that you are not the only patient in the practice, and that some demands may take longer than what you anticipated. Staff remember bad-tempered patients as well as patients remember bad-tempered staff.
MAKE THE MOST OF YOUR VISIT
Bring the following items to your appointment. Doing so can mean a more efficient and thorough visit for you and your health care providers.
If you leave the appointment feeling you need more time and assistance understanding diabetes care, ask to be referred to a diabetes education class. Use available resources such as diabetes-related magazines, books, cookbooks, websites, and local support groups. Call your local ADA office to find out about these and other hometown and national resources.
MORE RESOURCES TO EXPLORE
MAGAZINES, JOURNALS, AND OTHER PERIODICALS
Position statement: Standards of medical care in diabetes. American Diabetes Association. Diabetes Care 30:S4-41, 2007
BOOKS
Diabetes Type 2 and What to Do, 2nd edition, by Virginia Valentine, June Biermann, and Barbara Toohey. Lowell House; Los Angeles, CA. 1998.
YOU—The Smart Patient: An Insider’s Handbook for Getting the Best Treatment, by Michael F. Rozen and Mehmet C. Oz, with The Joint Commission. Free Press; New York, NY. 2006.
WEBSITES
American Diabetes Association……WWW.DIABETES.ORG
National Committee for Quality Assurance……WWW.NCQA.ORG
dlife Incorporated……WWW.DLIFE.COM
American Association of Clinical Endocrinologists……WWW.AACE.COM
American Medical Association……WWW.AMA-ASSN.ORG
U.S. Department of Health and Human Services……WWW.HEALTHFINDER.GOV
American Board of Medical Specialists……WWW.ABMS.ORG
2 How to interpret an A1C score
THE FACTS ARE IN
Since 1987, research has proven that blood glucose numbers are directly related to future diabetes complications. The landmark Diabetes Control and Complications Trial (DCCT) provided clear evidence that poor glucose control increases the risk of certain types of diabetes complications, including eye, kidney, and nerve damage in those with type 1 diabetes. Other studies followed individuals with type 2 diabetes and demonstrated that lowering average blood glucose could reduce similar complications. For both forms of diabetes, better blood glucose control over time means less chance of complications.
Blood glucose numbers change minute by minute. There are 1440 minutes in a day, so if you want a continuous snapshot of your blood glucose, you’re in for a lot of finger pricks (or a continuous glucose monitor, which we’ll discuss later). Fortunately, there is a test that will show you what your average blood glucose levels have been over a 3-month period of time. The Hemoglobin A1C (A1C) test is a blood test that measures what your average blood glucose has been for the last 90–120 days. Some other names you may hear or see for this type of test are “glycohe-moglobin,” “HbA1c,” or simply “your percentage.” The preferred reference is “A1C.” This number is an important figure in your diabetes control game plan. Single glucose checks are important, but they can sometimes be misleading. Nothing gives you a better understanding of your overall diabetes control than your A1C.
WHAT IS AN A1C TEST?
A1C is short for a type of hemoglobin, which is a protein found inside your red blood cells. Hemoglobin performs several essential functions, such as carrying oxygen to the cells in your body. It also carries glucose. An A1C check looks at the amount of this glucose to determine your average blood glucose.
To understand how this test works, imagine your arteries and veins as structures forming highways though which liquids and solids can travel. Now imagine that your blood is the traffic on these highways. Blood isn’t just a uniform liquid—it contains a variety of types of cells within its liquid mass, and red blood cells are one of the cell types present. As blood moves throughout your body, the glucose that is also present in the liquid highway will stick to the red blood cell. In other words, it binds, or “glyco-sylates” with the blood cell’s hemoglobin. The more glucose that is in the blood, the more glucose will be found sticking to the hemoglobin. Since the red blood cell lives about 90 days, an A1C test involves looking at mature red blood cells and seeing how much glucose is found sticking to them. The amount is measured in terms of a percentage. For example, an A1C result of 6% means that 6% of the hemoglobin tested has glucose stuck to it.
Keep
