You don't have to be obese to have diabetes. I don't understand why doctors do not discuss Metabolic Syndrome & tell patients they need to lose weigh but Healthcare will not provide that coverage. I don't agree with the scale used here in the US this is the way big Pharma keeps making $$. Thank you for sharing. Great video.
First timer to your channel. Well written, well narrated (with clear articulation). I taking note of your recommendation of the CGM. Over the past 3+ years, my opinion of the FDA as a public health guardian has dropped to zero. They are nothing more than a clearing house for big pharma. (read Karen Eban's two books including "Bottle of Lies").
You mentioned that blood transfusions can influence HbA1c test results. Blood donation can also lower A12 test results as the donated red blood cells are replaced with new non-glycated blood cells. It may result in an inaccurate measure of one’s health.
Education is enlightenment for the opportunity to execute proper procedures for optimal health . Thank You for this as well as all of your other very important and helpful video forums .👍
Question, let's say that you are eating in a way to have an acceptable A1C for a few weeks but then you have a few very bad high sugar intake/high blood glucose days. How will those few days affect your A1c over a 3 month period? In my case, it seems that a few very bad days over a three month period tend to cause a high A1C reading even though when I eat in a way to cause my blood sugar to be normal/good as being shown when I test my blood sugar via strips my pancreas and cells seem to be working properly.
Good night Dr Leonid! 6 monthly ago I did my test for A1C coming back 5.9 for pre diabetes. My glucose with food was 90. I didn't understand because I was no over weight and a do exercise. After this , I did diet, more exercise and fasting and lost 15 pounds . Back to the doctor to my test again ,after 3 months. My cholesterol go down ,my glucose fasting was 84 but A1C still 5.9. I was back again for my annual.This time lost more 5 pounds, cholesterol go down again glucose fasting 82 but A1C still 5.9. I am so sad because I don't know what to do. Please ! I need help to understand what's helping. I am American Brazilian. Could make different for my test
I have the same problem as you and also exercise, get 10,000 to 15,000 steps 3x week and then dog walking or exercise the other 4 days. My a1c doesn't go lower than 5.9 either even though my average monthly glucose is 96. Can't find a Dr locally or online that can answer my question or help.
Hi Lindy! After two years my A1C . I lost 25 pounds in total. Didn’t change I am so frustrated about this. The year in my regular test I asked to do insulin resistant and came come back very low like I not insulin resistant 3,5 and my glucose was 86 very good numbers. Still don’t understand why my A1C doesn’t go down. I wish the best to you. Thank to share your story 🙏🏼
Interesting talk and video, Why don't Doctors also ask for measures of resting insulin in blood work tests. Sadly my Doctor when I asked for this test to be added for Me, His reply " I would not know how to interpret that" How can you determine Insulin Resistance, which is very important, without that test?
Dr Kim, I am wondering where you place the importance of a c-peptide test to determine insulin resistance? Maybe it is in video and I did not catch it. Great video. I look forward to your future content! Thank-you.
Thank you Thalia. I didn’t get into c-peptides but it’s a great topic all by itself. The C-peptide test is usually not covered by insurance (in the US); I usually lean on fasting insulin levels, and calculating HOMA-IR, and can identify insulin resistance much earlier than by using A1c. 2 hour oral glucose tolerance test is a great test as well, just difficult to do in an office setting.
@@LeonidKimMD I have Blue Cross Federal Employee Plan and my annual C-Peptide is covered thankfully. The test is part of my annual surveillance for a small Side Branch IPMN (Intraductal Papillary Mucinous Neoplasm") cyst. I also have CA 19-9 and CEA tumor marker tests. My cyst was an Incidental Finding during an MRCP done in 2015 post Lap Cholecystectomy due to persistently elevated levels of Alk Phos. I have been having MRCPs for the past 7 years and other Incidental Findings like NAFLD in 2019 have been picked up by the MRCP. At that time, my A1C had gone from 5.5 to 5.9 in one year and I had gained 6 lbs and weighed 176 lbs (I now weight 150) which my doctor attributed as the cause of my A1C elevation and he was right because I immediately made some dietary adjustments (not too drastic) and started to drop lbs and 3 months later, my A1C was back to 5.5. Unfortunately, when I had my yearly check-up 2 days ago, my A1c has now gone up to 5.8 which once again puts me in the pre-diabetic range so I am going to have to go back to making diet changes. This has been a very stressful year for me on a personal level and I admit, I have slacked off on my diet (not completely) but started eating blueberry muffins for breakfast in the past 3 months and I believe that's what caused my A1C to go up again so I just stopped eating them again. By the way, my C-peptide levels were normal at 1.9 ng/ml. Also, my FPG was normal in July at 79 and my Lipid Panel was excellent, so I really don't understand how my A1C results could have gone up from 5.5 to 5.9 in such a short amount of time. I am aware that A1C only measures the past 3 months but I still find it odd. I will follow-up with my PCP next week. Sorry for the long comment but I just discovered your channel and like your content and wanted to tell you my story. Will be looking forward to your videos.
I donate plasma and platelets frequently (monthly) during which 50 mls of blood is also drawn for testing. So this will slightly skew A1c results low. So I do my blood testing just before donation.
OGGT - A cheap easy version is to test your glucose (glucometers from pharmacy are cheap) at home every 15 minutes for 2 hours after your main meal. Do this several times to collect good data, especially when eating higher levels of carbs like potatoes. Your should peak at about 1 hour and be back to normal at 2 hours if healthy. If peak is over 140 mg/dL try to modify diet. If it takes loner than 2 hours also try to tweak diet. Bad actors are likely simple carbs.
@@joanneclark8256 there are many sites where you can convert from mg/dL to mmol/L if that is what you are referring to being in Canada. 140 mg/dL is 7.8 mmol/L, so peaks shouldn't routinely go way above this. Good fasting levels should be around 5 mmol/L (90 mg/dL) and you should be back to around this level at 2 hours after meal.
@@joanneclark8256 depends on your budget and health. I would like to have one but at this point not worth it for me. If I was prediabetic I would be more inclined. But my HbA1c stays around 5%. I use a ketoMojo devise (about $40) for home use which gives glucose and ketones. Just have to get used to sticking your finger. CGM can tell a lot and I may get one at some point, but there are other things I need to do first.
My daily readings have been good for the past year of 90 to 110, occasionally 115. But for the past year, every 3 months, my A1c stays at 5.9 to 6.0. My bloodwork shows my kidney bloodwork is in the normal range.
I have a similar story (6.2). I've come to believe that I do not have prediabetes. All my other blood markers are excellent. I'm calling my doctor tomorrow to try to get some answers.
My A1c was tested and came out as 4.5 which seems so low to me. I never eat sugary food or processed food and the only sugar I eat comes from food or some carbs, but still. Can it be false ?
@@joanneclark8256 I mostly eat chicken chests cause it’s easy and I love it, some beef once a week, and I consume a lot of extra virgin olive oil, and only cook with avocado oil. Never use the other oils.
You seem like a nice guy with clear voice and talk, however (using your word that you kept using) you confuse the listener by saying things then their opposites repeatedly. It's better to say the standard then the unusual once each and stop. Don't go back and forth
New subscriber here! This is the best video I have ever seen about the A1C and its limitations.
Thanks for providing your well researched perspective on A1C. Much appreciated.
Thank you!
HOMA-IR seems to be a good screen for insulin resistance. The Kraft test will catch more than a regular glucose tolerance test.
Our doctors here have no idea what fasting insulin test is and their only marker is either FBS or HbA1c
You don't have to be obese to have diabetes. I don't understand why doctors do not discuss Metabolic Syndrome & tell patients they need to lose weigh but Healthcare will not provide that coverage. I don't agree with the scale used here in the US this is the way big Pharma keeps making $$. Thank you for sharing. Great video.
Very informative. Thank you! Most physicians, unfortunately, wont bother with the glucose test alternatives
First timer to your channel. Well written, well narrated (with clear articulation). I taking note of your recommendation of the CGM. Over the past 3+ years, my opinion of the FDA as a public health guardian has dropped to zero. They are nothing more than a clearing house for big pharma. (read Karen Eban's two books including "Bottle of Lies").
Is Karen a doctor?
You mentioned that blood transfusions can influence HbA1c test results. Blood donation can also lower A12 test results as the donated red blood cells are replaced with new non-glycated blood cells. It may result in an inaccurate measure of one’s health.
Education is enlightenment for the opportunity to execute proper procedures for optimal health . Thank You for this as well as all of your other very important and helpful video forums .👍
What an amazing explanation
You’re my new favourite
Really helpful Dr. limo, thanks for this gr8 vid! ❤️❤️❤️
Wonderful review of the methods and basis behind A1C estimation
Dr. Kim, could you cover CGM in more detail please.
Question, let's say that you are eating in a way to have an acceptable A1C for a few weeks but then you have a few very bad high sugar intake/high blood glucose days. How will those few days affect your A1c over a 3 month period? In my case, it seems that a few very bad days over a three month period tend to cause a high A1C reading even though when I eat in a way to cause my blood sugar to be normal/good as being shown when I test my blood sugar via strips my pancreas and cells seem to be working properly.
Nice description to the challange..no doc in India is thinking outside Hba1c
Good night Dr Leonid! 6 monthly ago I did my test for A1C coming back 5.9 for pre diabetes. My glucose with food was 90. I didn't understand because I was no over weight and a do exercise. After this , I did diet, more exercise and fasting and lost 15 pounds . Back to the doctor to my test again ,after 3 months. My cholesterol go down ,my glucose fasting was 84 but A1C still 5.9. I was back again for my annual.This time lost more 5 pounds, cholesterol go down again glucose fasting 82 but A1C still 5.9. I am so sad because I don't know what to do. Please ! I need help to understand what's helping. I am American Brazilian. Could make different for my test
I have the same problem as you and also exercise, get 10,000 to 15,000 steps 3x week and then dog walking or exercise the other 4 days. My a1c doesn't go lower than 5.9 either even though my average monthly glucose is 96. Can't find a Dr locally or online that can answer my question or help.
Hi Lindy! After two years my A1C . I lost 25 pounds in total. Didn’t change I am so frustrated about this. The year in my regular test I asked to do insulin resistant and came come back very low like I not insulin resistant 3,5 and my glucose was 86 very good numbers. Still don’t understand why my A1C doesn’t go down. I wish the best to you. Thank to share your story 🙏🏼
Interesting talk and video, Why don't Doctors also ask for measures of resting insulin in blood work tests. Sadly my Doctor when I asked for this test to be added for Me, His reply " I would not know how to interpret that" How can you determine Insulin Resistance, which is very important, without that test?
calculating HOMA IR is a very useful test for that
Dr Kim, I am wondering where you place the importance of a c-peptide test to determine insulin resistance? Maybe it is in video and I did not catch it. Great video. I look forward to your future content! Thank-you.
Thank you Thalia. I didn’t get into c-peptides but it’s a great topic all by itself. The C-peptide test is usually not covered by insurance (in the US); I usually lean on fasting insulin levels, and calculating HOMA-IR, and can identify insulin resistance much earlier than by using A1c. 2 hour oral glucose tolerance test is a great test as well, just difficult to do in an office setting.
@@LeonidKimMD I have Blue Cross Federal Employee Plan and my annual C-Peptide is covered thankfully. The test is part of my annual surveillance for a small Side Branch IPMN (Intraductal Papillary Mucinous Neoplasm") cyst. I also have CA 19-9 and CEA tumor marker tests. My cyst was an Incidental Finding during an MRCP done in 2015 post Lap Cholecystectomy due to persistently elevated levels of Alk Phos. I have been having MRCPs for the past 7 years and other Incidental Findings like NAFLD in 2019 have been picked up by the MRCP. At that time, my A1C had gone from 5.5 to 5.9 in one year and I had gained 6 lbs and weighed 176 lbs (I now weight 150) which my doctor attributed as the cause of my A1C elevation and he was right because I immediately made some dietary adjustments (not too drastic) and started to drop lbs and 3 months later, my A1C was back to 5.5. Unfortunately, when I had my yearly check-up 2 days ago, my A1c has now gone up to 5.8 which once again puts me in the pre-diabetic range so I am going to have to go back to making diet changes. This has been a very stressful year for me on a personal level and I admit, I have slacked off on my diet (not completely) but started eating blueberry muffins for breakfast in the past 3 months and I believe that's what caused my A1C to go up again so I just stopped eating them again. By the way, my C-peptide levels were normal at 1.9 ng/ml. Also, my FPG was normal in July at 79 and my Lipid Panel was excellent, so I really don't understand how my A1C results could have gone up from 5.5 to 5.9 in such a short amount of time. I am aware that A1C only measures the past 3 months but I still find it odd. I will follow-up with my PCP next week. Sorry for the long comment but I just discovered your channel and like your content and wanted to tell you my story. Will be looking forward to your videos.
Stress or sleep ..can cause to go up?
What foods are no good oils? Red meats ? What fruits and vefmggues? What is ok for breakfast...
Egg saturated?
Nice video.Thanks.
Very informative. Thank you!
I donate plasma and platelets frequently (monthly) during which 50 mls of blood is also drawn for testing. So this will slightly skew A1c results low. So I do my blood testing just before donation.
OGGT - A cheap easy version is to test your glucose (glucometers from pharmacy are cheap) at home every 15 minutes for 2 hours after your main meal. Do this several times to collect good data, especially when eating higher levels of carbs like potatoes. Your should peak at about 1 hour and be back to normal at 2 hours if healthy. If peak is over 140 mg/dL try to modify diet. If it takes loner than 2 hours also try to tweak diet. Bad actors are likely simple carbs.
Our monitors are 5.7 how can l convert? In canaldla and confused
Is cgm waste of money]?
@@joanneclark8256 there are many sites where you can convert from mg/dL to mmol/L if that is what you are referring to being in Canada. 140 mg/dL is 7.8 mmol/L, so peaks shouldn't routinely go way above this. Good fasting levels should be around 5 mmol/L (90 mg/dL) and you should be back to around this level at 2 hours after meal.
@@joanneclark8256 depends on your budget and health. I would like to have one but at this point not worth it for me. If I was prediabetic I would be more inclined. But my HbA1c stays around 5%. I use a ketoMojo devise (about $40) for home use which gives glucose and ketones. Just have to get used to sticking your finger. CGM can tell a lot and I may get one at some point, but there are other things I need to do first.
My daily readings have been good for the past year of 90 to 110, occasionally 115. But for the past year, every 3 months, my A1c stays at 5.9 to 6.0. My bloodwork shows my kidney bloodwork is in the normal range.
I have a similar story (6.2). I've come to believe that I do not have prediabetes. All my other blood markers are excellent. I'm calling my doctor tomorrow to try to get some answers.
What tests show kidney tests how what range is is ok
The racial/ethnic differences in HBA1C are interesting. I was not aware of this.
My A1c stays very low: 4.2 - 4.7. Glucose tolerance test showed significant hyperinsulinemia at every testing period.
I thought insulin fasting shows hyperinsulinemia? What numbers is for glucose?
a1c glycated or glycosylated: which one is correct?
both are correct
I have a A1C of 6.1 and glucose of 97 but take aspirin and beer. My Dr said anything about my A1c.
My A1c was tested and came out as 4.5 which seems so low to me. I never eat sugary food or processed food and the only sugar I eat comes from food or some carbs, but still. Can it be false ?
What oils and meat you eat?
@@joanneclark8256 I mostly eat chicken chests cause it’s easy and I love it, some beef once a week, and I consume a lot of extra virgin olive oil, and only cook with avocado oil. Never use the other oils.
thanks forsharing doc god bless
Viit e is used for fatty liver
Too many commercials
🙏🙏🙏
Saadhu ///
You seem like a nice guy with clear voice and talk, however (using your word that you kept using) you confuse the listener by saying things then their opposites repeatedly. It's better to say the standard then the unusual once each and stop. Don't go back and forth