Imagine that your last hemoglobin A1c result was 5.9. Now it's time for a new test, and the results show that your A1c is 6.1. Does this mean your control has gotten a lot worse?
We have to remember that all these lab tests we get are subject to all kinds of errors. First, they're performed by human beings, and all human beings occasionally make mistakes.
When I was first diagnosed, my hemoglobin A1 (the old test that didn't break down into A1c) was 16. This was equivalent to an A1c of about 13. Obviously not good! I was put on metformin and given the standard dietary advice.
I drastically reduced my food intake, especially starches and sugars, went back for another test in several weeks, and then saw my doctor. He said my A1 hadn't changed. I told him that was impossible. "If it had gone from 16 to 14, I'd believe you, but it's impossible that it hasn't changed when I've changed my diet so much ( read more about dietary changes for diabetes here) . My fastings ...
Don’t go from the nourishment of nuts to chowing down on carbs. That’s the opposite of what I mean by the title of this article. I mean to suggest that substituting nuts in your diet for some of your carbs makes sense. A study that will appear in the August issue of Diabetes Care, a professional journal of the American Diabetes Association, shows that eating nuts every day can help us manage our type 2 diabetes and prevent its complications. This research reports that eating just two ounces of nuts as a replacement for carbohydrates proved effective in managing our blood glucose and lipid levels. Dr. Cyril W.C. Kendall of the University of Toronto, who is the corresponding author, sent me the full-text of the study, “Nuts as a Replacement for Carbohydrates in the Diabetic Diet.” The abstract of the study is online . The lead author of the study is Dr. David J.A. Jenkins. That name is what brought the study to my attention because he created the most powerful tool t...
Some people think that when it comes to diabetic complications, the only thing that matters is your hemoglobin A1c level (A1c) . This is the test that is supposed to measure your average blood glucose (BG) level over the past several months.
High BG levels form what are called advanced glycation end products, or AGEs, and these long-lived products seem to gum up the works and cause diabetic complications, as well as normal aging.
Because it's an average, you can get the same A1c result if you have a constant BG level of 100 mg/dL (an unlikely event, but I'm using it to simplify), or if you spend half your time at 50 and half your time at 150 mg/dL. Because most studies of complication rates, for example the famous Diabetes Control Complications and Trial (DCCT), use only the A1c as a measure of control, many people think that's all that matters.
In fact, that's not true at all. Since then, some studies have suggested that the amount of glucose variability is as important as, or more im...
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