More on A1C
My last post got me thinking...
I trust that you all know by now that A1C is not a straight average - rather, it is weighted towards the most recent results to a great degree. That is, the most recent week "counts" for an order of magnitude more in the A1C result than the oldest.
I think the main reason why healthcare professionals don't tell this to patients is twofold: it's confusing, and also it points to a way to "cheat" on the A1C: simply wait for a "good" period of a week or two, then test. Even if the former 8-10 weeks were horrible, the A1C score will tend to reflect the most recent weeks much more strongly, resulting in a score closer to normal.
Anyhow, so we know the A1C is somewhat pointless as a 3-month average, even if that's how it's treated by so many. In fact, it is only useful as a 3-month average in people who have rather stable blood sugars - which means mostly type 2, not type 1, and certainly not brittle ones like me.
Now I'm beginning to wonder if even this limited usefulness is useful. In other words, what if because of my ability to manage my sugars more pro-actively through the use of a CGMS, I can have an "A1C of 7 that is more like a 6"? in other words, if the A1C is a weighted average of sugars in the blood, but those reflect more peaks and valleys than what is happening in my cells, then is it possible that my "effective average" is actually lower?
Oh, the possibilities!
I trust that you all know by now that A1C is not a straight average - rather, it is weighted towards the most recent results to a great degree. That is, the most recent week "counts" for an order of magnitude more in the A1C result than the oldest.
I think the main reason why healthcare professionals don't tell this to patients is twofold: it's confusing, and also it points to a way to "cheat" on the A1C: simply wait for a "good" period of a week or two, then test. Even if the former 8-10 weeks were horrible, the A1C score will tend to reflect the most recent weeks much more strongly, resulting in a score closer to normal.
Anyhow, so we know the A1C is somewhat pointless as a 3-month average, even if that's how it's treated by so many. In fact, it is only useful as a 3-month average in people who have rather stable blood sugars - which means mostly type 2, not type 1, and certainly not brittle ones like me.
Now I'm beginning to wonder if even this limited usefulness is useful. In other words, what if because of my ability to manage my sugars more pro-actively through the use of a CGMS, I can have an "A1C of 7 that is more like a 6"? in other words, if the A1C is a weighted average of sugars in the blood, but those reflect more peaks and valleys than what is happening in my cells, then is it possible that my "effective average" is actually lower?
Oh, the possibilities!
posted by Blinkered at 8:39 AM
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