The Hemoglobin A1c (HbA1c) Test for Diabetes

Reference:
http://www.webmd.com/diabetes/guide/glycated-hemoglobin-test-hba1c

Just wanted to get some opinions on your personal side about this.
I'm 49, and although in my family there are a couple people with diabetes neither my dad or mom had diabetes.

I've been religiously getting a blood work and physical exam for over the last 16 years, everything in the blood work has GREAT results, however the A1C has been showing steady at the lower bracket 5.7% for "increased risk of diabetes" for the last 2 years. Including results in January and now in August this year, at 5.7%

I am not and never been overweight and my diet is diverse and I think that I know the Hemoglobin A1C test should be below this level, so I am attributing the number to wine consumption. If my thinking is correct, well then this is really bad news because wine making is one of my favorite hobbies, not only to give away but also to enjoy a glass (or two?) every night with a meal.

If anyone out there follows carefully your blood results yearly, and you also drink wine, I'd like to know some feedback.

The dietitian at work can work with me to manage my diet but in my heart, again, I really think that it comes down to wine consumption.

I've been getting blood work being on some mild hypertension drugs. Recently they have changed the fasting blood sugar recommendation from below 120 to 100. I usually come in around 99-106, so we tested my A1C. I was 5.6 and my doctor said "no worries", and that we'd start thinking about doing something about it when it reached 6.0. The main things he said to do, 1) exercise regularly (I hurt my knee in February so I stopped walking regularly) 2) if you must drink alcohol, switch from beer to red wine, in moderation (I forgot the definition of moderation, too technical for me) 3) don't eat late in the evening before bed, ie. no snacks before calling it a night.

If you normally eat carb packed deserts or bags of chips at a time, or if your favorite thing to do is sit down with a warm loaf of homemade bread and a stick of butter, stop it, or at least cut down the frequency of it.

We cook very diverse meals since we have two type oners, so we need to keep the fat down (beef only once a week, lots of chicken and always veges). Realize that heredity can have something to do with developing type II diabetes.

My first question to your wine issue is what are you drinking? Is it sweet wine? If so, then yes, that could be an issue, especially 1 - 2 glasses per night.
If you are drinking dry red, then I wouldn't think that should be the culprit as the sugar has been removed. At a minimum, with the dry red, I would cut down the nightly intake to maybe 2-3 nights.

The highest calorie wines tend have the highest alcohol content. Alcohol has 7 calories per gram versus carbohydrates (sugar) which have 4 calories per gram.

This means some sweet wines can have less calories than some dry wines!

wineforfun said:

If you are drinking dry red, then I wouldn't think that should be the culprit as the sugar has been removed.

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That's right Mike.

I was drinking mostly dry reds and been drinking whites, off-dry.
I've been very healthy, I'm only 5'8" and weigh in at 162

We have a gym at work (oh yeah) and I exercise 4 times a week, close to an hour weights and about 20 minutes cardio, so I'm in good shape as my doctor puts it.

The 'fasting blood sugar level' came up to less than 100, like 95, so that is good but it only represents sugar level for a short period of time and may be affected by what you ate the day before.

The A1C on the other hand is the important variable as it measures it for the last ~3 months in average..

So, guess I want to bring it below 5.7 and maybe 'sacrifice' and not drink wine for a couple months to make sure that is really the culprit.

ibglowin said:

The highest calorie wines tend have the highest alcohol content. Alcohol has 7 calories per gram versus carbohydrates (sugar) which have 4 calories per gram.

This means some sweet wines can have less calories than some dry wines!

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I understand that. I am talking about carbs(sugar) not calories. I don't believe calories are as much his concern as the sugar intake.

I'm an active, healthy 30-something, and my hemoglobin A1C came in at 5.7 this year also. It was after a very stressful couple months and a cruise, so that's what I chocked it up to. The test wasn't included in previous panels, so I don't have anything to compare the value to.

I did a little research and found a few articles that said the test isn't necessarily a good indicator of diabetes because a healthy person's cells will live longer and collect more sugar over time, whereas a diabetic person's cells may die off sooner before retaining a concerning level of sugar, given false positives and negatives. (Note: this is my laymen's understanding, so forgive the incorrect terminology.)

Still, the results were the jump start I needed to get back on track. I've swapped my afternoon carby snack for nuts and stuck with the fruit and cheese platter lunch instead of yogurt parfaits. I struggle with eating dinner so close to bedtime because of life, but I do what I can. I won't be able to tell you if the changes have made a difference until next year, but I'm enjoying my glass of wine too, so I'm trying to find compromises elsewhere.

The key to a healthy HBA1c reading is exercise. Mine was at 6.3 and I have been walking 3-5 miles per day (mostly) and it is now 6.0. If I could manage to lose 20 pounds or so, I think I could get it to the mid 5's.

Also, before all you "young'uns" gasp at my numbers, let me point out that I am 74 years old and "gravitationally enriched" (i.e. 5'6" and 220 pounds of "muscle"). I am not really overweight, I am "under tall". I would have achieved my "ideal weight" if I were 6'4".

Rocky said:

The key to a healthy HBA1c reading is exercise. Mine was at 6.3 and I have been walking 3-5 miles per day (mostly) and it is now 6.0. If I could manage to lose 20 pounds or so, I think I could get it to the mid 5's.

Also, before all you "young'uns" gasp at my numbers, let me point out that I am 74 years old and "gravitationally enriched" (i.e. 5'6" and 220 pounds of "muscle"). I am not really overweight, I am "under tall". I would have achieved my "ideal weight" if I were 6'4".

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In this day and age of parsing words, terminology is in the spotlight. Rocky,,, there's lots of us out here saying "here-here"

Rocky said:

I am not really overweight, I am "under tall".

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Rocky, thank you! I'm planning to use that quote on my Doctor this October. I plan on saying, "a very wise 74 year old told once told me that it's not that we are overweight, but under tall".

ceeaton said:

Rocky, thank you! I'm planning to use that quote on my Doctor this October. I plan on saying, "a very wise 74 year old told once told me that it's not that we are overweight, but under tall".

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To quote 'Cheers':

"Whatcha up to, Norm?"
"My ideal weight if I were eleven feet tall."

Guys and Gals, I am blessed to have one of the best doctors in the Columbus area. I love the guy but he has ZERO sense of humor. Well, at least he used to have none but after having me as a patient for 16 years, he is coming around. I remember when I first went to see him and he was shocked by my weight. I was one of those guys who "carried it well" and I could regularly defeat the carney weight guessers who say they can guess your weight within 3 or 4 pounds. Doc looked at what his nurse had written and said, "Is this really your weight?" I think it was 212 at the time. He showed me a chart that said I should weigh, at most, 159. The truth of it is, I don't remember weighing 159 because I never got on a scale until Freshman Football and I weighed 165. Anyway, I looked at the chart and said, "No Doc, here is my weight. I should be 6 foot 4 inches tall." Did I mention he had no sense of humor? He said, "No, no, that is not how you read this chart."

"Dah, REALLY Doc?"

With his help, I feel better now than I did 15 years ago. He is so dedicated that I want to get my blood glucose and weight down for HIM!

a1c

Rocky then your about my exact height and former weight,I'm 5/6 and 192,I was 225 almost 230,lost the wait yet sugar goes up and down,gemo tested at the University of Penn nothing in my background for the big D..lost the weight still have it.A while back they actually lowered the test standards for (D) this put more of us on the list. The study also found that the body tring to heal itself produces more white blood cells and that thoughts everything else out of wack,like chronic arthritis.etc:just my thoughts.

I'm a physician and deal with this on a daily basis. The effect of alcohol on blood sugar is complex. Alcohol can actually have the direct effect of lowering blood sugar because it stimulates insulin secretion. On the other hand alcohol disinhibits people and results in increase in oral intake which obviously will increase blood sugar.

An A1c of 5.7% might be outside of the normal range but it is not consistent with diabetes, not even close. 6.5% is diabetes. The current recommendations for alcohol intake are 1/day and 7/week for women, 2/day and 14/week for men.

Remember that moderate alcohol intake is associated with reduction in risk of heart disease, stroke, and possibly diabetes.

Boy, Joe, would I love to get to 192. That was my playing weight in high school. I know how to lose the weight, I am just weak, especially at night. I probably consume as many calories after dinner as I do up to and through dinner. In the past 10 years I have been as high as 240 and as low as 209. I am still very active for my age, walking, working in the yard, making wine, occasional trips to the gym, etc. I just need to focus on the goal. "What gets measured, gets done!" we used to say.

Stressbaby said:

I'm a physician and deal with this on a daily basis. The effect of alcohol on blood sugar is complex. Alcohol can actually have the direct effect of lowering blood sugar because it stimulates insulin secretion. On the other hand alcohol disinhibits people and results in increase in oral intake which obviously will increase blood sugar.

An A1c of 5.7% might be outside of the normal range but it is not consistent with diabetes, not even close. 6.5% is diabetes. The current recommendations for alcohol intake are 1/day and 7/week for women, 2/day and 14/week for men.

Remember that moderate alcohol intake is associated with reduction in risk of heart disease, stroke, and possibly diabetes.

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There you go, Doc, that word "moderation" again! And therein lies my problem. For example, yesterday, I worked in the yard for about 4 straight hours (getting ready to sell the place) and then I came in and cleaned up. We were meeting our realtor and I guess the meeting went so well that after he left, I felt like a rye. Well, I ended up drinking two ryes, one the rocks, filling an old-fashion glass. That totaled about 8 oz. of liquor or about 500 calories. Of course, I could not just drink the liquor by itself so I had some crackers and cheese with it. Boom, probably 750-800 calories in about 45 minutes. I have to stop this behavior.

Rocky said:

I have to stop this behavior.

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Well Rocky, you are further along than most.........admitting and recognizing is the first step.

Due to my weightlifting and competing, I eat very strict. For me, I eat for a purpose, not pleasure. But I am amazed at the number of people I work with and know, that let food dictate them.
I guess for me, I am wired differently. I will have coworkers say "you're no fun, you won't eat any chips and dip". Of course I reply with "eating crap food doesn't equate to fun for me, as then I feel like crap".

Choices, it's all about choices.

I was diagnosed 8 years ago with type 2, they said that I had , had diabetes for at least 6 years before I went to the doctor, cancer runs both sides of my family so when stuff went down hill I just kept my mouth shut, I then had a grandma seizure, I was over 700 and had to be resuscitated 3 times on the way to the hospital, now after eating and exercise I am finally at 8.2, the damage done before I was hospitalized was an is quite extreme , I have 6 doctors besides my family doc, now mind you till the seizure , it had been at least 35 years since I'd seen a doctor, so long that when I ask for the last doc I had seen he had been dead for 10 years, my point is them six doctors plus my new and alive family doctor which makes 7 all recommended I drink a glass of red wine at night, so I researched it, for my heart -triple bypass, 5 major heart attacks, high blood pressure, otiose arthritis, diabetes, so far I've been resuscitated 14 times so far, all reds are not equal, elderberry is by far the best for all them things I only researched my illnesses, those above and a few more, but blackberry is good and the rest reds do work, but none come close to elderberries, I do semi-sweet, I back sweeten with clover honey, honey is also good for diabetes, now not one doctor said how big a glass so mine holds 18 ounces,, I've also had right leg amputated below the knee, left foot front half amputated, from the base of my skull down about 6 inches grinded down to my spinal cord about 5/15 wide to drain infection, that one had me in hospital 11 months straight, after all that each and every one of them doctors recommended red wine 1 glass at night , some said i could have 2 glasses one around noon the other at bedtime , for me the low 8's is progress, they say if i can make 7 that will be perfect for me, i can add a much longer list on illnesses and surgery's but you get the point, red wines 1 to 2 glasses a day is good for me, more or less for every thing i got, , today i tore down 1/8 mile of old fence and fixing to replace for a 4 acre bull pen, hard work, exercise any thing to get your blood pumping and gets you breathing hard, and wine them 3 things help greatly, as for weight, when diagnosed, i am 6-1 and weighed then 211, after the insulin, I went up to 256, doctors say i'm about the only one that it makes gain weight,,, my 2-cent worth says stick to healthy eating, no late eating, exercise or hard labor and red wine, because i can guarantee you, you do not want to end up like me, oh and by the way after so many surgery's and resuscitations, both have a tube run down your throat while on life support, that my trachea has so much scar tissue that it is closed off so i have a tracheostomy tube on my throat for life, not you or any one else would want this, but i am very happy and thank full for every day i see, i pick up brush, cut trees, pile rocks, build fences, just slower then before, if sharing my plight helps even one person then i am a very blessed man. i hope the best for you
Dawg
PS i was taking u-500 a very concentrated fast acting insulin i did 460 unit minimum know i doe 64 units of Lantus, yet again progress , eat right, get blood pumping and see your doc at least once ever year, that I'm a tuff guy crap will kill you, just look at me, but once again i need no sympathize, I am active, i work around my place , i have Dexter cattle, geese, chickens, hawgs, horses, dogs, my fruits, my berries and my garden, i am content and happy, but be smarter then me, stay healthy.
keep your power dry an your head down,,,,,,

My weight has been a perpetual battle since my thyroid died about 20 years ago.I work out "almost" regular but the weight goes like a yoyo.
I have to admit that if I drink after dinner, my snack calories increase.
I now no longer worry about what the scale says but what my blood pressure, cholesterol etc read,I may no longer be slim and light weighted but the doctors say my health readings are amazing.
Don't justify your health by the scale!

@hounddawg

WOW..!!