Picture this- an inner tube floating down the river with 10 of your friends on it. All of a sudden someone else jumps in and throws one of your friends off, then another, and another. All of a sudden there are only 3 of your friends left out of 10- and that is no fun! This is very similar to the scene playing out in your body. The inner tubes are your red blood cells (see picture above) which float around your body carrying oxygen molecules (you and your friends). When your blood sugars run high, excess sugar molecules (the people who kicked your friends off) see the red blood cells carrying the oxygen and decide they want a free ride too so they jump on and kick off your oxygen molecules. So why does this all matter? Well your A1C (also called hemoglobin A1C or HbA1C) is a measure of the amount of sugar stuck to your red blood cells. And the higher the A1C, the less oxygen that is riding your red blood cells being delivered to the cells in your toes, fingers, eyes, brain, etc. Overtime, if your A1C remains high, then those cells will begin to die due to lack of oxygen and this is where the complications of diabetes come from. Therefore, if you are able to maintain an A1C under 7 then that means that your cells are getting the appropriate amount of oxygen and your risk for complications is lower and THAT is my goal for you!!

When I worked at Children’s Hospital of Pittsburgh diabetes center, I used to describe A1C to my pediatric patients as another type of report card. So for those of you who haven’t received a report card in many, many years- it is back! The reason I compare your A1C to a report card is simply because it is an average of your blood sugars over a 3 month period of time. Meaning that having one or two individual high blood sugar readings from finger testing will not shoot your A1C up. It is many high readings over many days/weeks. But be encouraged because you can begin to make an immediate change that can quickly bring your A1C back to the American Diabetes Association’s target of less than 7.

Below is a chart showing A1C values (measured in %) and the matching average blood sugar value so that you have an idea of where you are measuring.

• 6%= average blood sugar 126
• 7%= average blood sugar 154
• 8%= average blood sugar 183
• 9%= average blood sugar 212
• 10%= average blood sugar 240
• 11%= average blood sugar 269
• 12%= average blood sugar 298

Your “just for today” challenge is an easy one- if you do not know what your last A1C was then call your doctor office and find out. If it is higher than 7 do not worry and know that starting today you can work to improve your numbers so that your next one will be better!