What does the A1 c mean?
Definition : 3 month average of sugar, i.e. it totals up all the blood sugars over a 3 month period and gives and average value. Little more complex than that it is a blood test that piggy back off the “metabolism” so to speak of the red blood cell.
The more well controlled the A1c the more the post prandial is contributing. The higher the A1c in other words more out of control the more the fasting is contributing.
There is a big difference between fasting sugars and post-prandial (after a meal) sugars and how they affect things. Also think about this if you consistently go very low and very high you may well have a beautiful A1c and think you are great when actually you are not!
Glycemic variability is a BIG problem.
I would far rather my patients ran an a1c slightly higher with less variability.
So is it worth doing? I honestly feel that the A1c gives us some information, however for myself I feel the download is far more useful in type 1 diabetics and that I am able to tweak therapy far more accurately with a download or a CGMS.
For type 2’s it is a good test to follow, i.e. a trend. Is it going up or is it coming down or is it stable so to speak.
What is A1c – it’s an average and it has its uses but context is everything and for type 1’s glycemic variability is the difference between health and illness.