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A1C is on the rise The most commonly used test for diabetes is a blood test given after hours of fasting, and then more testing after a patient drinks a sugar-loaded drink. Now, however, diabetes experts are calling for wider use of a different blood test that may be more convenient and reliable. Many people do not realize they have Type 2 Diabetes until it has already led to other health problems, such as cardiovascular disease, damage to the eyes, and failing kidneys. "As long as they have the diabetes and don't know it, they can't treat it. They can't prevent the damage it's doing to their blood vessels, their eyes, and their kidneys," said Dr. David Nathan from Massachusetts General Hospital in Boston. The most common form of diabetes screening requires patients to follow a restricted diet before they fast for 8 to 16 hours. Then blood is drawn at least two times. But this test measures the patient's glucose level only at the time the blood is drawn. Dr. Alvin Powers of Vanderbilt University Medical Center in Nashville, Tennessee, says other factors can influence the readings. "Things like exercise, your diet, whether you've been ill recently can influence blood glucose and require that that test be repeated," he said. Now doctors are being urged to give their patients a different test. The A1c blood test has been in existence for years. Recently, however, a group of international experts from three major medical associations called for the A1c test to be the standard. There is no fasting involved, it is more convenient and measures a patient's blood sugar level over a two to three month period. The A1c test measures glucose that has attached itself to hemoglobin, a protein in red blood cells. The amount of glucose that combines with hemoglobin is proportional to the total amount of glucose in a person's system. "It gives a much more accurate measure of whether someone actually has diabetes," Dr. Nathan said. Diabetes experts say the A1c test might identify patients early before it is too late to reverse the illness. Dr. Cinque's comments: I have never had my A1C checked. My blood glucose gets measured every year as part of the comprehensive blood panel that I have done. And since my glucose has always been fine, I have had no incentive to add the A1C test. But, if my blood sugar were to start rising, I would start testing for A1C. I'm all for trying to identify diabetes and pre-diabetes as early as possible. And for people who are at risk for diabetes, maybe the test would act as a wake-up call, and if so, it could be life-saving. The prevention and treatment of Type II diabetes rests solidly upon diet, exercise, and shedding excess body fat. Unfortunately, the treatment of Type II diabetes with oral drugs has been nothing less than a disaster. Whole classes of drugs, such as the sulfonylureas and the thiazolidinediones, have caused heart attacks, liver failure, and premature deaths. The public is largely unaware of the magnitude of this medical debacle, and it is still winding its way through the courts. Some of the harmful drugs have been taken off the market by FDA order, but other dangerous drugs are still being used. I'll say again that the only diabetes drug that I would ever consider taking is Metformin. And it's not that Metformin doesn't have any risks, but at least the risk/reward ratio for Metformin is quite favorable. All the others are bad news. Stay away. E-mail to a friend Next Article |