How People Use the A1C Test
People with diabetes regularly monitor their blood glucose, to ensure that it stays within safe levels. In addition to day-by-day testing, the A1C test is performed at least twice a year in order to check average blood glucose control for the previous three or four months. Since a person's blood sugar may be higher on some days than on others, a doctor may not want to adjust the dose of insulin or other diabetes medicines unless the A1C test demonstrates a longer trend.
As blood sugar rises, A1C (a modified form of hemoglobin) also rises. For people without diabetes, normal A1C ranges between 4 and 6%. For people with diabetes, the American Diabetes Association recommends levels stay below 7%. There are several ways to test for A1C, so the ADA cautions that results may vary from lab to lab. Age and other unique biological considerations may impact a person's A1C levels, so it is important that results are interpreted by your healthcare provider. A1C testing may help:
Confirm the results seen in daily or other regular blood sugar monitoring
Demonstrate whether a treatment plan is working or not
Show the impact of healthy choices on diabetes control
What Insulins People Use
- What types of insulins are there? Insulins are categorized by the length of time a dose takes to reach the bloodstream and begin to lower blood sugar and how long that action continues to work. Products available to treat type 1 diabetes and type 2 diabetes that requires insulin include intermediate-acting, rapid or very-short-acting, short-acting, long-acting, and biphasic.
- Which insulin is right for me? With the many forms available, the choice of which product or combination of products to use is determined by a doctor, based on the type and severity of diabetes, diet and exercise patterns, and other individual considerations.
- What is insulin made from? Insulin was first gathered from cow and pig pancreases, but while these sources helped many people, they were not identical to human insulin and caused some side effects. Most recently, insulin analogs, which are slightly altered versions of human insulin, provide greater flexibility in controlling high blood sugar.
How People Take Insulin
In what ways is insulin administered? It's possible for some insulin preparations to be swallowed or inhaled, but it is usually injected under the skin. Insulin is measured in units and is standardized to contain 100 units of insulin in 1 ml of insulin fluid.
What kinds of injections are available?
- Needles-Most commonly, people inject insulin into an area of the body using a syringe with a small needle on the end. Insulin syringes come in different sizes. The size of the syringe should be the smallest that will hold the dose to be injected. Syringes are available with various thicknesses (gauges) of needles. The bigger the gauge number, the thinner the needle and the less the pain of guiding the needle under the skin before injection.
- Pen devices-Multi-use pen devices are available which allow the user to "dial" and inject their insulin. Pens use replaceable needles and contain a prefilled tube of insulin that contains many doses.
- Insulin pumps-These provide better insulin control than individual injections and may be a good choice for some people. Pumps are expensive and require attention to detail for desired results.
How should used injection materials be discarded? After use, syringes, needles, empty insulin vials, and other items used for insulin dosing should be discarded in a "sharps container." Once sealed, these containers protect people who may come into contact with them from contamination or injury. Sharps containers must be disposed of according to legal and safety regulations.
Does insulin need special care? Insulin requires special handling and storage. Ask a pharmacist or certified diabetes educator for information about the best ways to preserve an insulin supply.
When do people take it? Ask your doctor or a certified diabetes educator about training before using insulin, as insulin use is tailored to a person's individual needs and requires significant education and training to gain the benefits and avoid the side effects. People who have had insulin prescribed for diabetes treatment work with their healthcare providers to determine the best program for administration. Many people with diabetes monitor their own blood sugar levels to know when and how much insulin they should take. For the best control, people with diabetes should use both primary types of monitoring: self-monitoring, which is usually done several times daily or several times weekly, and a lab analysis of your A1C levels, which may indicate whether changes in blood sugar patterns are short- or long-term.
What other factors affect diabetes treatment with insulin?
- Food-Diet is an important factor in effective diabetes prevention and treatment. People using insulin should monitor their blood sugar carefully and talk with their doctor about the role of diet in diabetes management.
- Alcohol-As alcohol may increase the action of insulin, leading to hypoglycemia (low blood sugar), people using insulin should avoid alcohol.
- Tobacco-Smoking may decrease insulin activity, and it compounds the health problems associated with diabetes, so people using insulin are cautioned to avoid smoking.