Author Archive for Pat F. Bass III, MD, MS, MPH

5 Super Foods That Should Be On Your Diabetic Food List

Have you ever wondered what foods should be on your diabetic food list?

Ideally these foods will have a low glycemic index, while providing the nutrients you need. Glycemic index (GI) looks at the impact of a food on your blood sugar. Foods are characterized as having a low, medium or high GI. When you eat a diet with a low glycemic index, you will hopefully get improved diabetes control.

Beans

Eating beans daily may just improve your A1c. A study published in JAMA internal Medicine demonstrated that patients consuming at least a cup of beans daily for 3 months reduce A1c levels by half a point and even decreased cardiovascular risk through lowering of blood pressure.

Low GI foods like beans are digested slowly and raise blood sugar levels slowly. High GI foods (think rice, potatoes and other starches) do just the opposite. Alternatively, the benefit may be due to high fiber rather than the low GI. Either way, other than being a little gassy, eating beans may improve your diabetes control and certainly will not hurt.

Berries

Berries are high in fiber, vitamin c, and folic acid. It does not really matter what kind. Blueberries, strawberries or others are all packed with benefits and are low in carbohydrates (also a low GI). Investigators in another study found that patients taking foods with a high flavonoid content (e.g berries along with chocolate and wine) had lower insulin resistance, improved regulation of blood sugar, and lower levels of inflammation. What is not clear from the current research is exactly how much, how often, or in what proportion berries and other foods containing flavonoids should be consumed for optimal glycemic management. For now it seems reasonable to to include berries as part of a well balanced diet.

Tomatoes

One of my favorite things about growing up in New Orleans were the thick meaty juicy red tomatoes that you can get there every summer. Tomatoes are low carb, low cal and contain the antioxidant lycopene that is thought to protect against both heart disease and prostate cancer. Tomatoes contain vitamin C, vitamin A, potassium, and fiber. Tomatoes also are a very low GI food.

Green, Leafy Vegetables

Like the other foods mentioned, most green, leafy vegetables have a low GI. In a UK study that looked at more than 200,000 people, increasing green leafy vegetable intake by one and a half cups per day reduced the risk of developing type 2 diabetes by 14%. Green leafy vegetables contain not only high levels of antioxidants, but foods such as spinach are also rich in magnesium. These foods have a low GI and are low in calories so you do not need to worry about eating too much.

Nuts

Replacing carbohydrates with nuts has been shown to improve glycemic control in some diabetic patients. The idea is that you substitute a healthy fat for a carbohydrate. Benefits have included not only a reduction in A1c, but also in lipids, a risk factor for heart disease

In the study that demonstrated this benefit, a mixture of unsalted and mostly raw almonds, pistachios, walnuts, pecans, hazelnuts, peanuts, cashews, and macadamias were given to participants.

Many patients will ask me if they can just take supplements of the chemicals that are thought to provide the benefits rather than take in these 5 diabetes super foods. Several clinical trials In the last several years that have taken this approach have not produced favorable results. I think you are much better discussing with your doctor or nutritionist what foods you should be on your diabetic food list and take the real foods rather than a supplement of what we think the beneficial compound is.

I would love to hear your thoughts and comments.

Diabetes Checklist: 8 Tests You Should Have This Year

If you search on the internet for diabetes, you can quickly find a lot to scare you. Rather than get overwhelmed with what could happen, make sure you understand what you can do to prevent your diabetes from getting worse. This know the results of these 8 tests and what to do if they are abnormal will go a long way to preventing diabetes complications. The tests you should have this year include:

  1. A1c. Hemoglobin A1c or HbA1c tells you and your doctor how well your diabetes has been controlled over the last 3 months. Normal is 5% or less. Your doctor will likely ask you to make lifestyle changes or changes to your medication regimen if your A1c is above 7%. Lower A1cs are associated with less complications of the eye, kidney, and nerves.
  2. Blood pressure check. Elevated blood pressure or hypertension has been called the silent killer. Persistent systolic blood pressure greater than 130 mmHg or diastolic blood pressure greater than 80 mmHg is compatible with hypertension. Your blood pressure can be really high and you may not experience any symptoms– so you need to check it regularly. Like diabetes, poorly controlled hypertension can lead to heart disease and stroke. Elevated blood pressure is treated with a combination of lifestyle changes and medication.
  3. Cholesterol check. This will include a blood test checking for both cholesterol and triglycerides and will need to be preformed while fasting. If your cholesterol levels are high, you may need treatment with medication in addition to lifestyle modification. If cholesterol is too high you are at increase risk for heart attack and stroke.
  4. Eye exam. Diabetes is the leading cause of blindness in the U.S. You should have a dilated (the doctor or optometrist will use drops to widen you pupils and better see the back of the eye) eye exam at least yearly. Diabetes can damage the retina (called diabetic retinopathy) and the exam is to look for any early signs of this complication. If diabetic retinopathy is not treated you can lose vision or even become blind.
  5. Foot exam. Diabetes can lead to nerve damage over many years. I am not referring to nerves like anxiety, but the nerves that allow you to feel. The medical term is neuropathy and you basically experience impaired sensation. Patients experiencing nerve damage from diabetes may not be able to feel that they have injured their foot. This can lead to infection and even amputations if not treated appropriately. Your doctor will often assess sensation with a monofilament test at least once per year.
    The doctor will have you close your eyes and say yes when you feel the monofilament on your foot. They will preform the test on several parts of the foot. Additionally, your doctor should inspect your feet for sores at each visit.
  6. Urine for protein. Diabetes is also the leading cause of permanent kidney damage that requires dialysis. This test is looking to see if you are spilling albumin or microalbumin into your urine, which occurs if diabetes has damaged your kidneys. A number of different treatments can slow progression, but it is essential that your diabetes be under good control.
  7. Creatinine. This blood test tells your doctor how well your kidneys are functioning. Creatinine is a waste product normally excreted by the kidney. When the kidneys are damaged and not working, creatinine build up in the blood stream causing the levels to elevate. Your doctor will get this test at least yearly. Again medical treatments are available, but good glucose control is essential.
  8. Oral health assessment. Poor diabetic control is associated with oral complications such as gingivitis (gum disease), periodontitis (extension of gum disease to underlying structure and bone), dry mouth, and oral infections. Your dental health professional can help you prevent and treat any complications of diabetes.

 

Do Diabetes and alcohol Mix?

Have you ever wondered if diabetes and alcohol mix? While I will talk about some generalities, every diabetic may respond to alcohol differently. Some diabetics safely drink alcohol without problems while others have a number of issues. Monitor your diabetes closely and know what alcohol does to your body.

Alcohol and Blood Sugar Control

Alcohol actually has very little effect on overall control of your blood sugar. In general, most diabetics should follow the guidelines as non-diabetics if they want to drink:

  • Women should not exceed more than 1 drink per day
  • Men should not exceed more than 2 drinks per day

In this scenario a drink is equal to a:

  • 12 ounce beer
  • 5 ounce glass of wine
  • 1.5 ounce drink with spirits

If you choose to drink you will want to talk with your healthcare provider to make sure the alcohol will not interfere with your medication or another medical condition.

Low Blood Sugar Reaction

You are at risk for developing low blood sugar when you are on treatment (insulin or pills) and choose to drink alcohol.

In a normal person, low blood sugar triggers the liver to generate glucose from stored carbohydrate in the liver. However, alcohol inhibits the liver’s ability to do this. The liver senses alcohol as a toxin that it wants out of the body. As a result the liver does not produce glucose until the alcohol is out of the body.

You can decrease your risk of hypoglycemia by never drinking on an empty stomach. Drinking with food, either a meal or snack, is a much better option. Additionally, you should check your sugar before going to bed and consider eating something small before going to sleep to prevent a low blood sugar reaction in the middle of the night– you want your blood sugar between 100 and 140 mg/dl before going to sleep.

Alcohol, Weight gain, & Diabetes

If you are trying to lose weight or just keep your weight under control, alcohol will not be your best friend. Alcohol adds significant non nutritional calories. Light beer contains 100 calories, while a sweet drink like a margarita may have as many as 250 calories. Additionally, when your liver breaks down alcohol it gets turned into fat (think beer belly). If you are trying to lose weight and taking in significant amounts of alcohol, you may be making it very difficult for yourself to lose or even maintain your current weight.

Should I Not Drink At All?

While this is a personal decision, too much alcohol is bad for anyone. It diabetics it can increase risk of longer term complications like heart attack or stroke by increasing weight, cholesterol triglycerides, and blood pressure. On a more positive note, small amounts of alcohol may decrease risk of heart disease.

A Few Tips For Drinking When You Have Diabetes

Here are a few tips to help manage alcohol when you have diabetes:

  • Continue to eat regularly.
  • Wear a medical ID bracelet (you really do not someone thinking you are drunk wean you are having hypoglycemia).
  • Drink slowly
  • Try a light beer
  • Use a mixer of diet soda or water if you need a mixer
  • Be careful about driving after you drink alcohol
  • Consider delaying driving for several hours
  • Know the symptoms of hypoglycemia and make sure people you are out with do too.
  • Always have a source of sugar with you.
  • Test more often as you may not display your typical hypoglycemia symptoms

 

Drinking when you have diabetes is a personal decision. Make sure you take steps to learn how alcohol affects you and your diabetes. Talk with your doctor about the pros and cons of drinking as well as specific strategies to manage safely.

10 Misconceptions About Diabetes Care

While 1 in 10 U.S. adults have diabetes, many people still have mistaken beliefs about the disease. If you understand these misconceptions about diabetes care, you will be much closer to better health and understanding what you need to do to achieve better diabetes control.

  1. Having diabetes is no big deal. Diabetes not only places you at increased risk of heart disease and stroke, but two out of three people with diabetes die from one of these conditions. Early diagnosis and appropriate management can prevent or delay long term complications.
  2. Diabetes only effects old people. Not true. The American Diabetes Association found 1.9 million new cases of diabetes in Americans over the age of 20 in 2010, and that more than 11% of people between 20–65 had a diagnosis of diabetes.
  3. Being overweight will cause diabetes. Overweight and obesity are risk factors for diabetes. However, being overweight or obese does not guarantee that you will develop diabetes as a fait accompli. Talk with your doctor about risk factors you can modify like physical inactivity, high blood pressure, or a poor diet.
  4. I will never be able to eat good food again. Restrictive diets are much less likely to succeed. You are more likely to be successful following general healthy eating guidelines that include eating more fiber, increasing vegetables, limiting soda, minimizing saturated fats, and eating more healthy fats. You do not need to go out and purchase special diabetes foods. While you will commonly hear fruit is good for you all over the press, talk to your doctor or dietician about how much and what kinds you can eat.
  5. I do not think I can take insulin. Not all types 2 diabetics need insulin. Diet and exercise my be tried alone first. A fair number of people may only need this or the addition of oral medications like metformin. Many patients with type 2 diabetes go a very long time before needing insulin.
  6. I do not want to catch diabetes. Diabetes is not a contagious disease that you can catch like the flu. If your mom or dad developed diabetes then you would be at increased risk compared to others.
  7. Eating too much sugar causes diabetes. While the average American consumes nearly 152 pounds of sugar per year and would all be better off if the number were less, there is no evidence that eating sugar directly leads to diabetes.
  8. I cannot prevent diabetes. Clearly false. Some estimates indicate that as much as 80% of type 2 diabetes could be prevented by increasing physical activity levels and making other healthy lifestyle choices.
  9. Insulin means that I have failed or am not taking care of myself. Eventually after years of having type 2 diabetes, your pancreas will decrease insulin production. It is nothing you did or did not due, but insulin is required to get blood sugar levels under control. Type 2 diabetes is a progressive disease and it may progress even though you are doing the things your doctor is asking of you.
  10. Insulin is difficult to take. With the development of insulin pens, you can take an easy to read injector and dial up the correct number of units without having to worry. Additionally, with the long acting insulins available today, many type 2 diabetics only need to give themselves one shot per day.

Hopefully identifying and addressing these misconceptions about diabetes care will clear up some concerns that were preventing you from improving your health. If you know of other common misconceptions related to diabetes please let me know. I would love to hear from you.

What Is An Insulin Pen?

What Is An Insulin Pen?

At some point you may want to consider an insulin pen as part of your diabetes plan.
You will need to decide if you want a disposable or reusable pen. Disposable insulin pens are refrigerated before use and then may be kept at room temperature once you start to use. When you have used all the insulin in the pen, you just throw it away. Most disposable insulin pens contain 300 units of insulin.

Reusable insulin pens have replacement cartridges that are reloaded with a new insulin cartridge. With the reusable pen, cartridges are stored in the refrigerator, while the pen is never stored there. With both pens you just dial in the appropriate number of units and give yourself the subcutaneous injection. Cartridges usually contain either 150 or 300 units of insulin.

What Types Of Insulin Are Available In A Pen?

Nearly all types of insulin are available in a insulin pen.

  • Long Acting
    • Levemir by Novo Nordisk
    • Lantus Sanofi-Aventis
  • Rapid acting
    • Apidra by Sanofi-Aventis
    • Humalog by Eli Lilly and Company
    • NovoLog by Novo Nordisk

Advantages of Using An Insulin Pen

  • Portable, discreet, time saving
  • Dial in exact dose of insulin
  • Easier than syringe and bottle, especially if you have vision or problems with fine motor coordination
  • Better adherence
  • Less damage to injection site because there is less handling of the insulin, which may reduce risk of contamination or infection
  • Less hypoglycemia because correct dose is delivered more often

Disadvantages Of An Insulin Pen

  • Many companies design pens to only work with their insulin (Owen Mumford Inc makes an insulin pen that works with Eli Lilly insulin cartridges
  • More expensive
  • Not all insulin brands have a pen available
  • Pens can only be used by one person
  • Cannot mix regular and long acting insulin so you may need more injections

What Questions Do I Need To Ask?

  • Is my insulin available in a pen?
  • What increments can my pen deliver?
  • What are the smallest and largest doses my pen can deliver?
  • How do you know if you are about to run out of insulin in your pen?
  • Can you see and read the numbers on the insulin pen to dial in the correct dose?

Accessories For Your Insulin Pen

There are a number of different products that may make your diabetes plan a little easier.

Frio Wallet

A Frio Wallet may be just what you need to travel with your insulin pen. The wallets let you keep your insulin pen cool in warm temperatures. The Frio wallets are approved as a medical device by the FDA and have been extensively tested by the British Medical Devices Evaluation Unit .

It is important to note that the Frio is not an alternative to refrigeration, but will allow you to keep insulin or any other medication at room temperature. According to the Frio website insulin can be kept between 64.4–78.8°F for 45 hours minimum, even at environmental temperatures of 100°F. The wallet can be ‘re-activated’/’topped-up’ to provide continuous safe storage conditions for subsequent periods of 45 hours minimum for up to 28 days- the useable life of insulin that is in use.

Timesulin Cap

A Timesulin cap sits on top of your insulin pen and tells you exactly how long it has been since your last dose. This will alleviate any anxiety that you might have about whether or not you gave yourself your insulin dose.
Basically the device is a smart cap that starts counting after each actuation. You just restart the timer after each dose.

Sources

  1. Carl V. Aschea,b, Wenli Luoc,d, Mark Aagrene. Differences in rates of hypoglycemia and health care costs in patients treated with insulin aspart in pens versus vials. Current Medical Research and Opinion. October 2013, Vol. 29, No. 10 , Pages 1287–1296.
  2. Bastian MD, Wolters NE, Bright DR. Insulin Pens vs. Vials and Syringes: Differences in Clinical and Economic Outcomes. Consult Pharm. 2011 Jun;26(6):426–9.

What Is Insulin Resistance?

What Is Insulin Resistance?

‘What is insulin resistance’ is a common question among patients newly diagnosed with diabetes or pre-diabetes. In this condition, your body still produces insulin, but it is not effective. This results in elevated blood glucose levels. In most patients, insulin resistance pre-dates an actual diagnosis of diabetes or pre-diabetes.

In fact, most patients will have insulin resistance for years before being diagnosed with pre-diabates or diabetes.

What Is Going On In The Body When I Have Insulin Resistance?

When you develop insulin resistance, cells in your body do not assist in uptake of blood glucose into muscle, fat, and other organs from the blood stream. Your body progressively requires higher insulin levels to get glucose from the bloodstream and into cells and organs that wish to use glucose for fuel.

Insulin is produced in the pancreas by beta cells. Blood glucose remains normal until the increased insulin levels are able to no longer counter act the insulin resistance or the beta cells cannot produce enough insulin to keep the bloodstream glucose normal.Over time the end result is elevate blood glucose levels, pre-diabetes, and then diabetes.

Type 2 Diabetes

Type 2 Diabetes

What Causes Insulin Resistance?

While your doctor can answer the ‘What is insulin resistance’ question, the ‘What is the the cause of insulin resistance’ is more difficult to answer. There are a number of different reasons experts believe that insulin resistance develops:

  • Obesity. Excess body fat is hypothesized to cause insulin resistance. Fat around the waist and belly fat are particularly problematic. Increased waist circumference and fat around the belly are associated with the production of hormones that increase insulin resistance. Increased waist circumference and belly fat are also associated with chronic inflammation that can be damaging to the body over long periods of time.
  • Inactivity. Inactivity has been shown in research studies to be associated with insulin resistance. Normally, muscles use stored glucose for energy and then take in more glucose from the blood stream. In fact, one of the reasons physical activity is good for you is that exercise makes muscles more sensitive to insulin.
  • Poor sleep. Sleep problems such as sleep apnea increase risk of obesity and insulin resistance. This is especially noted amongst night shift workers.
  • Genetics. Unlike the previously mentioned causes, you cannot do anything about your genetic risk. If your mom, dad, brother or sister have insulin resistance, you are more likely to develop insulin resistance.

    What Can I Do About Insulin Resistance?

    Woman exercising with dog

    Woman exercising with dog

    There are a number of things you can do to prevent progression to diabetes:

  • Change your lifestyle. Beginning an exercise program can make dramatic improvements. While many people shy away from exercise because of perceived barriers, walking for for as little as 30 minutes per day most days of the week can bring significant benefits. If you do this you will not only burn more calories, but also likely decrease caloric intake and fat.
    In the Diabetes Prevention Program, a federally funded program that looked to prevent diabetes in high risk individuals, patients losing 15 pounds reduced their risk of developing diabetes by 58% over a 3 year time frame.
    Increasing physical activity can help you:

    • Lose weight
    • Control glucose
    • Control blood pressure
    • Control cholesterol
  • Metformin. While not as successful as modifying risk factors, patients receiving metformin plus standard info about physical activity and diet decreased their risk of developing diabetes by 31% over a 3 year time frame.
  • Reduce risk. Insulin resistance increases your risk of cardiovascular disease. Not surprisingly, it is important to treat hypertension and high cholesterol in patients with insulin resistance. Additionally, smoking cessation is important in decreasing your risk of heart disease.

Sources

  • What Is Insulin Resistance?. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). Accessed September 10, 2013.
  • Weir, Gordon and Bonner-Weir, Susan. “Five Stages of Evolving Beta-Cell Dysfunction During Progression to Diabetes.” Diabetes 53 (2004): S16-S21.

Hypoglycemia

Hypoglycemia

Hypoglycemia is an important condition when you have diabetes. It is important to know not only the signs and symptoms, but also how to manage hypoglycemia should you experience it.

Do you experience different signs and symptoms?

Do you have different ways of dealing with hypoglycemia?

Check out the video and share your knowledge.

Yoga For Diabetes

Yoga For Diabetes

Yoga For Diabetes

Yoga For Diabetes

Do you know the benefit of yoga for diabetes? While yoga is well known to have a number of general health benefits, yoga may specifically benefit your diabetes.
General health benefits include:

  • Decrease stress and anxiety
  • Improved flexibility
  • Increased strength and tone
  • Stress relief

Research on Yoga For Diabetes

Much of the research on yoga for diabetes has been done in India– the country credited for its creation. A 2005 report from a medical school in India found that asana yoga regime under the supervision of an expert improved fasting glucose, post prandial glucose, and decreased waist-to-hip ratios. Other research suggested that the potential mechanism resulting from asanas yoga was increased insulin sensitivity. A report in the Indian Journal of Endocrinology and Metabolism in 2013 suggests that if you have had type 2 diabetes for less than 10 years and your fasting glucose is less than140 mg/dl, your blood sugar may respond to yoga alone. However, if you have more significant control problems, you will need medication along with yoga.
Overall, reports in the medical report the following diabetes outcomes can be improved with yoga:

  • Fasting glucose levels
  • Hemoglobin A1c levels
  • Insulin levels
  • Lipid levels including total cholesterol, LDL, VLDL, total cholesterol/HDL
  • Waist to hip ratio
  • BMI
  • General well being

Given that yoga started in India, it may not be surprising that research there has been positive. A UK study of complementary and alternative medicine treatments demonstrated improvements in HbA1c, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and weight. The intervention consisted of an Ayurvedic diet, meditation instruction, and an Ayurvedic herb supplement, while the control patients received standard diabetes education classes and standard care from their doctor. A 2005 systematic review in the Journal of the American Board of Family Practice suggests that yoga for diabetes may decrease insulin resistance and other cardiovascular risk factors, improve clinical outcomes, and aid in management of diseases such as diabetes. However, they also state that further high quality studies are needed to tease out and delineate the potential benefits of yoga and diabetes.

 

Specific Yoga Poses Meditation Yoga woman meditating at beach sunset

Many patients have trouble getting started. A relatively easy beginner yoga routine is called the “Sun Salutation.” It is great because it is simple and achievable no matter your current fitness or flexibility. (Make sure, however, to consult your doctor about your particular health situation before starting any exercise program). Give the following a try:

  1. Stand with a straight back with your palms together as in a prayer position.
  2. Breathe in and stretch your arms above the head.
  3. Breathe out and bend forward while touching your toes. It you cannot reach all the way just reach as far as you can.
  4. Breathe in and stretch the right leg away from the body in a big backward step and keep the hands and left foot firmly on the ground. Bending the head backward the left knee should be between the hands.
  5. Breathe in and hold the breath. Move the left leg from the body and, keeping both feet together and the knees of the floor, rest on the hands (arms straight) and keep the body in a straight line from head to foot.
  6. Breathe out and lower the body to the floor. In this position, only 8 portions of the body come in contact with the floor: the two feet, two knees, two hands, chest and forehead.
  7. Breathe in and bend back as much as possible bending the spine to the maximum.
  8. Breathe out and lift the body of the floor. Keep the feet and heels on the floor.
  9. Breathe in and bring the right foot along the level of the hands; left foot and knee should touch the ground. Look up, bending the spine slightly (same position as #4).
  10. Breathe out and bring the left leg forward. Keep the knees straight and bring the head down to the knees as in the third position.
  11. Lift the arms overhead and bend backward while inhaling. As in Position 2.
  12. Breathe out and let the arms drop and relax.

Steps 1–12 complete one round. Try to preform a set of 3. You will need to gradually build up the number of rounds you can complete. In the beginning you can shoot for a starter goal of 6 and should not do more than 30. Depending on your speed and intensity, this can be completed in 5- 15 minutes.
Traditional teaching would have you do this early in the morning before an open air window, but I would say to complete whenever you can. Yoga for diabetes does not have to be incredibly complex or time consuming.

Yoga For Diabetes video

Check out this video that shows you the basic yoga for diabetes steps discussed above.

 

 

Talk with your doctor and begin a yoga plan for your diabetes today.

Sources
1. Malhotra V, Singh S, Tandon OP, Sharma SB. The beneficial effect of yoga in diabetes. Nepal Med Coll J. 2005 Dec;7(2):145–7.
2. Manjunatha S, Vempati RP, Ghosh D, Bijlani RL. An investigation into the acute and long-term effects of selected yogic postures on fasting and postprandial glycemia and insulinemia in healthy young subjects. Indian J Physiol Pharmacol. 2005 Jul-Sep;49(3):319–24.
3. Elder C, Aickin M, Bauer V, Cairns J, Vuckovic N. Randomized trial of a whole-system ayurvedic protocol for type 2 diabetes. Altern Ther Health Med. 2006 Sep-Oct;12(5):24–30.
4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005 Nov-Dec;18(6):491–519.

How Much Can Decreasing My HbA1c Test Lower Complication Risk?

How Much Can Decreasing My HbA1c Test Lower Complication Risk?

Your HbA1c test results are directly related to your risk of developing complications from diabetes. Getting your diabetes under control can slow down progression towards complications such as diabetic eye problems such as retinopathy or kidney problems such as nephropathy. The greater your HbA1C test and the longer amount of time your HbA1c test is elevated, the greater your risk of complications.

What Is The HbA1c?

The HbA1c test measures how well your blood sugar has been controlled over the last several months. Unlike fasting glucose tests, this test is not affected by what you are eating today.

What Is a Normal HbA1c?

An HbA1c of 5.6% or less is normal. Prediabetes is associated with a HbA1c test of 5.7% to 6.4% and diabetes is diagnosed with a result of 6.5% or greater. Once you have been diagnosed with diabetes the goal is to keep your level below 7%.

How Does the HbA1c Test Affect My Risk of Diabetic Complications?

Lowering your HbA1c test by 1% decreases rate of any complication of diabetes by 21%. Additionally, each one percent you can lower your HbA1c test you can decrease the rates of:

  • Diabetes deaths by 21%.
  • Heart attack by 14%.
  • Microvascular disease like retinopathy or nephropathy by 37%.
  • Stroke by 12%.
  • Peripheral vascular disease by 43%.
  • Heart failure 16%.
  • Cataract Extraction by 19%.

What Does This Mean For Me

If you can get your HbA1c test under good control, you may never develop a diabetes complication or complications will develop more slowly. The lower you can get your HbA1c test the better. The longer your HbA1c test remains elevated, the risk for developing these becomes greater as well.

You probably will want to have a HbA1c test every 3 to 6 months . If your HbA1c test is in the pre diabetes range, your doctor may prescribe metformin in addition to lifestyle modifications. Otherwise, your doctor may recommend a new medicine or increase the dose of one you are already taking if your HbA1c is high.

What Can I Do If My HbA1c Test Is Elevated?

  • Lose weight.
  • Follow a meal plan
  • Increase your exercise
  • Take your medication as prescribed.
  • Take your medications regularly.

Sources:

* American Diabetes Association. Standards of medical care in diabetes–2012. Diabetes Care. 2011 Jan;35 Suppl 1:S11–63.

* Irene M Stratton,H Andrew W Neil, David R Matthews et. al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321:405.

Diabetes Scholarships

Diabetes Scholarships

Did you know that if you have diabetes, a diabetes scholarship can help you pay tuition for college?

The Diabetes Scholars Foundation Scholars Foundation offers scholarships for any student seeking higher education- n accredited four year university, college, technical or trade school.

The scholarships are merit based (i.e. your current grades are important), but you should also be active in the diabetes community. Your extra curricular activities are taken into consideration as well as how you manage your diabetes in the context of your everyday life. Your financial need is not one of the criteria for this scholarship.

There are a number of different diabetes scholarships you could consider applying for:

  • Leona M. and Harry B. Helmsley College Scholarship. 10 – $5,000 scholarships for a new freshman with type 1 diabetes.
  • Lilly Diabetes Tomorrow’s Leaders Scholarship. 11- $5,000;  5-  $4,000 ; 5-  $3,000 scholarships awarded to a new freshman with type 1 diabetes.
  • David’s Diabetes Scholarship. 1 $5,000 awarded to a student residing in South Carolina.
  • Lance Underwood Rising Star Scholarship. 1 $5,000 for a new freshman with type 1 diabetes.
  • Jay Franke Scholarship. 1 $4,000 scholarship for  a student pursuing an Arts Degree (ie music, theater, dance).
  • Bradley D. Gendron Memorial Scholarship. 1 $1,000 scholarship for a Colorado student.
  • Josh Smith Memorial Scholarship. 1 $1,000 scholarship for an Ohio student.
  • JDRF Medical/Research Scholarship. 1 $1,000 scholarship for a student majoring in a healthcare related field.
  • JDRF Advocacy Scholarship. 1 $1,000  scholarship for a student majoring in Political Science.
  • JDRF Outreach Scholarship. 1 $1,000 scholarship for a student majoring in Mental Health (Psychology/Social Work),
  • Nicky Randazzo Memorial Scholarship. 1 $1,000 scholarship for a student majoring in Business.

How Do I Qualify For A Diabetes Scholarships?

In order to apply you need to be a/an:

  • Type 1 diabetic applying to an accredited four year university, college, technical or trade school.
  • High school senior
  • U.S. citizen

You will need a recommendation from from your doctor or diabetes educator as well as a teacher from your school. All scholarships are reviewed by a blinded committee and then a separate committee awards the scholarships.