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July 16, 2005

A1c (Glycohemoglobin, HgbA1c), Diagnosis and Symptoms

Question from England:

I was diagnosed type 1 with GAD antibodies during pregnancy two years ago. Prior to this, in retrospect, I obviously had some insulin irregularities. If I skipped breakfast, for example, I would be fine until lunch but, if I ate breakfast, I would feel low in the middle of the morning. My brother and sister also have similar symptoms. In addition, I have checked their blood sugars with my meter and both often show post meal sugars above normal, although this quickly comes down. My brother, in particular, has had readings of 10.0 to 12.00 mmol/l 180 to 216 mg/dl]. I persuaded him to raise this with his doctor who did a urine check of some sort and told him not to worry. Should he be asking for an A1c to be done or would I be nagging him for no reason?

Answer:

Urine testing and hemoglobin A1c are not recommended for diagnosing diabetes. I would recommend he have his status checked with a fasting glucose level from a peripheral blood sample and have the test run in a clinical laboratory. The post-meal sugars you quote are high. He has the family history.

JTL