It’s estimated that almost 50% of the American population has diabetes or prediabetes – a condition where blood sugar is higher than normal levels. It is accompanied by insulin resistance, a risk factor for full-blown diabetes, and other health complications. National Health and Nutrition Examination Survey (NHANES) data estimates the recent prevalence of total diabetes, diagnosed diabetes and undiagnosed diabetes’ US trends to be 12-14% among US adults.
If you’re of African, Mediterranean, or Southeast Asian descent or have family members with sickle cell anemia or a thalassemia, an A1C test can be unreliable for diagnosing or monitoring diabetes and prediabetes. People in these groups may have a different type of hemoglobin, known as a hemoglobin variant, which can interfere with some A1C tests. Most people with a hemoglobin variant have no symptoms and may not know that they carry this type of hemoglobin. Health care professionals may suspect interference—a falsely high or low result—when your A1C and blood glucose test results don’t match.
Keep your vaccinations up-to-date. High blood sugar can weaken your immune system. Get a flu shot every year, and your doctor may recommend the pneumonia vaccine, as well. The Centers for Disease Control and Prevention (CDC) also currently recommends hepatitis B vaccination if you haven't previously been vaccinated against hepatitis B and you're an adult ages 19 to 59 with type 1 or type 2 diabetes.
When repeated, the A1C test result can be slightly higher or lower than the first measurement. This means, for example, an A1C reported as 6.8 percent on one test could be reported in a range from 6.4 to 7.2 percent on a repeat test from the same blood sample.3 In the past, this range was larger but new, stricter quality-control standards mean more precise A1C test results.
The earliest oral diabetes drugs were the sulfonylureas. These work by stimulating the pancreas to produce more insulin. The oldest of these drugs still on the market is chlorpropamide (Diabinese), which has been used for more than 50 years. The second-generation sulfonylureas are taken once or twice a day. They include glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, DiaBeta, Glynase), and glimepiride (Amaryl).
Eating more protein helps you to stay full for longer durations, lose weight and keep your blood sugar levels stable through the day. Since proteins are harder to digest than carbs, they offer sustained energy throughout the day and keep mindless snacking at bay. However, not all meats are the same. Choose lean cuts of meat that aren’t laden with animal fats. Completely eliminate processed meats like bacon, sausages, salami and other cold-cuts from your diet. Instead, focus on fresh chicken, turkey, fish and lean cuts of lamb. If you must eat red meat (we see no real reason to), limit it to no more than two servings a week.
Along with the hemoglobin A1c test, it's important for people with diabetes to have a dilated eye exam at least once a year as part of a complete eye exam. This important test can detect early signs of retinopathy, which may have no symptoms at first. A foot exam once or twice a year -- or at every doctor's visit -- is also imperative to detect decreased circulation and sores that may not be healing. Early detection of eye and foot problems in diabetes allows your doctor to prescribe proper treatment when it is most effective.
You should report any side effects that are not listed in the patient information leaflet to your doctor. In the case of type 1 diabetes this is likely unless research finds an alternative treatment. It is not so uncommon for people with type 2 diabetes to come off medication. This is particularly a possibility for people who have successfully lost a lot of weight.