Michelle Rupp: Hello and welcome into this week’s edition of AFMC TV. We’re so glad you joined us. We’ve got a big show planned ahead. We hope you enjoy. JJ Mayo joins us with J. M. Wellness. And JJ, we are talking about important health numbers that we need to know. And today we’re talking about A1C. What does A1C stand for, first of all?
JJ Mayo: Yeah, there’s a bunch of different names for that. Thanks for having me, Michelle. Yeah so sometimes it’s called hemoglobin A1C. You have HbA1C. You call it the A1C test. But basically, this test is a blood test and it’s the best test for diabetes. And what the reason is the best test for diabetes is that it really gives you a look at the average blood sugar that you have over 2-3 months. Whereas like when you go to the doctor when they do a finger stick to measure your glucose- That’s just a measurement in one point in time. And really this A1C test is going to be the best test because it really measures what your sugar, your average blood sugar is running over 2 to 3 months. And if you want to get into the weeds on it a little bit it’s basically the percentage of hemoglobin that’s coated with sugar. Right? Because hemoglobin is the molecule that carries our oxygen. It’s found on the red blood cell. And when you have excess sugar in your blood it coats the hemoglobin, and they can measure that. So, it’s a more complex test, but it really is the best test to determine diabetes.
MR: So, I would expect that then this test would also be a fasting test and maybe one that comes from your vein, not your finger.
JM: Yes, it could be. They now have devices that you can measure it for from a finger stick. But most of the time when you go to your doctor, they’ll do it through a blood draw. But here’s what I will tell you not a lot, and this is what your folks need to know- There’s a lot of doctors that still don’t measure an A1C test. And I’ve come across folks that they do just a blood sugar. Just a single test of their glucose and it comes back normal. But when you look at their A1C, their A1C is high. So, just know if your doctor is not measuring. Because sometimes they’ll measure it and they’ll just go, we didn’t measure an A1C on you because your glucose was fine. That doesn’t always mean that, you know, you should really have the A1C test done for sure.
MR: And how often should you have an A1C?
JM: Yeah. Usually, it’s every year. But if you had trouble in the past then you could probably go every three months, six months to monitor your progress. Especially if you have diabetes.
MR: So, what’s the magic number? What are you hoping comes back?
JM: So, because hemoglobin A1C, this test is a percentage, right? So, if it’s under 5.7%, you know, we just said what that means? That’s the amount that’s coated in sugar. 5.7% or less than that’s normal. Anywhere between 5.8 and like 6.4 is what we call prediabetes. And then anything at 6.5 or greater is considered diabetes. And you’re a diabetic at that point.
MR: How high could that number go?
JM: Oh gosh, okay. Yeah. So, I have some numbers because here’s the important thing to know. When you look at those percentages, there’s a translation between the percent. You know that hemoglobin A1C number and what your sugars are running. And I can’t remember those off the top of my head. But I’ve got them right here. Let me give you an example. If your hemoglobin A1C is 7, that means your blood sugar is running on average of about 154. 155 mg per deciliter which is really high. Right. If you’re going to do a single blood stick to measure glucose, we would consider diabetes anything over 126. But A1Cs, I’ve seen A1Cs in the 12s or 13s. And if you have a hemoglobin, A1C of 12, that means your average blood sugar is nearly 300. That’s scary. That’s life threatening.
MR: Yeah. That’s not good.
JM: No, not at all. And so that’s why you want it low.
MR: So, I know we’ve talked previously, especially if you find that you’re in that prediabetic range, not all hope is lost. Even if you’re diabetic, hope isn’t lost. But particularly if you’re dancing right around that border, you don’t have to fully crossover.
JM: No, not at all. I mean this is totally controllable through diet and through activity. And particularly diet because I always ask people, you know what caused the high blood sugar to begin with? Well, it’s eating carbohydrates. So, if you can control your carbohydrate levels and reduce those then that blood sugar will come down. And when people are first diagnosed, they get shocked. And so, and the doctor usually puts them on medicine and that’s fine to start out. But just I want people to understand that taking appeal does not fix this a dietary disease, which is what, you know, diabetes is.
MR: So, if someone is diagnosed and it, let’s say it comes out of left field, you know, they really weren’t expecting to hear those words. I could imagine that there might be some kind of shock you know there. What should be one of the first questions that they ask their doctor just right off the bat. Should they get counseling with a diabetic educator or something?
JM: Yes, I mean there are several action steps you know for people that are first diagnosed and it depends on how high it is. You know if it is a really high hemoglobin A1C the doctor will probably put them on medicine right away and that’s a good course of action but over time and at the same time, we should be able to get this under control and reduce that hemoglobin A1C through diet, in particular, but also exercise. And some of the lifestyle factors right. Losing weight is going to help improve that as well.
MR: How helpful or not is the internet in a case like this when you have do have your A1C number. Because that’s where you know we all go. We all go to Dr. Google.
JM: Yeah, Dr. Google is probably not the best choice. Not the first choice for people. I know it’s important to try to educate yourself but at the same time you need to find people that know what they’re doing in this area. And so, the internet is definitely not the first choice or a Facebook group, you know for people that have diabetes. It can get wild and crazy on some of these on some of these groups and pages.
MR: Yeah, it’s wonderful to know that there are support groups out there but for the immediate, it’s really get with your doctor.
JM: Yeah, you need to get a plan together right. It needs to be a plan. And the and the doctor will work with you, hopefully, on reducing the medicine. Getting off the medicine and then you know helping to do that through diet.
MR: Okay. All right. So, the most important thing is that we need to know what that A1C number is at least once a year? Yep. You can’t manage what you don’t measure.
MR: Yeah. All right. JJ, is there anything else we need to know?
JM: I think that’s it. Making sure your doctor does this at your annual physical even though your blood sugar, you know, the single finger stick may have been normal in the past. The A1C is really the best test to use.
MR: Alright, great information as always. Thank you so much.
JM: Thanks Michelle. Have a great day.
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