Diabetes
why a1c isn’t the whole story
Looking at the Whole Story
A1C is one of the most commonly used diabetes markers, but it does not tell the complete story. Looking beyond A1C provides a more accurate understanding of metabolic health.
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A1C reflects average glucose over approximately three months. However, averages can hide significant glucose variability.
Two patients may have identical A1C values while experiencing very different glucose patterns.
Measure: Review glucose patterns beyond A1C alone.
Do: Learn additional markers of metabolic health.
Reflect: Ask whether average glucose tells your full story.
For Real
Is This Your Story?
Two patients both have an A1C of 5.8%. One maintains stable glucose levels throughout the day. The other experiences frequent spikes above 200 mg/dL followed by crashes. Additional monitoring reveals dramatically different metabolic risks despite identical A1C values.
Markers
Additional useful markers include:
Fasting insulin, Fasting glucose, Continuous glucose monitoring, Time in Range, Triglycerides, Waist circumference
A1C also does not directly measure insulin resistance, which often develops years before glucose abnormalities appear.
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