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Hey Reader, Dr Karl here. Six doors, one opened. Four years and four months: Link to our books Unsubscribe | Update your profile | 600 1st Ave, Ste 330 PMB 92768, Seattle, WA 98104-2246 |
Hey Reader, Dr Karl here. What I think is happening, and what I cannot prove.I ruled things out before I landed anywhere. Was her blood sugar getting worse? No. Glucose fell 16 points over the four years and direct monitoring agreed. Was she iron deficient, which genuinely does distort A1c? No. Serum iron fell from 105 to 85, but ferritin nearly doubled, 160 to 288. That is not depletion. Was it a lipid shift? No. HDL went 58, 63, 76, 64. It wandered and came back. It cannot explain a...
Hey Reader, Dr Karl here. The chart says her average glucose was 117 to 137Here's what happens when the formula meets the actual measurement. There is a chart in every endocrinology office that converts your A1c into an estimated average glucose. It is printed on lab reports. It gets quoted back to patients as though it were a measurement. A person with an A1c reading of 5.7 to 6.4, that chart says your average glucose should be between 117 and 137 mg/dL. Assumed equivalence between A1c and...
Hey Reader, Dr Karl here. A1c tracks glucose beautifully, in only one group of people. A1c tracks glucose tightly in insulin resistant people. In everyone else it barely tracks at all. Two groups. One line is steep. The other is almost flat.That is one sentence and it undoes most of what A1c gets used for. Glucose verses Hemoglobin A1c Red line is the insulin resistant group. Steep. As glucose rises, A1c rises with it, more or less the way the textbook promises. Green line is everyone else....