What is A1c Test?

In your the body sugar sticks, particularly to proteins. The red blood cells that circulate in the body live for about 3 months before they die off. When sugar sticks to these cells, it gives us an idea of how much sugar is around for the preceding 3 months. In most labs, the normal range is 4-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it’s less than 7.0%. The benefits of measuring A1c is that is gives a more reasonable view of what’s happening over the course of time, and the value does not bounce as much as finger stick blood sugar measurements.

Although there are no guidelines to use A1c as a screening tool, it gives the physician a good idea that someone is diabetic if the value is elevated. Right now, it is used as a standard tool to determine blood sugar control in patients known to have diabetes. The American Diabetes Association currently recommends an A1c goal of less than 7.0%.

Studies have shown that there is a 10% decrease in relative risk for every 1 % eduction in A1c. So, if a patients starts off with an A1c of 10.7 and drops to 8.2, though there are not yet at goal, they have managed to decrease their risk of microvascular complications by about 20%. The closer to normal the A1c, the lower the absolute risk for microvascular complications.

Benefits of Controlled Blood Glucose Levels

The findings from a Veterans Affairs Diabetes Trial have showed that lowering blood sugar levels to near normal through intensive treatment may reduce the risk of cardiovascular disease and heart attacks for Type 2 diabetics, but only if treatment is begun relatively soon after diagnosis and if severe episodes of low blood sugar can be avoided. Data from three studies were presented over the weekend at a San Francisco meeting of the American Diabetes Assn., and although many questions remain unanswered, some generalizations are becoming possible.

All three studies suggest that the greatest reduction in the risk of heart attacks and cardiovascular disease is achieved by lowering cholesterol levels and by controlling high blood pressure. Controlling glucose can at best provide only a small further reduction in risk that may take many years to become apparent. But that does not mean that control of blood glucose levels is not a good idea.

Data from two of the studies confirmed that such control reduces the risk of kidney and eye disease, also complications of diabetes. New data from the VA study also show that severe hypoglycemic events should be avoided at all costs. And finally, data from the three studies may ease concerns about the oral diabetes drug rosiglitazone. An analysis last year of many previous studies suggested that the drug, sold under the brand name Avandia, increases the risk of heart attacks and death. But the new studies showed no such effects from the drug, which is still in wide use

What is Pre-diabetes?

Pre-diabetes means that the cells in your body are becoming resistant to insulin and your blood glucose levels are higher than they should be. Since the levels aren’t as high as they would be if you had Type 2 diabetes, the term “pre-diabetes” is used. Your doctor may also call this condition “impaired fasting glucose” or “impaired glucose tolerance. According to the Center of Disease Control and Prevention, 41 million adult Americans between the ages of 40 and 74 have pre-diabetes.

There are several risk factors. The risk factors are the same for pre-diabetes as they are for Type 2 diabetes. Some of them are being overweight or obese, having a sedentary lifestyle, family history, age, or having a previous diagnosis of gestational diabetes.

Often there are no signs or symptoms for pre-diabetes. Many times it is discovered during a routine physical with basic screening for fasting blood glucose levels. The normal level is below 100 mg/dl. If it’s 100 to 125 mg/dl, this indicates that you have impaired fasting glucose or pre-diabetes. Over 126 mg/dl most likely means a diagnosis of Type 2 diabetes.

If you are diagnosed with pre-diabetes, it will put you at a higher risk for Type 2 diabetes in the future. But it doesn’t have to mean that you will get Type 2 diabetes. A healthy lifestyle change can lower your risk and improve the way your body uses insulin. A low fat diet and calories can help you lose weight. The less fat and more muscle you have, the less resistant to insulin you will be. Exercising regularly not only helps you to lose weight, but also help lower your blood glucose level by using glucose as energy.

Vitamin D Linked to Developing Diabetes?

A report in the Archives of Disease in Childhood says there are a number of clues suggesting a link between low vitamin D  Zipitis of Stockport National Health Service Foundation Trust and Dr. A. K. Akobeng of Booth Hall Children’s Hospital have reviewed all published research on vitamin D supplementation and diabetes risk. Overall, they found, infants who were supplemented with Vitamin D were 29 percent less likely to develop type 1 diabetes than children who had not received supplements.

Proper clinical trials are required to determine the optimal dose and formulation of vitamin D, as well as when and for how long children should be given the supplements, Zipitis and Akobeng conclude. In the meantime, Zipitis said, “I would advise parents to encourage their pediatricians to prescribe vitamin D supplements for their infants. However, parents can also obtain these over the counter and provided they are used as per manufacturer instructions they should be extremely safe to use.”

Insulin Pump and Skin Problems

Insulin pumps are popular with children and teens, it helps them control type 1 diabetes. It has been reported that many of them have experienced skin problems at the infusion catheter insertion site. Although, few report thinking about stopping insulin pump therapy because of these problems.Insulin pump therapy has several advantages over insulin shots, including better control of glucose metabolism, Dr. Louise S. Conwell and colleagues from the Hospital for Sick Children in Toronto and colleagues note in The Journal of Pediatrics this month. “Over the years, studies have suggested that both injections and insulin pumps may cause dermatologic problems”, they add. “In the early days of insulin pump therapy, many patients developed infection and inflammation at the catheter site, but no study has looked at these complications in patients using modern pumps and rapid-acting insulin-like drugs.”

Conwell and colleagues surveyed 50 patients with type 1 diabetes who had used insulin pumps for longer than 6 months. 94 percent have reported scars smaller than 3 millimeters in diameter, two-thirds had swelling, just under two-thirds had lesions under the skin, and 42 percent had fat lumps under the skin.

The researchers reported that the thinner the patient, the more likely he or she was to have dermatologic complications of insulin pump use. Although, there was no relationship between long-term blood sugar control and risk of skin problems. Only 4 percent of parents and 2.4 percent of patients said they considered stopping insulin pump therapy because of related skin problems.

Tour de Cure to Benefit Diabetes Research

Tour de Cure is a fund-raising event to benefit the American Diabetes Association. It is held in 40 states nationwide. The Tour is a ride not a race. It has routes designed for everyone from the occasional rider to the experienced cyclist. No matter how far you ride there will be a route supported from start to finish with rest stops, food to fuel the journey and fans to cheer you all the way.

Every cyclist has their own reason for riding that drives them to the finish line. Maybe you have a family member or other loved one with diabetes, or maybe you have diabetes yourself. Some participants join because they love the thrill of riding with so many other cyclists on a great route. Others join because it’s a good excuse to dust off the bike and ride with the family.

Last year, more than 32,000 cyclists in 78 Tour events raised nearly $13 million to support the mission of the ADA: to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Participants this year are attempting to raise money to support research for a cure for diabetes. More than 33,000 other cyclists and volunteers are expected at more than 80 sites throughout the nation this spring. To register or volunteer, call the American Diabetes Association at (888) DIABETES or go to http://www.diabetes.org/tour.

Broncos Quarterback Jay Cutler Has Diabetes

Denver Broncos quarterback Jay Cutler has been diagnosed with Type 1 diabetes, his business manager Marty Garafalo confirmed. Cutler, who is 25-years-old will need daily insulin injections. Garafalo said that Cutler was managing his disease and “in no way is his football career jeopardized.”The 6-foot-3, 233-pound Cutler was taken by the Broncos with the 11th overall pick of the 2006 draft, becoming the first Vanderbilt player taken in the first round since 1986. Cutler, entering his third NFL season, threw for 3,497 yards and 20 touchdowns last season after supplanting Jake Plummer with five weeks left in the 2006 season.

“It’s something that he’s dealing with and something a lot of other people have,” Garafalo said. “Even though it’s a serious condition, it’s a condition that can be managed. That’s the way he’s treating it right now. “Everything’s fine,” Garafalo continued. “His condition is fine.”

There are many other athletes who have competed with diabetes include Hockey Hall of Famer Bobby Clarke, Charlotte Bobcats forward Adam Morrison, golfers Scott Verplank, Michelle McGann and Kelli Kuehne and Olympic swimmer Gary Hall Jr.

Diabetes and Exercise

Exercise is required to maintain a healthy lifestyle. Although, making time to go the gym or going for a run can be difficult for us to fit into our schedule. People with type 1 diabetes have other things that can prevent them from being able to exercise. Managing type 1 diabetes often requires several insulin injections or adjustments of an insulin pump, taking up to 10 blood samples a day. Exercise lowers blood sugar level and helps improve the body’s use of insulin. This is great for most of us, but diabetics often need to reduce their insulin dose before exercising. That not all! During exercise, maintaining normal blood glucose levels is also critical because too much insulin can lead to hypoglycemia and too little can cause hyperglycemia.

This is like a lot to keep track of, especially for someone already focusing on a particular exercise or physical activity at hand. Dr. Alan Marcus says, “Since diabetes affects everyone differently, it’s important for people to understand how daily activities such as work, sleep, eating and exercise affect their diabetes management.”

Exercise is a vital part of our life and it has many benefits too. “The data show that regular moderate exercise increases your ability to battle the effects of disease,” says Marilyn Moffat, a professor of physical therapy at New York University. “It has a positive effect on both physical and mental well-being. The goal is to do as much physical activity as your body lets you do, and rest when you need to rest.”

If you have type 1 diabetes and are not exercising now, talk to your doctor about how to get started. Over time, a sense of accomplishment, better sleep, less pain and enhanced satisfaction with life can become further reasons to pursue physical activity!

Researching Ways To Treat Diabetes

New findings may help in efforts to develop ways to treat type 1 diabetes. An estimated 1 million to 2 million Americans have type 1 diabetes, according to the American Diabetes Association. Scientists at Washington University School of Medicine in St. Louis have been studying immune cells thought to be responsible for type 1 diabetes.

They are using diabetic mice in their research. The scientists found dendritic cells in insulin-making structures in the pancreas called the islets of Langerhans and observed them carrying insulin and fragments of insulin-producing cells known as beta cells. This can be the initial step toward the start of a misdirected immune system attack that destroys the beta cells and prevents the production of insulin, resulting in type 1 diabetes.

“Now that we’ve isolated dendritic cells from the pancreas, we can look at why they get into the pancreas and determine which of the materials that they pick up are most critical to causing this form of diabetes. That may allow us to find ways to inhibit dendritic cell function in order to block the disorder,” study senior author Dr. Emil R. Unanue, a professor of pathology, said in a prepared statement.

Diabetes and Oral Health

People with diabetes are more prone to peritonitis, tooth decay, oral fungal infections, taste diminishment, gingivitis and delayed healing time than people without the disease, according to the American Dental Association (ADA). This is because uncontrolled blood sugar levels can cause and worsen those symptoms and conditions. According to the ADA, sugary and starchy foods contribute to high glucose levels in saliva, which can wear down tooth enamel, causing decay and cavities. 

Unfortunately, poor oral health can make your diabetes more difficult to control. Infections can cause your blood sugar to rise and require more insulin to keep it under control.

There are things you can do to have good oral health. You should see your dentist at least twice a year. Make sure your dentist knows that you have diabetes. Brush your teeth twice a day. It is recommended to use a soft nylon toothbrush and always brush the upper surface of your tongue. Floss everyday. Always look for early signs of gum disease, such as bleeding gums, redness, or swelling. If you notice any of these things call your dentist right away.

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