Thursday, May 19, 2005

Could you be one of those with Type 2 Diabetes and Don't Know it?

Type 2 diabetes is the most common form of the illness, and experts estimate a third of the people who have it don't know. An additional 41 million have "pre-diabetes," an impaired sugar tolerance that can lead to the full-blown disease. Do you know what your HBA1C is? Type 2 diabetes sneaks up on you, as the body gradually loses its ability to use insulin, a hormone crucial to converting blood sugar into energy. High glucose levels damage blood vessels and nerves -- eventually leading to blindness, kidney failure, amputations of feet and legs and heart disease. Diabetes is the nation's sixth-leading killer.

Tight control of blood sugar, either through diet and exercise alone or with a variety of medications, can prevent that damage. The best measure of control: the A1C test, a way of tracking average blood-sugar levels over two or three months.

AACE, the endocrinologists' group, defines glucose control as an A1C level below 6.5. But 67 percent of Type 2 diabetics aren't meeting that goal, concludes a new AACE analysis.


A normal A1C level is 5. While diabetes specialists differ on whether 6.5 or 7 signals good control, every point-drop lowers the risk of serious complications by 25 percent to 40 percent.

Yet an AACE-commissioned survey of Type 2 diabetics found that 84 percent believed they were doing a good job controlling their blood sugar, even though 61 percent went on to say they didn't know what the A1C test is.
Incredible.

Bottom line - ask your doctor at each visit what your HBA1C is. (It's a simple blood draw that measures your average blood sugar levels over the last 3 months). Much better than a random fasting blood sugar that can miss your problem enitirely. Even better yet, if you've had a few borderline tests from time to time (somewhere in the 110-126 range), do yourself a big favor and get the OGTT (oral glucose tolerance test). You drink a 12 oz bottle of sugary solution after having fasted the night before and then your blood sugar levels are measured hourly. Mine was 300 after 2 hours. Wake up call! Yet, often my fasting blood sugars are near 100 or below. I've found I'm extremely sensitive to carbohydrates and I suspect many other Americans are as well. Any intake of starchy carbs is asking for trouble, so you learn to eat differently and when you fall off the wagon, the HBA1C reminds you that you've been screwing up. I fell off the wagon recently and home tested with an HBA1C kit - 6.7. Not good, considering it used to be in the mid to low 5's. So I've changed my diet and got back on the horse and my morning blood sugars are now around 100 or lower, vs the 120's I had been getting. So my advice - educate yourself and ask to be tested and don't settle for a random fasting stick. It's ok to have that, but ask to be retested an hour or so after you've had a nice big bowl of Rice Krispies. You might be very surprised.

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