I was diagnosed in November 2004 with a fasting blood sugar of 9.2 mmol/L [166 mg/dl]. Through diet and exercise, I have reduced this substantially and my glucometer is now recording a 14 day average of 5.9 mmol/L [106 mg/dl]. I did not get an A1c at the beginning. In January 2005, my A1c was 6.1, then, in April 2005, it was 6.4, while, in July 2005, it was 6.1. I will be tested again soon. I have substantially reduced my carbohydrate intake to about 50 g a day and had hoped to get my readings in the 5s mmol/L [90 to 110 mg/dl]. I’m reasonably active on our farm and I play golf three times a week, walking the 18-hole course.

How accurate are the tests? I have heard there is variance and that several procedures are used by various laboratories.

It is true that there is some variation with the laboratory tests. This is dependent upon the laboratory performing the test and what methodology is used. There is also the issue that a good common standard has not been available to standardize results across laboratories. The variability can be decreased by using the same laboratory. In addition, each laboratory is supposed to establish their own normal range. You might do some investigating with your laboratory through the laboratory directly or through your physician about these issues. However, you seem to be doing well over time. If you have used the same laboratory, you have clearly made a difference since November 2004. However, after everything has been said, the A1c is still the best way to get an integrated blood sugar level from the previous three months. These levels have also been studied and correlated very closely with the development of outcomes, such as complications.

JTL