hello everyone today we are talking
about hemoglobin a1c a few things you
really need to know because if you don't
know these things you will be totally
misled about a1c so you better know
these facts today in this video that's
going to only take a few minutes
so remember to subscribe give it a
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like this and remember knowledge is the
power i'm dr ahmed erik i'm an
endocrinologist and a diabetes expert
and today we are talking about
hemoglobin a1c so guys remember to take
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so let's get started so guys if you
watched my previous avonc videos just
like this one or that one or this one we
make a1c videos why because a1c is the
most important test in diabetes and that
is the test that you always discuss with
your doctor so when your doctor says to
you everyone says nine percent and
you're like okay so what because you
don't know what it is right or your
doctor says you don't even see seven
percent you're like yeah
i'm down to seven i'm like okay so what
are you happy about they're like i don't
know
from nine to seven sounds good to me
well you better know a little bit more
now as you all know the event c is
average blood sugar it's a percentage we
look at the hemoglobins how sticky how
sugar-loaded your hemoglobins are and
what's hemoglobin well hemoglobin is the
basic molecule in your red blood cells
that carry the oxygen and when they are
stuck with too much glucose we call them
glycated we can tell how high your blood
sugar is we have a mathematical
calculation about your average blood
sugar so it's just a scientific things
you know so the thing is now if you're
for example your average blood sugar is
150 your a1c is around seven percent so
here's the deal if your doctor says your
avonce is seven percent but your blood
sugar is running in the two hundreds you
should ask yourself
is that really good or is my avonci
correct so what's wrong because i know
as a patient because i am an educated
patient doctor you better know your
patient
so
i am educated because i know that a1c
may not be right or it may be the other
way around your doctor may say
that your avon c is like nine percent
but your blood sugars are in the low
100s 80s 90s it never goes up you can be
like doc what are you talking about you
know my a1c is it doesn't make any sense
because my blood sugars are so good in
my fingers so so which one is incorrect
is it your finger sticks are incorrect
is your avon c incorrect well here's how
to find out
look at your cdc okay so cbc shows your
blood count in that blackout you have to
look at your hemoglobin it's generally
abbreviated as hb or hematocrit
abbreviated as hct sometimes if you're a
hemoglobin and hematocritus off the
chart you know you have a problem right
certain ethnicities also may have a
carrier status of certain disorders like
blood disorders like thalassemia for
mediterranean descent skill cell anemia
for african-american descent sometimes
they are carriers and they have some
abnormality in their hemoglobin variants
because we have different various
variants of hemoglobin in our blood and
we assume when we do a test we just
assume that you're just normal like
everybody else but you may not be that
normal person you may not even know also
if you're anemic for example if your
hemoglobin is down to 10 or 11 that
makes a huge difference
if you are treated versus untreated
anemia that also makes a huge difference
so so what difference does it make so if
you are anemic right so your body is not
really making new cells new red blood
cells new hemoglobin so your majority of
your red blood cells are full of the old
ones now what happens when you get old
you carry a lot of stuff you know you
accumulate a lot of stuff
same thing with the red blood cells they
accumulate a lot of red blood cells and
when there is no youngsters coming in it
looks like you know your hemoglobin is
very high in a false way now what
happens when you get treated let's say
your iron deficient your b12 deficient
and you start treating this and then
suddenly your body starts making all
these young red blood cells and suddenly
your blood is full of youngsters now
they don't carry the glucose because
again we are measuring the average of
three months and then when we sample
your blood and if you sample a bunch of
youngsters hemoglobin since of the older
ones not a good mix then we are going to
be misled thinking that your hemoglobin
a1c is good but actually it is not
because you know all these young river
the blood cells are not exposed to
glucose so we are assuming when we test
you that you have a regular 120 day
cycle of every red blood cell but again
if you're anemic and your cells do not
have an average of 120 days
then you will have falsely high or
falsely low numbers so if that's the
case you always question and discuss
with your doctor hemoglobin a1c may not
be the best test for you if that is the
case so what are the other tests well
there are other tests you can use after
discussing with your doctor such as
fructosamine such as glycomark and
there's some other like tests that are
out there depending on the country
you're in but the in the united states
we mostly use for dosamine and glycomark
glycomark test you cannot use if you're
on sglt2 inhibitor such as guardians
farsiga or invokina type of drug but
fructosamine can show your last two to
three week blood sugar spikes and that
may be helpful as well i know a lot of
insurance companies are judging you or
your doctor or your doctor is judging
you everybody's judging everybody right
you should have a quotation or notation
in your chart saying that this patient's
a1c is not valid because of this and
this so i hope this was helpful guys
remember to take the quiz and it's in
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