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Best Test for Measuring Diabetes Control

In the twenty years that I've been in practice, I've witnessed a skyrocketing rate of Diabetes Mellitus. More than half of the diabetics in my practice are poorly controlled, and each week it seems, I discover bleeding of the retina in someone who didn't know that he or she even had diabetes. So with this being National Diabetes Awareness Month, I'd like to tell you about a simple blood test that is better than measuring your blood glucose level. Most people are under the mistaken assumption that measurement of their blood glucose level at their annual doctor exam is sufficient to know if they've got diabetes. And diabetics themselves are often remiss in measuring their blood glucoses during the day to know if they're under control. But whether you're diabetic or not, you can benefit from a simple blood test that gives you an instant picture of how your glucose has been controlled over the past three months. It's called a Glycosylated Hemoglobin Test, or more commonly a Hemoglobin A1C, and here is how it works... Insulin, a hormone made in an organ next to your stomach called the pancreas, is responsible for moving glucose (sugar) from the bloodstream into your muscle and liver. If insulin is low (Type II Diabetes) or absent (Type I Diabetes), blood glucose levels can become too high. But depending on the time of the day, whether you've eaten or not, and whether you're exercising, the glucose levels can have a big range from low to high. That's where a Hemoglobin A1C Test comes in. The glucose molecules attach themselves to the hemoglobin molecules in your red blood cells. Once they attach, they never let let go. So examining these "glycosylated Hemoglobins" in the normal 120-day lifespan of your blood cells tells you instantly whether your blood sugars have been under control for the past few months. What's a good number? Normal people have Hemoglobin A1C's less than 6%. But good diabetic control is less than 6.5%. So when a patient tells me that this morning's glucose was normal, but her Hemoglobin A1C is 8%, I know she needs better control. -- Paul L. Krawitz, M.D., F.A.A.O., President Vitamin Science Inc.

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