What is Diabetes?

The Top Ten Questions About Diabetes

David Mendosa Dec 12, 2012 (updated Jan 10, 2014)
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Here are 10 questions about diabetes frequently asked by HealthCentral visitors and the answers provided by our patient expert David Mendosa.

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What is a normal blood sugar level?
What is a normal blood sugar level?
Q. Serena asks: I wonder what a normal A1C level is?

A.
Most doctors and labs will only say that it’s 6.0 or below. But it’s probably considerably less than than. One study by the NGSP regularly tests people who don’t have diabetes and aren’t obese. The levels for 95 percent of these people range from 4.7 to 5.7. A recent study, this one of young healthy Japanese women of normal weight, showed their average A1C level to be 5.2.

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What does the A1c measure?
What does the A1c measure?
Q. Tom asks: What does an A1C level of 6.9 mean?

A.
For many doctors and diabetes organizations this would mean that you are doing OK. But actually a level of 6.9 means that 6.9 percent of the hemoglobin in your red blood cells has a lot more sugar stuck to them than normally. It means that you have diabetes and aren’t managing it well enough to avoid complications.

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What is the most convenient way to check my A1c?
What is the most convenient way to check my A1c?
Q. Sitaram asks: Can I get my A1c tested at home? What is the best method without having an appointment with a doctor or a lab?

A.
Yes, you can, and I recommend it and do it myself. I use the Bayer A1CNow Self-Check that you can get in just about any pharmacy here. The package of two tests retails for about $30, so each test is about $15. I wrote about this test here
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What’s the point of fingerstick testing?
What’s the point of fingerstick testing?
Q. Liz asks: Why should I subject myself to painful daily fingerstick tests of my blood sugar when our A1c level is what really counts?

A.
When we get our A1C level tested every three months or more, it tells us what our average blood sugar level was. But it doesn’t tell us what we can do when we find out that it’s too high at the moment.


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How can I minimize the pain of fingersticks?
How can I minimize the pain of fingersticks?
Q. Lee asks: I think it’s stupid to hurt myself intentionally by pricking my finger to test with my blood glucose meter. What do you suggest?

A.
The problem isn’t your meter. It’s the lancet that you use to draw blood. The solution is to use the finest or thinnest lancet that you can get. Currently, that is the tiniBoy Lancet. In my experience this is the least painful way we now have to check our blood sugar level.

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Is diabetes progressive?
Is diabetes progressive?
Q. Will Asks: My doctor told me that my diabetes is bound to get worse no matter what I do. Is he right?

A.
Unfortunately, many of our health care people think that diabetes is “a progressive disease.” They mean we will have to take more and more medicine in an effort to forestall the complications of diabetes as long as possible. Usually, they start us on metformin, add one or two more drugs, and eventually put us on insulin.
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What supplements should I take?
What supplements should I take?
Q. Lisa asks: I don't want medications that shake down my pancreas. What herbs do you recommend for diabetes?

A.
Actually, alternative medicine is a medication. They are drugs, but none of them have been tested as well as prescription medicines and almost none of them are standardized. Some supplements as well as some vitamins and minerals can help us manage our diabetes But, I can't recommend any above FDA-approved prescriptions.
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How can I avoid taking diabetes drugs?
How can I avoid taking diabetes drugs?
Q. Bob Asks: I know that you only manage your diabetes by following a very low-carb diet. Is it safe?

A.
When I decided in 2007 that I wanted to stop using any diabetes medication, I knew that the only other way that I could manage my diabetes was with a very low-carb diet,  but I knew it had to be a high-fat diet and I wasn’t convinced that it would be safe. I still follow the diet, and my levels remain as low as they were then.

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What do you eat?
What do you eat?
Q. Jose asks: What do you usually eat on your very low-carbohydrate diet?

A.
Essentially, my diet is to eat no more than about 50 or 60 grams of carbohydrate per day.





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What do you drink?
What do you drink?
Q. Jose ask: I know that you must drink a lot of water. But what else? What about alcohol?

A. I do like water, particularly if it is cold and filtered. I especially like it carbonated. During the day I drink tea or stevia-sweetened lemonade. I do sometimes have a shot of single malt Scotch whiskey after dinner and occasionally a glass of wine with dinner.