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Glycated Hemoglobin

Think You’re NOT Prediabetic? Better Think Again

May 1, 2013 by James Bogash

It’s pretty clear that the percentage of the US population that is prediabetic is startlingly high. But of course, this does not apply to you, right?  Better rethink that.

I won’t repeat my belief that the diabetic spectrum is the worst thing that the human physiology experiences (oops…I guess I just did).  But this article isn’t about the horrendously high risk to your long term health that the diabetic spectrum produces, but rather just how common it is.

With my depth of understand into diabetes, it doesn’t take much time for me to decide if someone is headed towards diabetes.  Looking at a new patient’s health history, family history and the patient’s body type is usually enough.  Rarely, an additional tidbit from the patient is needed (very poor dietary habits despite a lean body type, high stress, etc..).  Labwork usually just confirms what I was already suspecting.

Labs are an interesting phenomena.  I’ve had patients over the years (usually male) who are genuinely afraid of having labs drawn.  I think this stems from the environment we have created in medicine.  In medicine today labs are run to find something wrong.  It’s just a matter of time before something on them is going to come back abnormal.  In our office, if we run labs, we’re trying to find out just how well that patient is living for his or her genetic structure.

When I look to evaluate the diabetic spectrum, I am not merely looking at blood glucose or HbA1c.  Rather, I’m looking at liver enzymes (AST, ALT), GGT, the entire lipid panel, urinary microalbuminuria levels and uric acid levels.  It’s about stepping back and looking at the whole picture.

When your doctor is able to understand how all of these lab values create a picture that combines with your body type, heritage and family history–this is when the true picture of whether or not you are headed to diabetes or not and just how fast you’re moving on that path.

So why the diatribe?  Of course, it relates to this particular article.

In this article, the CDC looks at the problem with prediabetes.  In 2010, a whopping ONE-THIRD of the US population was prediabetic.  All of this is ok, because once someone realizes that they are on the path to diabetes, he or she can make the lifestyle changes needed to divert the diabetic diagnosis (which can be read in my free downloadable ebook, Dr. Bogash’ Lifestyle Recommendations).

But how many of you walking around fall into this 1/3 statistic but don’t know it?

Are you sitting down?

89%.  Yes—only a mere 11% of the prediabetic population were even aware that they were prediabetic.

On the bright side, this is up from 7% in 2005.  What a mess.

This is like having all the risks of being a smoker, but not knowing that you’re a smoker.  That is the problem.  It’s not like this unaware population is doing ok, and it’s merely a fact that, at some point in the future, they are likely to become diabetic.

Being prediabetic is in no way, shape or form a benign process.  It is just as bad for you as diabetes, maybe even more so because the vast majority of people who are prediabetic are not aware of it.

Maybe it’s time to take a very hard look at yourself.  Carrying even a little too much weight around the middle?  Cholesterol or triglycerides too high?  Skip breakfast on a regular basis?  Stressed out all the time?  Have’t had your heart rate over 120 in years?

Don’t rely on your doctor to tell you.  I’ve seen way too many cases over the years where patients were clearly on their way to diabetes but the primary care doctor did not inform the patient that this was the case.

If any of this even might fit you, it’s time to make some changes.  Today.  With the massive increase in heart attacks, cancer and stroke, tomorrow may be too late.

Filed Under: Prediabetes Tagged With: Diabetes Mellitus, Glycated Hemoglobin, prediabetes, prediabetic

Risk Factors for Heart Disease: Diabetes Tops the List

January 22, 2013 by James Bogash

If queried, many would name high cholesterol as one of the major risk factors for heart disease. Not even close. Many wouldn’t think of a condition 50% of us have.

I was giving a short presentation last week and one of the participants asked about diabetes and heart disease.  I had mentioned that, for me, there is little difference between the two, and this appeared to be something she had not heard before.

While not surprising, this fact is very true.  84% of diabetics die of cardiovascular related complications (heart disease and stroke combined).  So it would seem to me that every diabetic needs to work on protecting his or her heart.

Here’s the good news: improving your lifestyle to protect or improve diabetes and improving your lifestyle to protect your heart are one and the same.  Good luck trying to find something to avoid or improve your diabetes that doesn’t have a protective effect on the heart.  Exercise?  Both.  Stress management?  Both.  Avoiding BPA in plastics?  Both.  Nuts?  Both.

You get the idea.

So why does this concept seem to be a secret?  Maybe it’s because primary care doctors or endocrinologists manage diabetes and cardiologists manage heart disease.  Sad to think this way, but it seems to fit.  The closest we seem to come to managing both conditions is to make sure that diabetics are taking his or her diabetic medications or that diabetics are taking their Lipitor.  No one seems to take into account that these two conditions are caused by the same lifestyle choices, rather than being two separate entities needing to be managed with distinct tools.

This particular study drives this concept home.  Researchers looked at HbA1c levels and how they related to the risk of heart disease.  HbA1c is a marker to see how well you have been managing your blood sugars over the past 3 months or so.  HbA1c is actually a protein in red blood cells that gets damaged by blood sugar when it goes up.  So, higher blood sugar = more damage to the proteins in your body.  EVERY protein, not just this one.  So lower is always better.  Higher means that every protein in every cell of your body is being damaged more.  Not good.

Here’s the problem: elevations in HbA1c do not just occur in diabetes.  Basically, it’s a spectrum, with lower numbers being better and higher numbers getting worse.  Whether or not you are diagnosed with diabetes, higher HbA1c numbers are not good, and in the study, elevated HbA1c levels were associated with heart disease regardless of whether or not the person had been diagnosed with diabetes (yet).

The bottom line is, regardless of whether you are diabetic or prediabetic, your heart is in grave danger.  Luckily, you don’t need to pick which condition you want to make lifestyle changes for.  My recommendations can be found here.

Are you at risk?

Filed Under: Uncategorized Tagged With: cardiovascular disease, Diabetes And Heart Disease, diabetes management, Diabetes Mellitus, Glycated Hemoglobin, heart disease, Heart Disease And Stroke, Heart Disease Diabetes, Manage Heart Disease, Risk Factors For Heart Disease, Risks Of Heart Disease

HEMOGLOBIN AND CHOLESTEROL PREDICT FUTURE CARDIOVASCULAR EVENTS – (11-30-03)

November 11, 2012 by James Bogash

Joint Effects of CRP, Glycated Hemoglobin in Predicting Future Cardiovascular Events of Patients With Advanced Atherosclerosis

Cholesterol? Didn’t somebody say cholesterol? Please?? I thought I heard someone, somewhere say cholesterol…

Circulation — Abstracts: Schillinger et al. 108 (19): 2323.

Read entire article here

Filed Under: Cholesterol Tagged With: atherosclerosis, cholesterol, CRP, CVD, Glycated Hemoglobin

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