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c/bloodwork·submitted 1 year ago by u/laila_yilmaz

A1c: what the trials say vs what this community says

Discussionbranch of 12 comments

A1c: what the trials say vs what this community says. It is the sort of thing everyone half-believes and nobody writes down. My A1c moved and I spent a fortnight convinced I knew why. The repeat six weeks later was back in range and I had changed nothing. Compared two draws across two labs and spent a week worrying…

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12 comments, started 1 year ago
u/copay_card_cc32 points·1 year ago

Same lab as the previous draw?

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u/customs_seizure_sid20 points·1 year ago

Why so many single values look alarming and turn out to be nothing.

A reference interval is built to contain about 95% of a healthy reference population, so one test in twenty falls outside one by construction. Add biological variation, assay imprecision, fasting state and time of day, and a genuinely stable person will produce occasional out-of-range results.

That is why repeat testing before acting is standard. Regression to the mean handles most of it. None of which means an out-of-range value should be ignored — it means it should be repeated and taken to somebody who can put it in context, which is emphatically not a ranked feed.

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u/thermal_mass_tom23 points·1 year ago

Added ApoB to the panel after a thread here. It told me something the standard lipid panel had been hiding.

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u/santiago_rasmussen12 points·1 year ago

Same view — ApoB if you add one thing. It answers a question the standard panel only gestures at.

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u/ahmed_fonseca8 points·1 year ago

Same view — ApoB if you add one thing.

Adding the obvious one — take it to whoever ordered the panel. This board cannot read it for you.

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u/anya_rautio4 points·1 year ago

Same view — ApoB if you add one thing.

santiago_rasmussen is right that a reference interval is not a target. It is a description of a population.

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u/santiago_szabo2 points·1 year ago

Push back: a value just outside a reference interval is a common finding in healthy people. It is a reason to repeat.

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u/laila_yilmazOP18 points·1 year ago

That is a non-fasting value and the interval you are comparing it against is a fasting one.

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u/laila_yilmazOP7 points·1 year ago

Small fix — a reference interval is not a treatment target, and the post above uses them interchangeably.

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u/chidi_abubakar6 points·1 year ago

one measurement is a point, two is a line, three is a trend

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u/freya_baptista0 points·1 year ago

one measurement is a point, two is a line, three is a trend

This is the sentence to read before anybody panics about a single value.

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u/kofi_balogun15 points·1 year ago

What did the repeat show?

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About c/bloodwork

What to measure before you start, what to re-measure, and how to interpret movement without panicking. ApoB over LDL-C, HOMA-IR as a crude free tool, ALT and the fatty-liver story, eGFR noise during rapid loss, and the deficiencies that a 1,100-calorie appetite will hand you.

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