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MULTI-TEST A1C SYSTEM

Practitioner Direct

How Does A1C Relate to Glucose Control?

A strong relationship exists between A1C and plasma glucose – an increase in A1C equates to an increase in plasma glucose.[1, 2] Although a single plasma glucose measurement or a single daily glucose profile may not reliably predict A1C, plasma glucose levels measured over time can provide a reasonably accurate estimation of A1C, which allows patients and their HCPs to set day-to-day glucose targets to achieve long-term A1C goals.

 

The table below shows the range or blood glucose that corresponds to an A1C value. The relationship between average blood glucose and A1C was derived through a combination of Continuous Glucose Monitoring (CGM) and 7- and 8- point self monitoring of capillary blood glucose. Corresponding blood glucose values and ranges below are updated as prior relationship between average blood glucose and A1C did not use CGM and relied on infrequent self blood glucose monitoring.[2]

 

A1C Value (%) Blood Sugar Level (mg/dl) Blood Sugar Level (mmol/l)
5 97 (76-120) 5.4 (4.2-6.7)
6 126 (100-152) 7.0 (5.5-8.5)
7 154 (123-185) 8.6 (6.8-10.3)
8 183 (147-217) 10.2 (8.1-12.1)
9 212 (170-249) 11.8 (9.4-13.9)
10 240 (193-282) 13.4 (10.7-15.7)
11 269 (217 – 314) 14.9 (12.0 – 17.5)
12 298 (240-347) 16.5 (13.3 – 19.3)


Data in parentheses are 95% Confidence Intervals.
To convert (mmol/mol) A1C units (IFCC traceable) to (%)A1C (DCCT traceable) use the following equation(%A1C=(0.0915*A1C mmol/mol) + 2.15.

 

 

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  1. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2002. Atlanta, GA:
    U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2003.
  2. Standards of Medical Care in Diabetes - 2008. Diabetes Care, Volume 31, Supplement 1, January 2008.
  3. Daniels, E. et al, Point of Care Testing to Improve Glycemic Control.Intl J or Health Care Quality Assurance 2008; 21 (3): pp. 325-335.
  4. Data on file; Evaluation of the A1CNow SELFCHECK with lay-users. August 2008.
    * Study results with healthcare professionals showed that the accuracy of A1CNow+ with fingerstick samples was, on average, 99%. This means that, on average, a true 7.0% A1C could read approximately 6.9%A1C. An individual A1CNow+ result may differ by as much as -1.0% A1C to +0.8% A1C from the true result. This represents the 95% confidence limits of a Bland-Altman plot.
  5. Rohlfing CL, et al. "Defining the Relationship Between Plasma Glucose and HbA1C", Diabetes Care 2002;25:275–8.
  6. Nathan, DM, Kuenen, Borg, R, Zheng, H, Schoenfeld, D, Heine, RJ. "Translating the A1C Assay Into Estimated Average Glucose Values" Diabetes Care Volume 32 (8), August 2008.