Surveying potential issues with the test

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One problem with the hemoglobin A1c test is the slowness with which it changes when major changes are occurring in treatment. Despite marked improvement in the blood glucose levels, the hemoglobin A1c changes slowly. Obtaining a hemoglobin A1c more often than every three months is of little value in showing improved glucose control.

Another problem with the hemoglobin A1c measurement is the difference in how the test is performed in different labs. Because each insurance company mandates it, I send my patients to three different labs to have the test done. The normal values in one lab aren't the same as in the other labs. Recently, the significance of this problem became clear when an insurance company changed the lab to which I could sent its patients. The change left me unable to compare the old test results to the new test results because of different normal values. Fortunately, there's an ongoing effort to standardize the method of performing the hemoglobin A1c test; the movement is based on the method used in the Diabetes Control and Complications Trial, where the normal level was 6.05 percent or less.

Testing at home

ëYou can also do the hemoglobin A1c at home every three months. A test called A1c Now can be performed with a finger stick, similar to a blood glucose measurement (see the later section "The Basics of Testing Blood Glucose at Home"). You mix a large drop of blood with a solution and put it in the testing — device. It takes eight minutes to get the result of the hemoglobin A1c. The test is accurate, and you can bring the result to your child's doctor so he can act on it immediately. The A1c Now test is available without a prescription at pharmacies.

You can also obtain the materials to collect a drop of your child's blood and send it to one of the following testing laboratories. This approach to A1c testing takes a little longer than a home test (a few days rather than eight minutes), but you can still get the result to pass along to your child's doctor.

^ AccuBase A1c Glycohemoglobin: Each test costs $26.95 and includes lab analysis and reporting.

Diabetes Technologies, Inc P.O. Box 1954 Thomasville, GA 31799 Phone 888-872-2443 Fax 229-227-1752

Web site

^ A1c at Home: Each test costs $19.95 and includes lab analysis and reporting.

Flexsite Diagnostics, Inc.

3543 SW Corporate Pkwy.

Palm City, FL 34990

Phone 772-221-8893

Fax 772-221-9671

Web site

^ BioSafe A1c Hemoglobin Test Kit: Each test costs $24.95 and includes lab analysis and reporting.

Lab 123, Inc

100 Field Drive, Suite 240 Lake Forest, IL 60045 Phone 888-700-8378 Web site

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