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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The Times on Type 2 Diabetes Part 2 of 2 Blood Sugar and Heart Disease Gina Kolata's recent story on diabetes in the New York Times is attempting to correct some common misconceptions about diabetes. In my previous post on this blog , I commented on her point that it's wrong to blame patients for their disease because it has a strong genetic component, and focusing on weight loss alone is not the answer. Another point that Kolata emphasizes is that it's not just blood sugar control that is important in diabetes. Most people with diabetes die from heart disease , so patients need to control their cardiovascular risk factors as well. These include blood pressure and cholesterol levels. I agree. But this idea is not new. The American Diabetes Association has had a campaign since the turn of the century for people to learn their "Diabetes ABCs," or A1c levels, blood pressure, and cholesterol levels. But again, apparently no one was listening.
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