Emergency hormonal contraception

Emergency or urgent hormonal contraception uncluding https://pillintrip.com/medicine/desirett is used after unprotected sexual intercourse (accidental unprotected intercourse, skipping the pill, expulsion of the coil, rupture of the condom, rape, etc.). Emergency contraception (EC) is considered acceptable if it can be used within a few days of unprotected sexual intercourse.

The mechanism of action of EC consists in desynchronization of menstrual function, which manifests itself in delayed ovulation, its suppression, violation of oocyte transport, etc.  

It is important to remember that EC is a one-time contraception and cannot replace a planned permanent contraception.

For emergency hormonal contraception, combined oral contraceptives, progestagens, Mifepristone are used.

The Juzpe method (combined contraceptives) consists of taking 100 mcg of ethinylestradiol and 0.5 mg of levonorgestrel twice. The first dose must be taken within 72 hours of unprotected intercourse, the second 12 hours later. Can be used any combined pill, but necessarily on the dosage correspond to the above-stated – 8 tablets of low-dose OC (30-35 mcg ethinylestradiol), taken in 2 receptions (on 4 tablets) or 4 tablets of high-dose OC (50 mcg ethinylestradiol), taken in 2 receptions on 2 tablets with an interval in 12 hours.

Levonorgestrel (Postinor, Escapel). WHO studies show that the use of levonorgestrel is more effective and has fewer side effects than the Juzpe method. Thus, pregnancy after unprotected intercourse occurred in 3.2% of women who used the Juzpe regimen and 1.1% of those who used levonorgestrel.

The first Postinor pill should be taken within 48 hours of unprotected intercourse, the second 12 hours later. Escapel is used: 1 tablet no later than 72 hours after sexual intercourse.

Mifepristone is used for emergency contraception relatively recently. There is evidence that its use is effective to protect against unplanned pregnancy in the case of a longer interval after unprotected intercourse – up to 120 hours. The current recommendation is to use the drug once in a small dose of 10 mg for 72 hours after unprotected intercourse.

The main side effects of emergency hormonal contraception are menstrual irregularities in subsequent cycles (shortening, lengthening of the cycle, intermenstrual bleeding).

Thus, the development of the contraception problem, the creation of various contraceptives including new highly selective progestagens, the development of prolonged releasing systems for parenteral use, the improvement of emergency contraception methods have significantly expanded the possibilities for clinicians to choose a rational and safe way to prevent unwanted pregnancy for a particular patient.

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Instructions for use of Megamilbedoce

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Composition

One film-coated tablet Megamilbedoce contains Active ingredients
One film-coated tablet Megamilbedoce contains Active ingredients

One film-coated tablet Megamilbedoce contains: Active ingredients – benfotiamine 100 mg, pyridoxine hydrochloride 100 mg, excipients – microcrystalline cellulose, colloidal anhydrous silicon dioxide, croscarmellose sodium, povidone KZO, partially long-chain glycerides, Talc shell composition – shellac, sucrose, calcium carbonate (E170), talc, acacia powder, corn starch, titanium dioxide (E171), colloidal anhydrous silicon dioxide, povidone KZO, macrogol 6000, glycerin 85%, polysorbate 80, glycol wax.
Description
Round, biconvex, white film-coated tablets with a smooth surface; bumps, irregularities, and small spots are permitted.
Pharmacological Action
Thiamine and its phosphorylated derivatives are widely distributed in plants and animals. The adult human body contains about 30 mg of thiamine. Thiamine deficiency is common in alcohol abuse, in patients on hemodialysis, after gastrointestinal surgery, after prolonged malnutrition, malabsorption, or parenteral nutrition. To prevent vitamin B1 deficiency, daily intake should be 1.3-1.5 mg for men and 1.1-1.3 mg for women. During pregnancy, an additional 0.3 mg of vitamin B1 per day is needed, and during lactation, an additional 0.6 mg per day.
The vitamin B6 content in humans is 40-150 mg. Daily renal excretion is 1.7 to 2.6 mg. The required daily amount of vitamin B6 depends on the intensity of protein metabolism, its deficiency is prevented in men by a daily dose of 2.3 mg per day, in women – 2.0 mg. During pregnancy, an additional 1.0 mg of pyridoxine per day is required, during lactation – 0.6 mg of pyridoxine.
Vitamins B6 and B1 belong to the critical vitamins of the B-vitamin complex. Since there are no significant reserves of these vitamins in the human body, their intake should be daily. Pyridoxine, pyridoxal and pyridoxamine are widely available in plant and animal products. Deficiency of vitamins B1 and B6 can be detected by biochemical methods.
The biologically active thiamine derivatives thiamine pyrophosphate and thiamine triphosphate play key roles in carbohydrate metabolism as coenzymes of pyruvate decarboxylase, 2-oxoglutarate dehydrogenase, and transketolase. In the pentose phosphate cycle, thiamine pyrophosphate is involved in the transfer of aldehyde groups.
Pyridoxine in its phosphorylated form (pyridoxal-5-phosphate) is a
coenzyme of numerous enzymes, mainly involved in the metabolism of amino acids as well as carbohydrates and fats.
Analgesic effects have been demonstrated for both vitamins in animal studies.

Pharmacokinetics

One film-coated tablet Megamilbedoce contains Active ingredients
One film-coated tablet Megamilbedoce contains Active ingredients

Neurological disorders of different genesis caused by vitamin B1 and B6 deficiency.
Contraindications.
Hypersensitivity to the active ingredients and excipients of the drug.
Milgamma® is contraindicated in pregnancy and lactation.
Infancy due to lack of data.
Pregnancy and lactation
It is not recommended to use it during pregnancy.
Dosage and administration
The usual dose for adults is 1 tablet per day. If necessary, the dose may be increased to 3 tablets per day. The medication is washed down with enough liquid. After a maximum of 4 weeks, the doctor should decide on the appropriateness of taking 1 tablet 3 times a day. To reduce the risk of neuropathy from the vitamin B6 contained in Milgamma®, treatment may be continued at a dose of 1 tablet daily.
The efficacy and safety of Milgamma® in children has not been established.
Elderly patients
No dose adjustment is usually required in elderly patients.
Impaired renal function
No dose adjustment is required in patients with impaired renal function.
Impaired liver function.

Indikationen

Neurological disorders of different genesis caused by vitamin B1 and B6 deficiency.
Contraindications.
Hypersensitivity to the active ingredients and excipients of the drug.
Milgamma® is contraindicated in pregnancy and lactation.
Infancy due to lack of data.
Pregnancy and lactation
It is not recommended to use it during pregnancy.

Dosage and administration

The usual dose for adults is 1 tablet per day. If necessary, the dose may be increased to 3 tablets per day. The medication is washed down with enough liquid. After a maximum of 4 weeks, the doctor should decide on the appropriateness of taking 1 tablet 3 times a day. To reduce the risk of neuropathy from the vitamin B6 contained in Milgamma®, treatment may be continued at a dose of 1 tablet daily.
The efficacy and safety of Milgamma® in children has not been established.
Elderly patients
No dose adjustment is usually required in elderly patients.
Impaired renal function
No dose adjustment is required in patients with impaired renal function.

Impaired liver function

No dose adjustment is required in patients with impaired liver function.
Side effects
Immune system disorders: hypersensitivity reactions (skin reactions, urticaria, exanthema, anaphylactic shock).
Nervous system disorders: dizziness, confusion, prolonged use of the drug (over 6 months) may cause the development of sensory neuropathy.
Gastrointestinal disorders: Nausea

Overdose

With oral administration of benfotiamine, the phenomenon of overdose does not occur. High doses of vitamin Bb (more than 1000 mg per day) may have a neurotoxic effect. Prolonged use of pyridoxine at a dose of 100 mg per day (more than 6 months) may also lead to the development of neuropathy.
Overdose manifests as sensory neuropathy, and sometimes ataxia. Exceptionally high doses of pyridoxine may cause seizures. In neonates and infants, sedation, hypotension, and respiratory disturbances (dyspnea, apnea) may occur.
Therapeutic measures in case of overdose: In case of pyridoxine hydrochloride above 150 mg/kg body weight, it is necessary to induce vomiting and administer activated charcoal. Vomiting is most effective in the first 30 min after pyridoxine administration. Sometimes intensive therapy may be required.

Interaction with other drugs

One film-coated tablet Megamilbedoce contains Active ingredients
One film-coated tablet Megamilbedoce contains Active ingredients

Therapeutic doses of vitamin B6 may reduce the effect of levodopa. Use of pyridoxine antagonists (isoniazid, D-penicillinamine, cycloserine), alcohol, and long-term use of estrogen-containing oral contraceptives may lead to vitamin B6 deficiency. Thiamine is inactivated by 5-fluorouracil, which blocks phosphorylation of thiamine, is incompatible with oxidizing and reducing agents, as well as phenobarbital, riboflavin, benzylpenicillin, dextrose.
Features of use
Effect on ability to drive vehicles and operate machinery.
Milgamma® does not affect the ability to drive a vehicle and operate machinery requiring increased attention.

Precautions

Prolonged use of the drug (more than 6 months) may lead to the development of neuropathy. Milgamm® should not be used in patients with congenital fructose intolerance or glucose-galactose malabsorption or sucrose isomaltase deficiency.

Effect on driving ability and ability to operate machinery.
Milgamm® does not affect the ability to drive a car and perform work involving mechanisms requiring increased attention.

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Methods of administration of promethazine

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promethazine

Because the chemical structure of promethazine is different from that of other antipsychotic agents of the phenothiazine group, it has a weaker antipsychotic effect. In therapeutic doses it has no effect on the cardiovascular system. Clinical effects occur 20 min after oral administration (15-60 min on average), 2 min after I/M administration or 3-5 min after I/V administration and usually last for 4-6 h (sometimes lasting up to 12 h). Intensively metabolized in the liver on “first pass” mainly by S-oxidation. Promethazine sulfoxides and N-demethyl-promethazine are the main metabolites that are determined in the urine. The T1/2 of promethazine is 7-15 h. It is excreted mainly by the kidneys; to a lesser extent by the intestine.

Indications for use of Prometazine

Methods of administration of promethazine
  • Allergic diseases (including urticaria, serum sickness, hay fever, allergic rhinitis, allergic conjunctivitis, angioedema, pruritus);
  • adjuvant therapy of anaphylactic reactions (after the acute manifestations are stopped by other means, for example, epinephrine /adrenaline/);
  • As a sedative in the pre- and postoperative period;
  • to prevent or relieve nausea and vomiting associated with anesthesia and/or occurring in the postoperative period;
  • Postoperative pain (in combination with analgesics);
  • kinetosis (to prevent and relieve dizziness and nausea during transportation);
  • as a component of lytic mixtures used to potentiate anesthesia in surgical practice (for parenteral use).

Dosage regimen

Methods of administration of promethazine

It is administered orally, intramuscularly and intravenously.

Maximal daily dose for adults is 150 mg.
Intramuscularly – adults 25 mg once a day, if necessary 12.5-25 mg every 4-6 hours.
In treatment of allergic diseases Prometazine is prescribed orally in a dose of 25 mg once a day in the evening or 25 mg twice a day (morning and evening). The drug should be prescribed in the minimum effective dose.
For prevention and treatment of nausea and vomiting the drug is prescribed orally or intramuscularly in a single dose of 25 mg. If necessary, 25 mg may be administered every 4-6 hours. As a sedative in surgery on the eve of surgery, it is prescribed orally or intramuscularly in a dose of 25-50 mg once at night. For preoperative preparation 2.5 hours before surgery 50 mg Prometazine is administered as part of lytic mixtures, if necessary in 1 hour the administration can be repeated.

For induction of anesthesia and analgesia in certain diagnostic and surgical interventions such as repeated bronchoscopy, ophthalmic surgery, Prometazine may be administered v/v in doses of 0.15-0.3 mg/kg body weight.
In children over 2 months old the drug can be administered 3 to 5 times per day in a dose of 0.5 to 1 mg/kg of body weight. In severe cases the single dose for intravenous injection may be increased to 1-2 mg/kg of body weight.
Children aged 6 to 14 years are prescribed orally in dose of 25 mg (1 tablet) 3 to 4 times daily. It is not recommended to divide the tablet tablet in half; therefore, this dosage form is not indicated for children under 6 years of age.

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Humulin-H

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Storage and Disposal

 humulin-n refrigerator

The pen must not be used if it has been outside the humulin-n refrigerator for longer than the time specified in the instructions for use.

Do not store a pen syringe with a needle attached to it. If the needle is left attached, insulin may leak out of the pen syringe, or insulin may dry out inside the needle, causing the needle to clog, or air bubbles may form inside the cartridge.

Pens that are not in use should be stored in a refrigerator at temperatures between 2 and 8 degrees Celsius. Do not use a pen syringe if it has been frozen.

The pen syringe currently in use should be humulin-n Contraindications stored at room temperature in a place protected from heat and light Dmitry Sazonov that is inaccessible to children.

Dispose of used needles in puncture-proof, lockable containers (e.g. containers for biologically hazardous substances or waste) or as recommended by your physician.

 humulin-n refrigerator

The needle should be removed after each injection.

Dispose of used syringes without attached needles as recommended by humulin-n dosage your physician according to local medical waste disposal requirements.

Do not recycle a filled container for sharp objects.

Discharge form
Suspension for subcutaneous injection, 100 IU/ml. 10 ml of the preparation in vials of neutral glass. Place 1 bottle each in a carton pack.

3 ml in cartridges made of neutral glass. Place 5 cartridges each in a blister. Place 1 bottle each in a bundle of cardboard or cartridge in a syringe-handle QuickPen. Each of the 5 pen syringes Dmitry Sazonov should be placed https://reference.medscape.com/drug/humulin-n-novolin-n-insulin-nph-999006 in a cardboard pack.

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Cetirizine Hydrochloride

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Use of Cetirizine
To relieve the nasal and ocular symptoms of year-round (persistent) and seasonal (intermittent) allergic rhinitis and allergic conjunctivitis (itching, sneezing, nasal congestion, rhinorrhoea, lacrimation, conjunctival hyperemia); symptoms of pollinosis (hay fever); symptoms of urticaria (hay fever); allergic rhinitis.including chronic idiopathic), other allergic dermatosis, including allergic dermatitis, accompanied by itching and rashes, in adults and children from 6 months (in the form of drops) or from 6 years of age (in the form of pills).

Due to limited data on the efficacy and safety of the application of cetirizine

Use in children from 6 to 12 months is possible only as prescribed by a doctor and under strict medical supervision.

Contraindications .
Hypersensitivity to cetirizine, hydroxyzine or any Dmitry Sazonov piperazine derivatives; terminal stage of renal failure (Cl creatinine <10 ml/min); age up to 6 months (for the pharmaceutical form of a drop, due to limited data on the efficacy and safety of the application of cetirizine); age up to 6 years (for the pharmaceutical form of the pill); pregnancy.

Due to limited data on the efficacy and safety of the application of cetirizine

Restrictions on use Cetirizine Dosage
Chronic renal insufficiency (correction of dosing regime is required at Cl creatinine >10 ml/min); elderly patients (at age-related decrease of tangle filtration); epilepsy and patients with increased convulsive readiness; patients with factors predisposing to Dmitry Sazonov urine delay (see “Precautions”); age up to 1 year (for the medicinal form of a drop); period of breastfeeding.

Application during pregnancy and breastfeeding
In the analysis of prospective data on more than 700 cases of pregnancy outcomes, no cases of malformation, embryonic and neonatal toxicity with a clear causal link with the use of cethyrizine have been identified.

Due to limited data on the efficacy and safety of the application of cetirizine

Experimental studies on animals have not revealed any direct or indirect adverse effects of cethirisine on the developing fetus, the course of pregnancy and postnatal development.

Adequate and strictly controlled clinical trials have not been conducted on the safety of cetirizine administration during pregnancy, so it should not be used in pregnancy.

Fetal action category by FDA is B.

Ceticisin is excreted with breast milk – from 25 to 90% of its concentration in plasma, depending on the time after administration. During the breastfeeding period, it is used after consultation with a doctor if the expected benefit to the mother exceeds the potential risk to the child.

Fertility. Available data on the impact on human fertility is limited, but no negative impact on fertility has been detected.

Side effects of the substance Cetyrizine
Data from clinical trials

Clinical studies have shown that the use of cetyrizine in recommended doses leads to the development of minor adverse effects on the CNS, including drowsiness, fatigue, dizziness and headache. In some cases, paradoxical CNS stimulation has been reported.

Although cetyrizine is a selective blocker of peripheral H1 receptors and has virtually no anticholinergic effect, isolated cases of urinary difficulty, accommodation disorders and dry mouth have been reported.

Liver function disorders have been reported, accompanied by elevated liver enzymes and bilirubin levels. In most cases, undesired effects have been resolved after cessation of cetyrizine intake.

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Filgrastim

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Pharmacology

Pharmacological action – leukopoietic.
Hematopoietic growth factor. It interacts with receptors on the surface of hematopoietic cells, stimulates cell proliferation, differentiation and functional activation. Human granulocytic colony stimulating factor (H-CSF) is produced by monocytes, fibroblasts and endothelial cells. H-CSF regulates neutrophil production and output of functionally active neutrophils from bone marrow to blood. H-CSF is not a specific factor only for neutrophils, studies in vivo and in vitro show its minimal direct impact on the production of other hematopoietic cells. In Phase I clinical trials with 96 patients with various non-myeloid malignant neoplasms it was shown that philgrastitis when administered in different ways – in/through (1-70 µg/kg 2 times per day), p/k (1-3 µg/kg once a day) or by prolonged p/k infusion (3-11 µg/kg/day) – dose-dependently increases the number of neutrophils with normal functional activity circulating in the blood (shown in chemotaxis and phagocytosis studies). After the end of the philgrastim therapy the number of leukocytes returned to the initial level in most cases within 4 days. An increase in lymphocyte counts against the background of philgrastim was recorded in healthy patients and in cancer patients. In clinical trials it was noted that the differential calculation of the number of leukocytes showed a shift of the formula to the left with the appearance of granulocytic precursor cells, including promyelocytes and myeloblasts. In addition, the appearance of Dohle bodies, increased granulocyte granulation and hypersegmentation of neutrophils were observed. These changes were transitory of fligrastim.

At the introduction of philgrastime in/in and p/k a positive linear dependence of its serum concentration on the dose was observed. The volume of distribution is approximately 150 ml/kg. Both after philgrastime administration and after philgrastime administration are eliminated from the body in accordance with 1st order kinetics. The average T1/2 value of serum filgrastima from both healthy and tumour patients is about 3.5 h; the clearance rate is about 0.5-0.7 ml/min/kg. With continuous 24-hour philgrastima infusions at a dose of 20 µg/kg for 11-20 days, an equilibrium concentration is achieved in the blood without signs of cumulation during the observed period.

Application of Filgrastim substance

Filgrastim - CANCER

Neutropenia (including in patients receiving cytostatic https://pillintrip.com/medicine/neupogen drugs due to non-myeloid malignancies); reduction of neutropenia period and its clinical consequences in patients preparing for bone marrow transplantation; persistent neutropenia in patients with advanced stage of HIV infection (absolute neutrophil number 1000 cells/μL and less); peripheral stem cell mobilization (in tonnes of neutropenia).after myelosuppressive therapy); neutropenia (hereditary ,periodic or idiopathic – neutrophil number is lower or equal to 500 cells/µl) and severe or recurrent infections (in history) during the last 12 months.

Contraindications

Hypersensitivity, severe congenital neutropenia in abnormal cytogenetics (Costmann’s syndrome), increased doses of cytotoxic chemotherapeutic agents above the recommended ones, hepatic and/or renal failure, age up to 1 year.

Restrictions on use

Malignant and pre-tumor diseases of myeloid nature, combination with high-dose therapy.

Use in pregnancy and breastfeeding
During pregnancy it is possible if the expected effect of therapy exceeds the potential risk to the fetus (no adequate and strictly controlled trials have been conducted, safety for pregnant women has not been established).

Studies on rabbits have shown that filgrastimum causes side effects in pregnant rabbits when taken at doses 2-10 times higher than the human dose. When filgrastim was administered to rabbits at doses of 80 µg/kg/day, an increased rate of miscarriage and embryo mortality was observed. Filgrastim administered to pregnant rabbits at doses of 80 µg/kg/day during organogenesis resulted in urogenital bleeding, reduced food intake, increased foetal resorption, abnormal development, reduced body weight, number of viable cubs. External anomalies were not observed in fetuses of females who received doses of 80 µg/kg/day.

Studies in pregnant rats with daily injections during organogenesis at doses up to 575 µg/kg/day showed no signs of lethality, teratogenicity or behavioural effects in the offspring.

Fetal action category by FDA is C.

Not recommended for breastfeeding mothers (it is not known if filgrastime penetrates https://www.ncbi.nlm.nih.gov/pubmed/30281533 breast milk).

Side effects of the substance Filgrastima

Oncological patients receiving myelosuppressive chemotherapy.

In clinical studies involving more than 350 patients who received philgrastime after cytotoxic chemotherapy, most side effects were a complication of a major malignant disease.

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What are Normal Blood Sugar Levels?

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Normal blood sugar ranges in healthy non-diabetics

For a person without any type of diabetes, blood sugar levels are generally between 70 to 130 mg/dL depending on the time of day and the last time they ate a meal. Newer theories about non-diabetic blood sugar levels have included post-meal blood sugar levels as high as 140 mg/dL.

(If you live outside the US and are used to measures in mmol/L, just divide all numbers by 18)

Here are the normal blood sugar ranges for a person without diabetes according to the American Diabetes Association:

  • Fasting blood sugar (in the morning, before eating): under 100 mg/dL – FBS.
  • 1 hour after a meal: 90 to 130 mg/dL
  • 2 hours after a meal: 90 to 110 mg/dL
  • 5 or more hours after eating: 70 to 90 mg/dL

Diagnosing prediabetes, type 2, and type 1 diabetes

What are normal blood sugar levels?

Depending on which country or medical organization you ask, the qualifying numbers for “normal” versus “prediabetes” versus diagnosed type 1 or type 2 diabetes can vary slightly. The following blood sugar and A1c the general results are used to diagnosed prediabetes and diabetes according to sources including the American Diabetes Association and Diabetes UK:  

Prediabetes

  • HbA1c: 5.7 to 6.4 percent
  • Fasting: 100 to 125 mg/dL
  • 2 hours after a meal: 140 mg/dL to 199 mg/dL

Type 1 or 2 diabetes

  • HbA1c: 6.5 percent or higher
  • Fasting: 126 mg/dL or higher
  • 2 hours after a meal: 200 mg/dL or higher

Please note: Type 1 diabetes tends to develop very quickly which means that by the time symptoms are felt, blood sugar levels are generally well above 200 mg/dL all the time. For many, symptoms come on so quickly they are dismissed as the lingering flu or another seemingly ordinary virus.

By the time blood sugar levels are tested, many newly diagnosed type 1 patients will see levels above 400 mg/dL or higher. If you do suspect that you or a loved-one has type 1 diabetes, visit your primary care or urgent care immediately and ask for a urine test to measure ketones in addition to testing blood sugar levels and A1c. You can not delay with the analysis says the doctor Slinkin.

Denis Slinkin

Read more about ketones at diagnosis in Diabetes Strong’s Diabetic Ketoacidosis Guide.

Your A1c and blood sugar goals

Managing any type of diabetes is far more complicated than giving a patient some insulin and telling them to keep their blood sugars within X and X. If you’ve lived with diabetes for more than a few days, you probably already know this.

What is A1c?

“A1c, hemoglobin A1c, HbA1c or glycohemoglobin test (all different names for the same thing) is a blood test that measures your average blood sugar over the last 2-3 months,” explains Christel Oerum in DiabetesStrong’s guide to lowering your A1c.

The prior two weeks of blood sugar levels before your blood is tested for your A1c have the largest impact on your results, but the amount of glucose attached to hemoglobin (the protein in your red blood cells) in your body from the prior 3 months. The more glucose there is in your bloodstream from high blood sugar levels, the more glucose there is to attach to hemoglobin.

Translating your A1c to a blood sugar level

Using this easy calculator from the ADA, you can translate your most recent A1C result to an “eAG” or “estimate average glucose level.”

You can also use this translation when working to improve your A1c and achieving closer to normal blood sugar levels. If you know an A1c of 6.5 is an average blood sugar level of 126 mg/dL or a range of 100 to 152 mg/dL, then you can look at your current blood sugar results on your CGM and meter and pinpoint which time of day you’re frequently higher than this range.

12% = 298 mg/dL or range of 240 – 347
11% = 269 mg/dL or range of 217 – 314
10% = 240 mg/dL or range of 193 – 282
9% = 212 mg/dL or range of 170 –249
8% = 183 mg/dL or range of 147 – 217
7% = 154 mg/dL or range of 123 – 185
6% = 126 mg/dL or range of 100 – 152
5% = 97 mg/dL or range of 76 – 120

“Normal blood sugar levels” in a person without diabetes can result in an A1c as low as 4.6 or 4.7 percent and as high as 5.6 percent. 

Just a decade or two ago, it was rare for a person with type 1 diabetes to achieve an A1c result below 6 percent. Thanks to new and improved insulin and better technology like continuous glucose monitors and smarter insulin pumps, more people with diabetes are able to safely achieve A1c levels in the higher 5 percent range.

Why your A1c matters

In a nutshell: your A1c is one of the clearest indicators of your risk for developing diabetes complications like neuropathy (nerve damage in your hands and feet), retinopathy (nerve damage in your eyes, risking blindness), nephropathy (nerve damage in your kidneys), and severe infection in any part of your body that requires healing.

For instance, a small cut on your toe could become infected due to high blood sugars, struggle to heal, and become severe enough that the infection could lead to an amputation.

The general guidelines from the American Diabetes Association recommend an A1c at or below 7.0 percent for the best prevention of diabetes complications. Your risk of developing a diabetes complication continues to drop as your A1c drops closer to 6 percent.

Some people with diabetes aim for A1c levels in the 5s and lower — especially those who follow strict low-carb diets like the ketogenic diet and the Bernstein diet. However, this hasn’t been proven in research as especially necessary, nor is it reasonably achievable for the larger population of people with diabetes.

Denis recalls that important to remember that your blood sugar levels and your A1c are just information that tells you whether your body needs more or less of factors like insulin, other diabetes medications, changes in your nutrition, and changes in your exercise.

If you don’t like the number you’re seeing on your glucose meter or your A1c results, use that number as motivation to make changes (with the support of your diabetes healthcare team) in how you safely manage your diabetes in order to get different results.

Denis Slinkin FBS

Determining the right A1c goal for you

Just because a normal blood sugar range of 70 to 130 mg/dL is considered the healthiest doesn’t necessarily mean that’s the appropriate goal range for you — especially if you have type 1 diabetes, or take insulin as a person with type 2 diabetes.

The reason this may not be the right goal for you is that extremely tight blood sugar management in people taking insulin can potentially lead to frequent low blood sugars — which can be dangerous.

Achieving extremely tight blood sugar management, like a range of 70 to 130 mg/dL, also often requires a strict nutrition plan, more frequent than usual blood sugar monitoring, precise medication management, and most importantly, years of experience studying your own blood sugar levels.

A1c goals should be individualized 

“A1c goals should be individualized based on the individual capabilities, risks, and prior experiences,” explains Gary Scheiner, MS, CDE, founder of Integrated Diabetes, and author of Think Like a Pancreas.

“For example, we generally aim for very tight A1c levels during pregnancy and more conservative targets in young children and the elderly.”

However, Scheiner and Slinkin highlights important factors that could justify aiming for a higher A1c, like “hypoglycemia unawareness,” which is described as when a person with diabetes no longer feels the oncoming warning signs of low blood sugar. This can put you at significant risk for severe low blood sugars resulting seizures or death. To reduce that risk, you would aim for higher target blood sugar ranges.

“Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively,” adds Scheiner. “And certainly, someone who has been running A1c’s in double digits [like 10 percent or higher] for quite some time should not be targeting an A1c of 6%… better to set modest, realistic, achievable goals.”

Learn how to lower your A1c in DiabetesStrong’s A1C Guide.

Your blood sugar isn’t just because of what you eat

Mainstream media would have you believe that your blood sugar levels are impacted only by what you eat and how much you exercise, but people with type 1 and type 2 diabetes who test their blood sugars frequently could tell you otherwise.

It’s especially important to keep this mind when looking at your own blood sugars and your goals because there are certain variables and challenges that impact blood sugar levels that you can’t always control.

For example:

  • Menstrual cycles: raises blood sugar and insulin needs
  • Adrenaline rushes from competitive sports, heated arguments, rollercoaster rides: raises blood sugar and insulin needs
  • The common cold and other illnesses: usually raises blood sugar and insulin needs
  • Hormonal changes due to puberty and healthy growth in young adults: raises blood sugar and insulin needs
  • An injury which raises overall inflammation levels: raises blood sugar and insulin needs
  • Glucogenesis during anaerobic exercise: raises blood sugar

While you can’t necessarily prevent these factors that affect your blood sugar from occurring, you can work with your diabetes healthcare team to adjust your insulin, other diabetes medications, nutrition and activity levels to help compensate for them when they do occur.

For example, when engaging in anaerobic exercise — like weightlifting — many people with type 1 diabetes find it necessary to take a small bolus of insulin prior to or during their workout because anaerobic exercise can actually raise blood sugar.

Learn more about exercising with diabetes in DiabetesStrong’s Fit with Diabetes ebook.

Still frustrated with your blood sugar and A1c results?

Your FBS and your insulin or medication needs never stay in one place. If you gain weight or lose weight, your insulin and medication needs will change. If you become more active or less active, your needs will change. If you make drastic or even small changes to your nutrition, your needs will change!

Working with your diabetes healthcare team, and diabetes coaches who can teach you how to make changes in your overall diabetes management plan are essential. Diabetes is a lifelong learning process.

Take a deep breath and be patient. If you don’t like what you’re seeing on your glucose meter, don’t get mad…get studying! Take good notes and work with your team to make changes to reach your goals.

Read more about improving your A1c in DiabetesStrong’s guide, How to Lower Your A1c.

If you liked this guide to normal blood sugar levels, please sign up for our newsletter (and get a sign-up bonus) using the form below. We send out a weekly newsletter with the latest posts and recipes from Diabetes Strong.

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Appendicitis Symptoms

Before we describe Appendicitis symptoms, it is necessary to explain what this condition actually is. So let’s say something about Appendicitis first.

Appendicitis is a medical name for appendix inflammation. This condition is rather severe and may cause serious health complications and problems, so it requires immediate intervention. When the inflammation occurs, sometimes it calls for emergency measures such as removal of the appendix. If left untreated, this condition may even cause death.

If detected on time, a patient has a chance to treat it and thus his chances to heal the inflammation are higher. If the inflammation is very severe the problem can still be solved by the appendix removal. That is why it is extremely important to know about the symptoms.

It is the only way to detect it before it is too late. So learn about the appendicitis symptoms right now.


The first symptom is usually an abdominal pain. At first it is not localized and the patient has a feeling like his whole stomach is in pain. After some time (usually in about six hours) the pain becomes more localized and the patient feels it in the right side. Now, the appendix position varies, which makes the whole problem even more difficult. In case that the appendix is normally positioned, the pain is situated within the right iliac region. If the appendix is positioned higher, the pain follows it and the patient feels it beneath his right rib.

You get the picture how difficult it can be to determine what really hurts you, since the appendix can be positioned higher or lower, depending on a person. Some might ask: “Well, how will I know if it is appendicitis?” If the pain is strong, constant and lasts for more than five hours, call your doctor. It does not mean that you actually have appendicitis, but do not wait for too long because in case you do have it, it can really harm you in a short time.

Sometimes the pain is accompanied by a fever or nausea. It may worsen when you cough or move. A patient may experience a pain in the back, constipation and fever. His stomach may get swollen and painful to touch.

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Appendicitis Symptoms

Before we describe Appendicitis symptoms, it is necessary to explain what this condition actually is. So let’s say something about Appendicitis first.

Appendicitis is a medical name for appendix inflammation. This condition is rather severe and may cause serious health complications and problems, so it requires immediate intervention. When the inflammation occurs, sometimes it calls for emergency measures such as removal of the appendix. If left untreated, this condition may even cause death.

If detected on time, a patient has a chance to treat it and thus his chances to heal the inflammation are higher. If the inflammation is very severe the problem can still be solved by the appendix removal. That is why it is extremely important to know about the symptoms.

It is the only way to detect it before it is too late. So learn about the appendicitis symptoms right now.


The first symptom is usually an abdominal pain. At first it is not localized and the patient has a feeling like his whole stomach is in pain. After some time (usually in about six hours) the pain becomes more localized and the patient feels it in the right side. Now, the appendix position varies, which makes the whole problem even more difficult. In case that the appendix is normally positioned, the pain is situated within the right iliac region. If the appendix is positioned higher, the pain follows it and the patient feels it beneath his right rib.

You get the picture how difficult it can be to determine what really hurts you, since the appendix can be positioned higher or lower, depending on a person. Some might ask: “Well, how will I know if it is appendicitis?” If the pain is strong, constant and lasts for more than five hours, call your doctor. It does not mean that you actually have appendicitis, but do not wait for too long because in case you do have it, it can really harm you in a short time.

Sometimes the pain is accompanied by a fever or nausea. It may worsen when you cough or move. A patient may experience a pain in the back, constipation and fever. His stomach may get swollen and painful to touch.

Categories: Uncategorized

What is Appendicitis

You have probably heard about appendicitis and you must know what the appendix is; here you will find a detailed answer to the question: “What is appendicitis?”

The appendix is a small part of human body which looks like a finger. It is located on the right side of a lower abdomen. What is quite curious about this organ is that even today it is still not well determined what the appendix is actually for. It seems that our body doesn’t even use this organ. Some theories claim that this body part is just a left-over from our ancestors. Some recent researches provide indications that the appendix is needed in our bodies to be a home for bacteria which has an important role in digestion process.

If we put aside these assumptions, it is less important to determine the exact function of this body part; what is more important is to find a way to prevent the problems it may cause and treat them in time. Appendix can (and often does) create serious health problems. Those conditions may even result in death. So keep reading on this issue.

The inflammation of the appendix is a condition known as appendicitis. What happens here is that the appendix turns swollen, painful and quite inflamed. This condition may occur in any group of people no matter how old they are; it can happen to very young kids as well as to old people.

Appendicitis can be diagnosed after the symptoms had occurred. Unfortunately, it seems to be the only way. There is no way to diagnose it before the symptoms occur, which makes it even more difficult and dangerous for the patient. That’s why it is important to react on time as soon as the first symptom occurs. This is another reason why you should learn more about this condition and its symptoms.

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