New Way to Control Glycemic Variability

David Mendosa Living With It Medical Journalist Living with Diabetes and Author of Fitness and Photography for Fun, www.mendosa.com/fitnessblog After earning a B.A. with honors from the University of California,... Send Message Subscribe: David Mendosa

Wednesday, June 10, 2009
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The A1C is certainly the gold standard to see how well we are controlling our diabetes. But even gold isn't good enough for us. The A1C doesn't show our glycemic variability. For those of us who have our blood glucose levels under reasonably good control, our glycemic excursions are even more imp...

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interpreting Glycomark results
Karen LaVine
Wednesday, June 10, 2009 at 06:21 PM

Thanks, as always, for the helpful information David. Did the endocrinologists you interviewed give you any parameters they are using re: interpreting the results? If a glycomark test result is elevated, how soon should it be rechecked?

re: interpreting Glycomark results
David Mendosa
Wednesday, June 10, 2009 at 06:34 PM

Dear Karen,

Excellent questions -- as usual! None of the endos mentioned testing more often than they test A1C. But one of the doctors told me that if his patient had considerable glycemic variability, he would put him on insulin right away.

Best regards,

David

This makes sense.
gail
Wednesday, June 10, 2009 at 10:27 PM

At my last appt. I told the doc I was experiencing some high swings that last much longer than the 2 hrs recommended. My A1c is hanging around 6.3 for six months now so he doesn't want to adjust it yet. I know it's in good part under control because I get in exercise but still, I don't like seeing a 180+ 3 hours after supper.

Limitations
Gretchen Becker
Thursday, June 11, 2009 at 08:36 AM

People with extremely good control should know that the Glycomark test only works when your BG levels go high enough that you're spilling glucose in the urine. This is usually around 180 mg/dL, but some people have lower or higher renal thresholds.

The reason is that the test involves competition between glucose concentrations in the renal tubules and the compound that is being measured.

re: Limitations
Doris J Dickson
Wednesday, July 01, 2009 at 10:31 AM

Are you kidding? That's useless. As a tight tolerance person my target is 85 - before, during and after meals. In fact, I don't eat carbs if I'm higher than 110 period. I fix it first.

180 makes me sick as a dog - headache, nausea, fatigue or hyperactivity, etc. And I test my blood sugar 15 times a day so the last thing I need is something that tells me I hit 180.

I'm saddened that so many diabetics are that high so often and many think it is OK. Thanks for filling in the blank on this product.

Doris J. Dickson

re: Limitations
Leaking Ink
Wednesday, July 01, 2009 at 11:26 PM

Thank you, Gretchen for the info. That is quite helpful to know.

Not worth it for me.

Untitled Comment
Doris J Dickson
Wednesday, July 01, 2009 at 10:26 AM

Hi David ... what about those of us in the 5.0 ball park? I/we still have plenty of excursions (claim no perfection) but this test would still be very valuable? Is it accurate for my/this group? Do you know?

Thanks.

Doris J. Dickson

re: Untitled Comment
David Mendosa
Wednesday, July 01, 2009 at 01:40 PM

Dear Doris,

I would certainly be accurate enough. But the experts tell me that in your well-controlled range it probably wouldn't help you enough to get the test.

Best regards,

David

re: re: Untitled Comment
David Mendosa
Wednesday, July 01, 2009 at 01:41 PM

Dear Doris,

I mean, of course that "it" would be accurate enough. "I" probably wouldn't be!

David

re: re: Untitled Comment
Doris J Dickson
Wednesday, July 01, 2009 at 01:45 PM

Thanks for looking into it David.

From a financial reference point (and I realize labs vary) but do you know how much an uninsured person would pay for this test?

Thanks again.

Doris J. Dickson

re: re: re: Untitled Comment
David Mendosa
Wednesday, July 01, 2009 at 02:10 PM

Dear Doris,

Sorry, but I wouldn't know. You can call your local lab and ask them what they charge. That's what I would do!

Best regards,

David