem reasonable?
It does - I'll be getting an A1C in a couple of weeks - so I hope the above thinking is correct. Thanks

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