Diabetes has become one of the most prevalent chronic diseases in the United States and is the leading cause of lower extremity amputations. Additionally, diabetes is the most common cause for the onset of blindness during the adult years, as well as kidney failure. Unfortunately, diabetes is the seventh leading cause of death and its prevalence is increasing; it is expected that 1 in 3 Americans will have diabetes by year 2050. 

There are two types of diabetes. Type 1 diabetes, which usually presents in young people, and is due to the pancreas being unable to produce enough insulin to control the body’s sugar levels. Then there is type 2 diabetes, which is an extremely common problem for patients as they age. Additional risk factors include obesity and a family history of diabetes. Type 2 diabetes is usually due to what is called insulin resistance. Insulin resistance is when the body’s sugar levels are unable to be regulated due to the body not responding to the insulin that is being produced, hence resulting in high blood sugar. 

As patients with diabetes already know, there are two very common tests that are able to track the blood glucose levels. The first test is most commonly called the finger stick test. This test is performed by piercing the skin on the tip of the finger just enough for a drop of blood to come to the surface. A small hand held device is then used to measure the glucose level by absorbing the blood at the surface of the finger. This test is rather painless and most patients with diabetes will do this test a couple of times throughout the day. This finger stick test only measures what the current amount of glucose is in the blood, so the results can be skewed by eating right before doing the test or fasting.

However, unlike the finger stick test, hemoglobin A1c is able to take a picture of what the average glucose levels have been over the course of three months. Hemoglobin is a part of your blood’s chemistry, which carries oxygen throughout the body. However, if a patient’s diabetes is uncontrolled and has a high blood glucose level, the excess glucose with bind to the hemoglobin, which will serve as evidence for uncontrolled diabetes.

Similar to the finger stick test, the hemoglobin A1c is measured only using a drop of blood, but occasionally a blood sample may be needed. The sample is the sent to a lab for analysis. The amount of hemoglobin A1c is reported in a percentage. A normal value is 5.7% or lower. Between 5.7% and 6.4% indicates pre-diabetes, which means that you are at risk for diabetes and within a matter of time if no lifestyles changes are made, will most likely result in full blown type 2 diabetes. Any values greater than 6.5% is indicative of diabetes; however those patients already diagnosed with diabetes should work to keep their hemoglobin A1c at 7% or lower. Good habits such as eating healthy, exercising, and taking your medications as prescribed will most likely keep the result around 7%. If you go to the doctor and before going, you refrain from eating, your finger stick test will show a lower and maybe even normal glucose level; however, the hemoglobin A1c will show the true control of your diabetes over the course of three months. 


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