Paul Saladino· MD
but it has a lot of flaws that we need to take into consideration. One is just inherently, when you're measuring an average, you're missing the ups and downs, right? And we're going to talk about, as you mentioned, that postprandial or potential spikes in glucose. But, an average is capturing the middle. So, your glucose could be swinging a lot all day long versus someone who has a pretty stable glucose level, and you might have the same average as that person. So, we're missing that variability, which is an important component of assessing glucose tolerance. But, additionally, the A1C test in general is relying on your red blood cells. So, it's capturing that hemoglobin on your red blood cells, which we're estimating on average lives 90 days. But, that's not always true for everybody. So, somebody with anemia, which is extremely common, that's going to skew their red blood cell life and skew the test results. Someone who had recent blood loss, smokers, someone with B12 deficiency, all of these things might skew the A1C test and cause either to be falsely high or falsely low.