Thursday, April 12, 2018
Doctor’s Perspective
Maintaining a good blood sugar level

By Dr. Anthony Policastro
Patients with Type 2 diabetes will often talk about their Hemoglobin A-1-c (Hb A-1-c). Often they will focus on the number alone. It might give them a false sense of security. All that HbA-1-c does is tell you about what your average blood sugar has been for the last three months. However, if we look at a chart and compare Hb A-1-c levels to what the average blood sugar is for that level, it tells a different story. Hb A-1-c level Average Blood Sugar
4 68
5 97
6 126
7 152
8 183
9 212
10 240
11 269
12 298
13 326
14 355

This tells us many things. First, the average blood sugar rises 25 to 30 points with each point increase of Hb A-1-c. Thus, the person who brags that their level is not that high, does not realize that even 1 point means 25 of blood sugar increase. The second is that unless the Hb A-1-c is under 5.7, it is too high. Anything above that level is at the very least considered pre-diabetes. A level 6.5 is considered true diabetes. Blood sugars consistently above 100 - 110 are causing damage to the blood vessels of the body in all the different organs. We also know the nerve damage occurs with blood sugar levels above 140 (Hb A-1-c 7.8). Effects on the blood vessels in the eye occur at lower levels. They can be seen with blood sugars consistently above 126 (Hb A-1-c 6.0). The other caution is that Hb A-1-c measures that average level of blood sugar. There is mounting evidence that high sugar loads after meals can be a cause of separate damage. So even if the average level is good, there is a need to stay away from high sugar loads that temporarily raise the good sugar into the 200 plus range. This is especially true for the risks to the kidney. The bottom line is that the only good blood sugar is a normal one. The only good Hb A-1-c is a normal one. If either one is high, there will likely be long term complications.