Benefits of Strict Glycemic Controls - Offer Your Thoughts On a Candid Discussion

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I think that even though deciding on desired end points is important, it is more important to empower the patient in as much as blood sugar values are more useful than HbA1C, since a patient can buy a glucometer and self monitor often and regularly to see how making improvements in ones diet and lifestyle are positively affecting his blood sugar values. Of course s/he can get HbA1C readings every 3-6 months, depending on the doctors recommendations.

I would love to know how you readers feel about it, as well as would love to hear from the other NV dietitians.

By, The Dietetic Team @ NutritionVista.com

NutritionVista

User Comments

15 June, 2009 | Kanchan Saggi, Dietitian, NutritionVista.com | Reply

A1C is a reflection of the glycemic behavior over the period of 3 to 12 weeks. A well controlled blood sugar level will keep the HbA1C level within the normal range (6.5% - 7%) whereas, uncontrolled blood sugar levels will cause the HbA1C to rise. So, it’s quite obvious that one has to keep their sugar levels under control. A regular monitoring of your fasting and post prandial levels are of utmost importance and go a long way in helping one to keep his/her blood sugars stable. In case of exercising strict glycemic control, its good to religiously self monitor your glucose levels using a glucometer, before and after your meals and initially sometimes even at midnights, this will help one control a hypoglycemic effect. If the PP sugar levels are well under control (130 – 150mg/dl)... that indicates a well controlled HbA1C of 7% (which can be checked once in three months). In case of fluctuations in your blood sugar levels while using a glucometer, then it’s always advised to get your blood samples tested in a lab for a detailed blood sugar test along with HbA1C, once in three months.
I strongly feel that HbA1C would be more useful in checking blood sugar control in people who might be pre-diabetic and (b) monitoring blood sugar control in hyperglycemic patients.
Has rightly pointed by our honored bloggers that strict diet control and exercise regime proves to be always helpful in the long run. So it’s all about understanding the condition and the correct treatment in response.

15 June, 2009 | Vijayalakshmi | Reply

2 articles, which focused on findings from clinical trials, caught my attention.
1.The 1st article cited the long-term effects on the developing brain and increased risk of apparent and unrecognized hypoglycemia with tight control during the first 7–10 yr of life And how tight Glycemic control is difficult to maintain especially in adolescents but imperative, as hypoglycemia or negative glucosuria can lead to many neurological problems including seizures..
2.Another article featured in the July issue of Diabetes care where the American Diabetes Association (ADA), the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD) have joined forces to recommend the use of the hemoglobin A1C assay for the diagnosis of diabetes. The committee has said that an A1C value of 6.5% or greater should be used for the diagnosis of diabetes even if it is more expensive as "A1C values vary less than FPG [fasting plasma glucose] values and the assay for A1C has technical advantages compared with the glucose assay," (A1C gives a picture of the average blood glucose level over the preceding 2 to 3 months)
However one message that came out strong & clear is that diagnosis should not alternate between A1C and blood glucose levels.They should stick with one in reviewing a patient's history,"

15 June, 2009 | Padmashri Shanmugaraj | Reply

Kindly accept my wishes for having taken control of your life. Well, it is a common belief that once a person is diagnosed with T2DM, it is impossible to lead a normal life. The awareness is, however, being created that with sensible food choices and a regular exercise regimen, blood sugars can be controlled effectively, so much so that a diabetic may even be allowed to have a dessert once in a while!

15 June, 2009 | tsg,Krishnamurthy | Reply

I have heard many a times people saying that a well controlled Diabetic leads a healthy and a long life....the actual logic behind this is you get so disciplined in life while living with diabetes that you began to master the art of healthy living. It’s pretty simple, it’s all about following a principled eating pattern as you gracefully age through the years. The first time when I was diagnosed with T2DM, my number were really high and my Doctor was forced to put me on Insulin.... that’s when I felt aghast about my self, my morbidly obese structure, huge waist line and the sky rocketing blood sugar levels. The Doctor was point blank that there were no short cuts and I need to take charge of it right away. My head was reeling and I needed help!!
I was referred to a Dietitian by my Doctor who helped me through with my dietary needs, got hold of an exercise instructor and followed my regime religiously and there I go glad to note my body was responding to the new changes that I had inculcated in me. Trust me on this, I am proud to say that I was off Insulin injections by the end of 6 months and the doc put me on oral hypoglycemic agents (tablets).... yes I do see a drastic difference in my waist line too & most importantly the person in me. I feel good about my self. I urge each one of you'll to adopt a healthy lifestyle pattern to take charge of your life. It’s worth the effort!!!

14 June, 2009 | Prem | Reply

At a routine check up my H1.. was above 7. At age 67+ I refused to accept the label "diabetic". Attended nutrition classes, and my teachers recommended strict carb control. It was tough for one week - but I stuck to it. As also the 3-5 miles of walking (not strolling) a day. In 3 months my weight was down from 195 pounds to 158, scared me lest it was something else. I also kept close record of readings via a glucometer. The combination of diet and exercise have kept me off diabetic medication, and i feel less sluggish as i lugging around less weight!! At the last count, a month ago, my H1. was 5.8 and i get upset if my glucometer reading exceeds 130.
I would urge those teetering in my boat to follow the nutritionist's/dietitian's advice and keep a close contact. In three months time, the results can be staggering. I'll be darned if I am going to give in to something over which i have total control. To those who are "TO BE OR NOT TO BE" I would suggest start right now, this instant, for who knows what tomorrow will bring - i would want it to bring to you good health. Bon Chance.

13 June, 2009 | Padmashri Shanmugaraj | Reply

I strongly feel that hemoglobin A1c targets should be individualized (especially in the older patients) based on the patient's blood glucose levels of the past. Emphasizing on the patient's overall well-being and empowering the patient to make sensible food choices should be our priority.

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