What is HbA1c and How does it relate to Diabetes?

The diagnosis of diabetes is usually straightforward. Any one of the following tests may be diagnostic for the presence of diabetes:

- If one has a persistently elevated fasting blood sugar (> 126 mg/dl).
- If the non fasting blood sugar is > 200 mg/dL or greater in people with symptoms
- The individual has an abnormal oral glucose tolerance test, with a 2-hour glucose value of 200 mg/dL or greater.

Once the diagnosis of diabetes is made, all individuals undergo other tests to ensure that they have not developed any complications of diabetes. Your doctor may order a glycated Hemoglobin A1C test (HbA1c).

HbA1c is simply hemoglobin which has been attached to glucose molecules. Hemoglobin is found in red blood cells which have a life span of about 8-12 weeks. Normally if the blood glucose levels are normal or well controlled, the sugar does not bind to hemoglobin.

However, if the sugars have been poorly controlled and are high, they get attached to the hemoglobin and this is known as glycation of the hemoglobin molecule. So measuring HbA1c gives an idea how well the glucose levels have been over the long term. The higher the glucose levels, the greater will be the levels of HbA1c. Some patients come to see their physician and tell them that their blood sugars have been great and well controlled. Well, by measuring the HbA1c levels, the physician can immediately tell how well the glucose levels have been over the last 3-4 months.

The test is simple to perform and requires some blood. Results are usually available within an hour. The normal HbA1c ranges from 3.5-5.5%. In diabetes about 6.5%-7% is good.

Measuring HbA1c indicates your average blood sugar level over the past 2-3 months. Generally a target level of HbA1c less than 7% is preferred.

The current guidelines recommend routine screening for type 2 diabetes beginning at age 45, especially if you're overweight. If the results are normal, the test should be repeated every three years. If the results are borderline, the test should be repeated every year.

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Coenzyme Q10 and diabetes Part 2

Another problem with CoQ10 sold in health food stores is that the dose of the supplement is not regulated. It is available in a wide range of concentrations and sold under many generic names. And each product appears to have a different concentration of CoQ10.

There are also reports of contamination of CoQ10 products with various chemicals. Since many of these health supplements are made in the Orient and not well regulated, it is wise for all diabetics to check with their health care provider before they start CoQ10.

For the present, all diabetics should know that CoQ10 is not a substitute for insulin or any of the other oral diabetic medications.

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Diabetes 101

Diabetes is the disorder of the present century. Almost every race and ethic group is affected by it. This chronic disease has been steadily growing in numbers and is posing serious challenges to our health care system. Among all the ethnic groups in North America, Diabetes is more severe and difficult to control in blacks, Latinos and Asians. The number of Americans who have diabetes is close to 7-9 million which is 4 times the number two decades ago. Infact it is estimated that there are close to a million more individuals who have the disorder but do not know about it. The longer these individuals have a delayed diagnosis, the greater are the chances that they will already have developed irreversible complications of the disease.

Type 2 diabetes

Diabetes mellitus is a disorder characterized by high levels of blood glucose. The major problem with type 2 diabetes is that the hormone insulin is either low or not secreted or has problems working at the cellular levels. Insulin is responsible for lowering the blood glucose. When the blood glucose levels stay elevated for prolonged periods, one can develop serious complications including blindness, kidney failure, heart disease and blockage of blood supply to the legs.

The majority of Americans develop type 2 diabetes in their middle ages. This form of diabetes develops because for some unknown reason the body fails to either make enough insulin or fails to secrete insulin. Sometimes the insulin levels are adequate but fail to work. The major treatment of type 2 diabetes is with the use of drugs, diet and/or exercise. These drugs work in a number of ways. Some act to break down the excess sugar, other drugs prevent excess glucose from getting into the body and other drugs stimulate the release of insulin from the pancreas. In many obese individuals, the diabetic drugs fail to work and insulin is required.

Type 1 Diabetes

Type 1 diabetes is also common and affects a significant number of children. In type 1 diabetes, the insulin is never made in the pancreas and the individual presents with diabetes as a child. In most cases, the diabetes will be evident during school age. One needs life long insulin to treat this form of diabetes.

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Insulin Pumps Part 1

For many diabetic individuals, monitoring blood sugar and taking diabetic medications or administering insulin every single day can be a chore. Now scientists have come up with an insulin pump.

The insulin pump delivers a constant amount (basal) rate of insulin 24 hours a day to control your blood sugar. One can program the pump to administer additional doses of insulin after a meal or to correct high levels of sugar.

The insulin pump is about the size of a thin wallet and can be carried on a belt underneath the clothing. A thin plastic tubing from this pump is then tunneled under the skin using a special needle. This tunneled site needs to be rotated every 2-3 days.

The insulin pump needs to be programmed for it to work.

Advantages of an insulin pump include the following:

- The pump controls your blood sugar levels without you having to worry about needles and syringes. Your basal rate is preprogrammed. If you do decide to eat an extra meal or have high sugar, all you have to do is press the button and a supplemental dose of insulin is delivered.

- Instead of giving insulin needle injections 2-6 times a day, you rotate the tubing site every 2-3 days.

- There is less time wastage and you do not need to carry a bunch of syringes and needles wherever you go

- In general, individuals who use the insulin pump have much better control of their blood sugars and hence fewer diabetic complications

- Individuals who use the insulin pump also have fewer incidences of hypoglycemia (low sugar).