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A1c Blood Test Is Unreliable for Diabetes Screening

The A1c test a useful blood test that indicates the average of blood glucose levels during the preceding 80 to 100 days. It measures the percentage of a blood protein that becomes “sticky” due to sugar attached to it. The test value rises with the rising levels of blood sugar (glucose).

In healthy people, 5 to 5.5 percent of hemoglobin is sticky with sugar (glycated hemoglobin is the scientific term for it). A value of 6.5* or higher on more than two occasions is accepted as a valid criterion for diabetic diagnosis. The red blood cells have a life span of about 120 days and that explains the value of the A1c test in assessing blood glucose levsls over a period of 80-100 days.

The Value and Pitfalls of A1c Test

In general, the A1c test is useful for monitoring the success of diabetes treatment A value of 5.6% or less is considered optimal. The American Diabetes Association (ADA) recommends that every diabetic should have an A1C test done a minimum of twice a year, with more frequent testing for those with poor control or changes in treatment. I use this test more often.

It is a mistake to rely on the A1c test to exclude the diagnosis of diabetes in the initial screening. There are simply far too many errors made in such testing. I illustrate my point:

Case One – Diabetes With Normal A1c Level

Majid Ali, M.D.

A1c blood tests is used for screening for diabetes. In my view this test is far too unreliable to be used for this purpose. In this A1c Test Series, I present case studies to support my position.

Glucose in the blood sticks to A1c protein contained in red blood cells. It is called hemoglobin and carries oxygen. Proteins attached to sugars are called glycoproteins, which that makes A1c a glycoprotein. A1c is known by several names, including glycated hemoglobin, hemoglobin A1c, HbA1c, A1C, and Hb1c.

The American Diabetes Association (ADA) advises that diabetes be diagnosed when the A1c test value is 6.5% or higher of total hemoglobin (48 mmol/l or more). This position is not supported by any reliable data.

Case Study

A 54 yr-old 5′ 11″ man weighing 265 lbs.  consulted me for for hypertension (BP (185/120), shortness of breathing on walking, allergy, liver enlargement (with liver cell death [Steatosis]) and enlarged prostate. The presence of diabetes was ruled out by his doctor on the basis of a A1c test which was considered “within normal limits). The Table below presenrs his insulin and glucose profiles clearly establishing the diagnosis of diabetes Type 2. After eight weeks of integrative management his A1c test value of 5.1%.

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Insulin and Glucose Profiles of a 54 yr-old 5′ 11″ Man weighing 265 lbs. With An A1c Value Considered Normal and Previously Undiagnosed Diabetes.
2.2.2013	Fasting	½ Hr	1 hr	2 Hr	3 Hr
Insulin	24.3	52.1	69.1	119	38.4
Glucose	106	165	193	205	80
April 4, 2013 Post Dr. Ali’s Breakfast
Insulin	6.9	14.9
Glucose	70	146
August 30, 2013 Weight constant at 196
Insulin	2.96	31.2	20	14.8
Glucose	70	146	148	138

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Dr. Ali explains more.

Prediabetes Diagnosis Majid Ali MD

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Diabetes Diagnosis – the ADA Shame Majid Ali MD

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Reversing Diabetes Part of the Way Majid Ali MD

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A1c Blood Test Is Unreliable for Diabetes Screening

Case Two: Positive A1c Test Without Diabetes

A1c blood tests is used for screening for diabetes. In my view this test is far too unreliable to be used for this purpose. In this A1c Test Series, I present case studies to support my position.

A1c test is used for diagnosis of diabetes. I think this practice should be discontinued. Why? Because this test Is unreliable for this purpose. Two case studies presented below illustrate my point. In both cases, the A1c test results would have been gravely misleading had I not done insulin profiling tests.

Insulin and Glucose Profiles of a 64- yr-old 5’9″ Woman Weighing 158 lbs. Who Presented With Kidney Colic, Allergy, Chronic Sinusitis, Adrenal Nodule, and A Positive A1c Test Without Diabetes.
4.29.2014	Fasting	1/2 Hr	1 Hr	2 Hr	3 Hr
Insulin	Not done	150	125	133	102
Glucose	95	134	93	96	113
A1c, 6.4%;, Testosterone, 118 ng/mL and 120

Please consider other articles in this series for additional information.

Should blood sugar tests for diabetes be banned? Radio show

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