A1C: A Cautionary Tale

A1C. Glycated hemoglobin. Expressed as a percentage of how much sugar is attached to the hemoglobin protein and measuring how well your body controls the amount of sugar in your blood over a 2-3 month period.  Ok, why is that important?  Because, A1C is the primary test for diabetes.  There's a line on the graph (6.5%) that if you cross, you are officially diabetic.  My last blood test showed A1C = 6.6.

It is amazing how a little tenth of a percent changes your perspective.  I have been "pre-diabetic" for several years, but like most of you, denial and complacency grabs ahold. My first thought: Well this is the craps, another step on the road to a walk-in bathtub.  My goal is to avoid drugs, Metformin ... insulin, for as long as I can. I am an amateur genealogist and as I trace the family tree back in time, I find many deaths attributed to "diabetes or complications from diabetes", including my father.  Given this family history, if I live long enough, it is inevitable that at some point I will have needles in my daily routine. 

For now, I am focused on my diet. Imperative I lose weight I am told.  (I recently published "Weighty Matters" which is actually an outline of my plan). Giving up or dramatically reducing snacking and desserts has over the years been a successful weight loss program for me, although my discipline has not been stellar, leading to a sine wave weight chart.  And with biking through the summer, I usually lose 10 lbs or so but recover that and more during the winter. My big weakness, well, one of them, is baked goods which my wife is a wizard at creating. But while this sacrifice is painful I am hoping going off the wagon occasionally is not fatal. 

The blood sugar culprit is carbohydrates. The body converts carbs to glucose. Most foods contain carbs. It is actually impossible to avoid unless you're willing to survive on kale and eggplant and of course you need carbs for energy, but maybe not quite so much.  The recommendation is to limit carb intake to 60g/meal, which means for the first time in my life I need to look at those nutritional facts (FYI: there's an app "Calorie King" that will give you nutrition info on a vast number of items). Just for perspective, a banana has 30g carbs, a slice of pizza about 40g.

34 million Americans have diabetes and another 88 million are pre-diabetic, 38% of the population, by any measure an epidemic. Unfortunately, initially diabetes is asymptomatic. Thus, an annual blood test should be part of your regimen. The consequences of ignoring this disease can be dramatic.  A whole bunch of "..opathies" can potentially spring on you.  Retinopathy (blindness), Neuropathy (pain, especially feet and potentially loss of limbs, Nephropathy (kidney disease), diabetic coma (death), heart disease, stroke, increased risk for Alzheimer's, keoacidosis and other unpronounceable conditions.  If those are not a motivator, then you are not paying attention.

The best way to avoid diabetes is to pick the right ancestors. Genetics play a big role. But you can help yourself. Diet and exercise are another big factor.

• Manage your weight.  Unless you have the body of a long-distance runner, target a 7-10% weight loss. 2/3 of Americans are overweight or obese.
• Healthy diet. Low fat/low carbs. Plenty of fruits, vegetables, whole grains, lean meats. And if you're a sugar addict like me, cut it out.
• Get off your duff. Exercise is key. Walking is great, say 30 minutes/day. Bicycle, jog, swim ... keep moving, keep it wigglin'.
• Beyond a regular exercise regimen, don't sit for long periods of time ... get off your duff every 30 minutes or so.
• Moderation in all things, including moderation. It's ok to enjoy your favorite foods, just not in daily super-size servings.

Now I am hardly the one to be lecturing you on your life-style, but as I was once advised - tell people what to do or someone else will do it.

I'll try for something more cheerful and less self-centered next go-round.

Dec 2021 UPDATE

I have taken my own advice - at least to some degree - and lo and behold after 9 months: A1C=5.5 

Copyright ©  2021  Dave Hoplin