A1C issues

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Permalink Reply by Kelly Rawlings on November 3, 2009 at 2:58pm

To put your one-time number into perspective, the intensive control group type 1s in DCCT had an average A1C 0f 7.08 and they were the ones who avoided complications!

Just don't go and buy a bunch of at-home A1C kits and drive yourself crazy with the plethora of results you'll get!

For story purposes, I tested 4 kits within 48 hours of my result from endo. My endo uses an instant read device rather than a lab test, so I'm a bit skeptical!
Endo: 6.7
ReliOn mail-away kit: 6.7
Appraise mail-away kit: 6.6 (ReliOn and Appraise test sheets get mailed to same lab)
A1C at Home mail-away kit: 7.6
Bayer A1CNow device with results right away (2 tests in one kit): 7.6, 7.4

Yikes!! Contacted the companies and was basically told not to compare results from one lab with results from another. But I thought that's why labs followed SOPs, etc., to ensure consistent results?!

And, meter averages only go so far. I've had the same 2-month averages and widely different A1C results (probably because I didn't check the same number of times/times of days in the two periods).

So, in short, your result is just a temporary blip. Sorry that all your efforts didn't get the gold star this time, but we know they usually do :-)

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Permalink Reply by sweetpotater on November 3, 2009 at 10:38pm

Wow, 6.7 to 7.6?! That's a pretty big range. I've used the ReliOn mail-away kit for my last 3 tests, ever since my insurance stopped paying for ... well, basically anything. I know the result is "just a number," but still – aside from testing my FBG every morning it's basically the only tool I have to help me evaluate how I'm doing with my treatment. So I do take it kind of seriously.

All this makes me think maybe I ought to just bite the bullet and pay out of pocket for the hospital lab's $150 A1C test, plus the $90 doctor visit that's required to get the result, since they won't tell me directly, even though I'm paying for everything myself! What a racket. But, I guess it's still cheaper than the complications I'm hoping to avoid.

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Permalink Reply by Kelly Rawlings on November 4, 2009 at 6:34am

After my one-person science experiment with the kits, I'm not convinced the at-home A1C kits provide the kind of data that can be helpful in making self-management decisions. At first I was pleased people had other options to assess level of control, but knew that most health professionals poo-poo the at-home kits.

I still use my meter to guide my decisions. But I can tell you, I'd be putting in a lot more effort to get to the root of the issues if I was certain I had a 7.6 vs. a 6.7! Based on my meter average, I'm sticking with my 6.7, but meter averages can be misleading, depending on how often and when a person tests.

I was very careful to follow all package directions exactly, wash and dry my hands on clean paper towels, etc., keep the test sheet with the dried blood drops under the same temperature conditions before mailing them, etc.

Yes, $240 is a lot cheaper than complications! And FBG tests don't show how your glucose responds to your meals, so if you have out-of-range spikes there, could equal a higher A1C. I'm hoping you avoid complications, too. Best wishes!

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Permalink Reply by Anthony Holko on November 4, 2009 at 11:40am

The 5 second meters are also super inaccurate so we are out on a thin branch. I would not trust any readings from home A1c test kits based on Kelly's results. I use a 15 second ascentia that still works for the moment with the contour strips but when it dies I don't know what I will do since the 5 second contour meters are also very inaccurate as all 5 second meters. Maybe some marketing department will discover accuracy and re-introduce the super accurate 60 second meters of 10 years ago or a new FDA with balls will impose accuracy standards that will be better than plus or minus 20%.

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Permalink Reply by Jan on November 4, 2009 at 11:35am

Yes, you did have an increase, but you are still under 7, and you are on top of things now. How have your three day averages been on your meter? That is how I figure DN's is going up (before cgms). I like the A1cs 6.4 and under also, and do everything to keep her in this range, but sometimes they can creep up. Now that you are aware of it, I'm sure you can get the next one down. There are a lot of people who would be very happy with 6.8. No, I am not one of them.

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Permalink Reply by Michelle Hughes on November 4, 2009 at 7:27pm

Anything below a 7.o is great! Don't worry about it. Still do what your doing. It sounds like your a good controlled diabetic.

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