November is National Diabetes Awareness Month and a perfect time to discuss why a diabetic’s lucky number is always #7.
Roughly 9.5% of the population has diabetes with almost half of those people being undiagnosed and not receiving treatment. While many patients present with classic diabetic symptoms—extreme thirst, hunger, urination, and unintentional weight loss—most patients discover they are diabetic by a routine blood test during a yearly physical.
Patients with diabetes need to monitor their blood sugars daily to make sure they are keeping their blood glucose levels within normal limits, but those tests present with a fairly high level of error due to eating habits, time of day of testing, etc. These levels also only determine the blood glucose levels at a single moment of time as opposed to an average level of control over a longer time span.
One test that is much more indicative on how well someone is managing their diabetes correctly is the A1C test. (Reader warning: Doctor lingo ahead!)
The A1C test is sometimes called the Hemoglobin A1C, HbA1c, glycated hemoglobin, or glycohemoglobin test. Hemoglobin is the part of a red blood cell that carries oxygen to the cells. Glucose attaches to or binds with hemoglobin in your blood cells, and the A1C test is based on this attachment of glucose to hemoglobin.
The higher the glucose level in your bloodstream, the more glucose will attach to the hemoglobin. The A1C test measures the amount of hemoglobin with attached glucose and reflects your average blood glucose levels over the past 3 months. This test gives us a 90-day indication of blood sugar control.
The A1C test result is reported as a percentage. The higher the percentage, the higher your blood glucose levels have been. A normal A1C level is below 5.7 percent. Patients with an A1C of 5.8 - 6.4 are considered pre-diabetic, and patients with an A1C of 6.5 or above are diagnosed as being diabetic.
Once a patient is diagnosed as being diabetic, it is extremely important to then keep their A1C below 7. Long-standing uncontrolled blood glucose levels trigger the extreme negative consequences of diabetes, including bleeding in the retina leading to blindness. These complications elsewhere cause patients to lose their extremities (toes, feet, legs, etc), kidney damage, and ultimately death.
Sadly, as a doctor, we often have patients come in that are being treated for diabetes but who have no idea what their A1C levels are. Many of the patients claim their doctors haven’t shared that information with them or that they have forgotten the number. The doctors at Brookside Optometric try to impress on our patients how important that lucky #7 is in their lives. If your doctor isn’t sharing this information with you - make them; if they are - remember your number. If it is higher than lucky #7, then you need to improve your control.
Know your A1C number and keep it at or below Lucky #7! If you are a diabetic, your vision and your life depend on it. Now that we have emphasized the importance of the A1C, we will discuss the next level of diabetic control related to “Time in Range” monitoring in Part II.