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Day 2 ADA Chicago: A1C

The high point of the second day of the American Diabetes Association convention in Chicago has been not something I learned about diabetes in general. It is instead what I learned about myself.

The convention could not be better organized. Everything goes off without a hitch, which has to be remarkable considering the tremendous logistics of having so many people in one place.

My only complaint is that there is nowhere enough time to even skim the surface of all the information available on diabetes. A convention like this consists of four main parts: oral presentations, poster presentations, exhibits, and meetings with old friends.

Getting together with people I haven’t seen for a year, albeit briefly in most cases, is the emotional heart of the conference. But the informational heart of the conference for me this year was different from last year’s ADA in Washington, D.C., where the oral presentations were most exciting for me.

This year what is exciting me the most is the exhibits of new and continuing products to help those of us with diabetes. More than 4,000 exhibitors are here to show off 231 exhibits.

Of these, the most exciting for me so far has to be the exhibit of A1C testing. The booth for the Metrika home A1C test, called the A1CNow, offered us immediate A1C results, and I took advantage of the offer yesterday during the second day of the convention.

I wrote about this device here last year. The main change since then is that while it then took a 10-microliter drop of blood, the new version takes 5 microliters. It claims to have “99 percent lab accuracy.”

The big news for me personally is that I tested at the non-diabetic level of 4.6. That’s down from 5.3 just six months ago and down further from 6.8, which was my A1C level when I started using Byetta – and losing weight – in February 2006.

Update Day 3: The Sanofi-Aventis booth is also offering an A1C test here. They use the Siemens DCA 2000+ Analyzer, which is a laboratory instrument. Its test result was 4.7, within the margin of error when compared with my A1CNow test result.

The A1C is still the gold standard for measuring blood glucose control. It’s looking more and more like it will remain on the pedestal. On Friday night I attended a huge session, with about 1,000 people in attendance, that debated in a “current issue” session “How Important is Glucose Variability for Long-Term Outcomes?”

The leading French endocrinologist, Dr. Louis Monnier, argued that the MAGE – the mean amplitude of glycemic variability – is more important than the A1C or anything else in diabetes control. An endocrinologist from the U.K., Dr. Eric S. Kilpatrick, took the opposite view. In my article for the June 2006 issue of Diabetes Wellness News on “The Future of Pumps I reported on Dr. Monnier’s leading edge research.

When they had finished their presentations, the moderator asked us to vote by show of hands who had made the more impressive case. While I was agnostic on the question, by a two-to-one vote (according to the moderator) the audience agreed with Dr. Kilpatrick that the MAGE isn’t any better than what we are doing now to measure the risks of complications. That is certainly not a scientific way to determine such an important question, but it is a preliminary indication of the sense of the diabetes community.

While I come from within view of the Rockies, which gave John Denver a “Rocky Mountain High,” I have a Chicago high. The combination of my new A1C test and the validation of the A1C itself certainly was the high point of my second day here at the ADA in Chicago.

This article is based on an earlier version of my article published by HealthCentral.

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