David Mendosa recently posted a blog about " glycemic variability ." Most people have come to expect that their diabetes control is primarily evaluated by the hb A1C level. Indeed, the hb A1c is correlated with a three-month estimated average glucose level, which is very helpful to know in terms of the effectiveness in medical (insulin or oral) therapy. However, what is less often discussed is the importance of glycemic variability: the ups and downs of glucose values that occur naturally and as a result of medication. How does glycemic variability play a role in the management of diabetes? The latest information to date indicates that glycemic variability is extremely crucial in blood vessel inflammation and in physical/emotional well-being. The rate of those glucose excursions (highs and lows) profoundly effect how one feels emotionally, physically, and now cognitively, according to a recent article in Diabetes Care (a journal associated with the American Diabetes Association) .
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uncontrolled high blood pressure
Before using this medication, tell your doctor or
pharmacist your medical history, especially of:
high blood pressure (treated/controlled)
blood disorders (e.g., sickle cell anemia, white blood cell
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At every visit, patients ask "how did I do?" or "what is the hb A1c result?" High blood pressure and pulse rates are recorded prior to learning the results of the hb A1c. Families are incredibly anxious that the hb A1c will (or will not) accurately reflect the past 3 to 4 months of blood sugar readings. Most view the hb A1c as a grade that determines just how well they have managed their diabetes control between visits. I often hold my breath, hoping that my young patient has improved his/her hb A1c, because the visit has the potential to be a "downer" if they have not.
Much has already been written about how the hb A1c helps us to determine diabetes control. The hb A1c (or glycosolated hemoglobin) is a reflection of the amount of glucose that adheres to the hemoglobin molecule. There is a direct correlation--the higher the blood glucose concentration, the higher the hb A1c. The hemoglobin molecule resides in the red blood cell circulating throughout the bloodstream. Because re...
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