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The chart that changed how I read A1c

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 ...

She did everything right for four years. One number went the wrong way.

Hey Reader, Dr Karl here. A1c is not a glucose test. It is a protein test. ​ It measures the percentage of your hemoglobin that has glucose stuck to it. Hemoglobin lives inside red blood cells. A1c has two inputs, not one: 1. how much glucose is in your blood, and 2. how long your red cells stay Nobody ...

Her A1c wasn’t measuring her glucose. It was measuring her red cells.

Last time: her insulin, glucose, inflammation and weight all improved over four years, her CGM went flat, and her A1c went up to 5.7 and parked at the prediabetes line. Here is what A1c actually is, because almost nobody is told. A1c is not a glucose test. It is the percentage of your hemoglobin that has glucose stuck ...

Everything got better. One number got worse.

Four years of work. Here is what moved. Fasting insulin 9.6 to 3.4. Fasting glucose 108 to 92. CRP 3.6 to 0.47. HOMA-IR 2.6 to 0.8. Thirty-five pounds over ideal body weight down to twenty-four. No medication for any of it. ​ And her hemoglobin A1c went from 5.3 to 5.7. Up! In the wrong ...

Your health is in your own hands, about 95 percent of it

Hey, Dr Karl here. Your health is in your own hands, about 95 percent of it. Four years. One woman. Insulin 9.6 to 3.4, glucose 108 to 92, CRP 3.6 to 0.47, HOMA-IR 2.6 to 0.8, and a move from one population into the other. She did the work. I read the numbers. Those are two different jobs and only one of them is mine. Which ...