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Diabetes

Hemoglobin A1c

03/08/2010

Question:

I do not have diabetes. In my current lab test as part of my annual physical. My A1c reading was 6.0 - high end limit of normal for this lab. My glucose was negative.

What can cause mild elevations of hemoglobin A1c?

I take 325 mg aspirin per day and 400 units of vitamin E. I was also in the last stage of a chest cold.

Thank you

Answer:

Hemoglobin A1c is a measure of your average blood sugar (glucose) over the past 3 months, particularly the last 2 months. It not only takes into account your glucose when you wake up first thing in the morning and haven't eaten for 10-12 hours, but also includes your glucose right after you have eaten (postprandial). So, an A1c of 6.0% means that your average blood sugar (fasting, just eaten) over the past 3 months has been 126.

As you note, this is just at the high end of normal. More than likely, the reason your A1c is on the high end of normal is that your fasting sugars are normal, but your postprandial sugars are higher than normal. Although this does not mean that you have diabetes, it does mean that you may be at risk later on in life.

If you aren't exercising, it would be worthwhile starting now. Most organizations recommend that you get 150 minutes of aerobic exercise (e.g., walking at a good pace to get your heart rate up, but not too fast to get breathless) each week (30 minutes per day for 5 days). Also, it might be worthwhile to watch your carbohydrate intake. It would be a good idea to have your A1c repeated in 6-12 months to determine if this 6.0% was just a "fluke" test, or if you really are predisposed toward diabetes.

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Response by:

W. Fred Miser, MD W. Fred Miser, MD
Professor of Family Medicine
Director of Ohio State Medicine Residency Program
College of Medicine
The Ohio State University