Comments on: Goodbye A1c, Hello ABG?

By: Eric Jensen

Eric Jensen — Thu, 05 Jul 2007 21:22:05 +0000

It seems to me that one interesting thing about all of this discussion about A1c is that everyone agrees that it can be deceptive, since it averages over highs and lows. Before we had an alternative, it was the best we could do. But now that CGMS exists, what we really need is some sort of statistic that takes into account the actual daily variations of blood glucose, and time spent high and low. It’s not a simple blood test, but as CGMS improves (and becomes widespread once it starts to be reimbursed), then it *will* be a simple download/calculation. The interesting clinical challenge will then be what sort of statistic actually correlates well with patient outcomes. Mean blood glucose is a simple one, but probably not the best one, I’d guess.

By: Frank Varon DDS

Frank Varon DDS — Thu, 05 Jul 2007 18:08:29 +0000

Now, I was at that particular ADA session and NO FINAL decision has been made until after the EASD meeting in September as to how and when these changes are to take place. There will be changes but the ADA and the EASD and IFCC have been going at it since this issue was first brought up by the IFCC (lab gods) in 2002. YES, 2002! One MD during the Q&A portion vented his frustration at the quibbling over the delays in confronting the clinical chemistry standardization issue. He was applauded by a large portion of the audience. But I can see both points of view (ADA and EASD) and they are both valid. There will be changes but lets wait until September to see how this is planned on being rolled out.

By: Elizabeth Henry

Elizabeth Henry — Thu, 05 Jul 2007 16:48:05 +0000

Some good news for diabetics: Chocolate has been studied for a variety of health benefits. An article written in April discussed a study on the beneficial effects of chocolate on diabetics. The study, conducted on obese diabetic mice, reported lower blood glucose and fructosamine levels in mice that were given supplements containing cacao liquor proanthocyanidins (CLPr). Researchers suggest that these supplements may prevent hyperglycemia as well as a diet full of cacao derived foods may offset type 2 diabetes mellitus. More clinical evidence based information is needed in this area.

Elizabeth Henry
Natural Standard Research Collaboration
http://www.naturalstandard.com

By: AmyT

AmyT — Tue, 03 Jul 2007 08:11:40 +0000

LOL, Khurt – most of the world uses the metric system, too, but somehow we haven’t managed to get on board.

By: Khurt Williams

Khurt Williams — Mon, 02 Jul 2007 19:04:55 +0000

It would seem that it’s the same old test with new terminiology.

Amy, what is so confusing about SI units? Your car engine displacement is measured in litres as is your diet soda and your food intake (grams of carb, protein etc) and medication (mg/dL). The entrire world, except the USA, has used it for years.

By: EmilyS

EmilyS — Mon, 02 Jul 2007 17:29:59 +0000

From what I read on the Scientific sessions blog, I thought that they were just going to start reporting A1c's in terms of mg/dL or mmol/L, and that the test itself had not changed. http://adascisessions.typepad.com/weblog/2007/06/an-old-test-wit.html I think the actual abbreviation would be ADAG, "A1c Derived Average Glucose".

By: Michael Park

Michael Park — Mon, 02 Jul 2007 17:09:40 +0000

AHH, this is scary.
HA1c numbers have always been ‘similar’ to MMOL – in as much as having one decimal point. However, the NON-Correlation between the two has always been stressed. It is possible to go back and forth from Hyperglycemia to Hypoglycemia and still have a great A1c.
From reading the available articles on the internet, it appears they merely want to do the work of a conversion chart.
A few points:
1) does it scare anyone else that they are doing the scientific work to calibrate this new nomenclature using CGM technology which is currently unsafe to use without howmany daily calibrations?!?
2)Are people really wanting to directly correlate the fact that an A1c of 7% is rougly equivalent to walking around with an average blood sugar of ca. 155mg/l? Or will that cause people to feel more guilty.

Mostly, I’m disappointed – reading the headline, I thought they had developed a NEW TEST, but no, they just want to paint the same test in a new light… a less truthful light.
Fundamentally, diabetes management shouldn’t be about making sure EVERY sugar check is perfect, it’s about lowering the overall effect that the disease has on your body – precisely what the A1c tests. By painting the lab work as an ‘average’, it puts the emphasis back onto the small scope- which I propose will have negative psychological ramifications.

By: Christine

Christine — Mon, 02 Jul 2007 17:04:46 +0000

ABG in the medical world means “Arterial Blood Gas” so I’m guessing if it becomes a common lab they will need to name it something else.

By: Challenge Diabetes

Challenge Diabetes — Mon, 02 Jul 2007 15:11:54 +0000

A1c vs. MBG – Not the Real Problem

I was at ADA recently and there was a heightened presence of A1c testing as a tool in the diabetes kit this year. Everyone assumes that a measurement of A1c = a measurement of historical glucose which is not entirely correct. Further, hemoglobin ma…

By: Kevin

Kevin — Mon, 02 Jul 2007 15:01:25 +0000

Lottadata is right on about the misinformation due to hemoglobin variants and that’s because everyone assumes that a measurement of A1c = a measurement of historical glucose which is not entirely correct. It’s only a measure of the glucose left over within a small fraction of your hemoglobin A and then only within the 1c and not 1d, etc… assuming that everyone has the same hemoglobin signature…which is entirely not true.

Further, hemoglobin makeup has the potential to change every few years so it’s not even measurable on the same scale within the same person unless you get your A1c on a frequent basis.

There’s more on this at challengediabetes.com where we discuss the relationship between accurate and strategically timed A1c checks as well as behavioral psychology.