All Posts tagged HgbA1c

Why sugar makes you go blind. 

Here’s an interesting study looking at the prevalence of diabetic retinopathy in patients across the spectrum of blood sugar control.  It showed that individuals with a Hgb A1c greater than 5.5% have the biggest increase in retina damage due to sugar exposure.  A Hgb A1c of 5.5% is equivalent to an average blood sugar of 111 mg/dL.  For reference, diabetes is diagnosed when a fasting blood sugar is 126 mg/dL on two occasions.  That means that individuals who have not been diagnosed with diabetes may already have retina damage from high blood sugars.

Now is the time to change.  Call our office at 539-0270 to schedule an appointment with our Nutrition Counselors and take control of your blood sugar.  Save your vision!

Association of A1C and Fasting Plasma Glucose Levels With Diabetic Retinopathy Prevalence in the U.S. Population

Implications for diabetes diagnostic thresholds

OBJECTIVE To examine the association of A1C levels and fasting plasma glucose (FPG) with diabetic retinopathy in the U.S. population and to compare the ability of the two glycemic measures to discriminate between people with and without retinopathy.
RESEARCH DESIGN AND METHODS This study included 1,066 individuals aged ≥40 years from the 2005–2006 National Health and Nutrition Examination Survey. A1C, FPG, and 45° color digital retinal images were assessed. Retinopathy was defined as a level ≥14 on the Early Treatment Diabetic Retinopathy Study severity scale. We used join point regression to identify linear inflections of prevalence of retinopathy in the association between A1C and FPG.

RESULTS The overall prevalence of retinopathy was 11%, which is appreciably lower than the prevalence in people with diagnosed diabetes (36%). There was a sharp increase in retinopathy prevalence in those with A1C ≥5.5% or FPG ≥5.8 mmol/l. After excluding 144 people using hypoglycemic medication, the change points for the greatest increase in retinopathy prevalence were A1C 5.5% and FPG 7.0 mmol/l. The coefficients of variation were 15.6 for A1C and 28.8 for FPG. Based on the areas under the receiver operating characteristic curves, A1C was a stronger discriminator of retinopathy (0.71 [95% CI 0.66–0.76]) than FPG (0.65 [0.60 – 0.70], P for difference = 0.009).

CONCLUSIONS The steepest increase in retinopathy prevalence occurs among individuals with A1C ≥5.5% and FPG ≥5.8 mmol/l. A1C discriminates prevalence of retinopathy better than FPG.

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Do know you know your blood sugar past, present, and future?

“Those who cannot remember the past are doomed to repeat it.”
-George Santayana, Life of Reason, Vol 1, Reason in Common Sense

Understanding where we are and where we’ve been helps us understand where we are going.  We use three blood tests to help people understand their past, present, and future as it relates to blood sugar disorders like diabetes.

The three tests are Hgb A1c, glucose, and insulin.

Hgb A1c: This is a test that measures the average blood sugar over the last three months.  It takes into account everything you’ve eaten, done, or experienced during that time that might alter your blood glucose.  It often runs higher than people expect but it helps take into account the effect of food on the body.  Diabetes can be diagnosed when this number gets to 6.5%.  Healthy values would be less than 5.5% or even lower.

Glucose: This is a measure of the amount of glucose floating around in the blood stream at any point in time.  It is simply a snap shot of what is going on.  Typically this is done fasting so as to assess the ability of your body to get back to normal when we stop letting our food choices get in the way.  Generally a level above 100 mg/dL is too high.  When it gets above 125 mg/dL we call that diabetes.  A non-fasting glucose show you how your body may be reacting to a high sugar meal too.  A non fasting glucose above 150ish ought to give you pause and make you rethink what you had to eat.

Insulin: This a measure of the work the pancreas is doing to get your blood glucose to its current level.  It helps us understand whether that job is easy or hard.  For instance if you have a normal blood glucose but a very high insulin level that means your pancreas is working extremely hard to maintain that normal glucose.  Your pancreas can’t do that forever and will wear out sooner than you might want.  When the pancreas fails the blood sugar starts to rise.  It is estimated that by the time your blood glucose rises above 100 mg/dL one half of your pancreas has already died off.  A high insulin level is a strong indicator that change needs to happen to prevent the damage of diabetes.

So if you want to know the past, present, and future of your body’s blood sugar come in and talk to us about these three tests.

-mbm

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