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June 15, 2008

A1c (Glycohemoglobin, HgbA1c), Diagnosis and Symptoms

Question from Peebles, Ohio, USA:

My doctor diagnosed me with type 2 in March 2008. She made the diagnosis on the result of my A1c test, which was 6.5. I have kept track of my blood sugar levels and they have been very normal, no matter what I have been eating. I requested an OGTT to confirm my belief that I am not diabetic. My test was normal, with a one hour reading of 166 mg/dl [9.2 mmol/L] and a two hour reading of 131 mg/dl [7.3 mmol/L]. I thought this would satisfy me, but now I'm confused. I would like to know more before I go to my doctor. Am I diabetic or not?

Answer:

The hemoglobin A1c is not used to make the diagnosis of diabetes. As much as doctors would like this test to do the trick, it has been shown time and time again not to be specific for the diagnosis of diabetes. You have had the gold standard. You do not have to have additional testing. Intermittently, you should have a fasting glucose to see if this state progresses. I would also suggest you maximize a healthy lifestyle. To date, you do not have diabetes. Do not let your physician put this on your records as it may cost you additional fees in insurance premiums.

JTL