In a study involving over 11,000 people with no history of diabetes, hemoglobin A1c test more accurately determined who would develop the disease compared with glucose testing, which measures blood sugar levels at a point in the time.

The A1c test was also able to better predict the risk of stroke (CVA), heart disease and death from diabetes, the researchers report in the New England Journal of Medicine.

The team found that people who had A1c levels of 6 percent or more were at greater risk of developing diabetes.

“The A1c has significant advantages over blood glucose test,” said Dr. Elizabeth Selvin from Johns Hopkins University in Baltimore and leader of the study.

The blood sugar levels can vary from day to day and from hour to hour.

The A1c test is more reliable, repeatable and allows doctors to follow the average glucose levels over time. The quantities are not affected by stress and disease and patients do not have to fast before the test, as with glucose, the researchers said.

In January, the American Diabetes Association recommended A1C test to control the disease and to identify people who may be at risk of developing it.

In the study, Selvin’s team examined blood samples from 11,092 middle-aged adults without diabetes whites and blacks, drawn between 1990 and 1992.

The researchers compared the A1c test with fasting glucose to identify those most at risk for diabetes, heart disease and stroke and die.

During the 15 years of follow up, 2251 people were diagnosed with diabetes, 1198 were heart disease, 358 stroke and died 1447, the team said.

Doctors think that it is normal to have A1C levels between 5 and 5.5 percent. With each increase, the researchers found that increased the incidence of diabetes.

Persons with levels between 6 and 6.5 percent were nine times more likely than those within the normal range to develop the disease.

According to the study, currently there are 9 million Americans with undiagnosed diabetes.

Diabetes occurs when the body becomes unable to use insulin effectively. The blood sugar levels rise, leading to complications such as heart disease, blindness and kidney failure.

About 24 million Americans have diabetes, according to the Centers for Disease Control and Prevention (CDC for its acronym in English).

The disease costs the United States about 132,000 million dollars a year on disability, lost productivity and premature deaths.

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The message to the general population is to maintain fitness in old age would have important implications and preserve life and function (muscle).

The expert said the study, published in BMJ, also suggests that a test of walking speed can know better the health status of older patients.

Previous studies have associated the slow gait with an increased risk of death in a given period, as well as to falls and other adverse health consequences, but none had shown the highest risk if the concentrated heart disease or other cause .

The investigation of five-year, part of the trial of Inserm called Three City Study, included more than 3,200 men and women with relatively good physical fitness, between 65 and 85 years who resided in three cities in France.

At baseline in 1999, the team used questionnaires and interviews in person to evaluate the health of each participant. Then, clocked the speed of each participant to walk as fast as possible without running, in a corridor.

In five years, 209 participants died (mostly from cancer, followed by heart disease and infectious diseases course and other causes), the mortality rate was 7 percent.

In the third who had walked more slowly (5.4 km/h or less for men and 4.8 km/h for women), the mortality rate was 44 percent higher than the two thirds of participants who had walked faster.

Mortality from myocardial infarction, cerebrovascular accident (CVA) and associated causes was 2.9 times more common in the slowest third of participants than among the fastest two thirds.

The increase in mortality from heart disease was seen in men and women was not associated with age or physical activity of participants.

There was no relationship between walking speed and other causes of death, including cancer.

What, then, what explains the relationship between walking and slow death from heart disease?

One possibility, is that the same risk factors that increase the risk of developing the disease, like high blood pressure and diabetes, also produce “silent stroke”, which prevent walking fast. That idea “deserves further studies to confirm it.

In a related editorial, Drs H. Rowan Harwood, Queen’s Medical Center in Nottingham, England, and Simon P. Conroy, University of Leicester, also in England, wrote that the loss of walking speed problems may appear in different organ systems, from the bones, muscles and lungs to the brain.

Some of these systems are linked through vascular disorders and smoking.

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