Diabetic Hemoglobin A1C and the Risks of Low Blood Sugar in the Elderly

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The diabetic hemoglobin A1C test is a fairly new way to portion glucose levels in the blood. It was industrialized when researchers discovered the glycation process, and in 1986 the testing schedule was launched into the healing community.

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How is Diabetic Hemoglobin A1C and the Risks of Low Blood Sugar in the Elderly

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It caught on fast because it is a breathtaking way to know a patient's blood sugar level averages over the last merge of months. And there was hope that giving diabetics a simple number to shoot for would encourage better blood sugar control.

Because it is so new, researchers are still doing tests to find proof that lower fractions (measured as percentages) in diabetics will also lower the risk for diabetic complications over many years. Most non-diabetics test in the range of about 4% to 6%. A type 2 diabetic can test 10% or higher if blood sugars are not being controlled.

And studies are showing that at levels higher than 8% the complications are going to multiply and get worse as the years pass by. This is a huge problem. The National found of condition says the appraisal of type 2 diabetics with poor blood sugar operate in the U.S. Is 40-60%. They see the diabetic hemoglobin A1C as a distinguished tool to turn this.

Diabetic Hemoglobin A1C Testing

As a type 2 diabetic I get the HbA1C test every three months. That's because I'm on insulin. If you are on oral medications or just diet and rehearsal to operate your blood sugars you probably only get the test twice a year.

And doctors are seeing that consistent readings of 6.5% or lower have been keeping the heart, kidney, retinal and peripheral complications from becoming life-threatening in type 1 and type 2 diabetes. Lower diabetic hemoglobin A1C does equal lower risk of complications.

The reason? If your HbA1C is lower, it means you have fewer Ages, industrialized glycation end products, in your blood and therefore in your organs, together with your brain, heart, blood vessels and eyes. The test is simply telling you how well you are keeping them out of your system.

What the Diabetic Hemoglobin A1C Is Not Telling You

Diabetic medications cause hypoglycemia to some degree, and insulin does this more than the oral medicines. You are trying to operate the number of blood sugar in your body by artificial means. Your body's defenses against a blood sugar that is too high or too low are delicate and complicated. Meds can't double it.

Minute by puny your endocrine law uses its arsenal of hormones to regulate your blood sugar so it does not go too low. When it senses a dip to 70 it releases epinephrine, you feel nervous, and your heart starts pounding.

Hormones tell your liver to publish some of the sugar stored there over the next few hours, and they restrict the number of glucose available to your hands and feet. If these measures do not stop the lowering of blood sugar you start having neurologic symptoms, blurred eyesight, profuse sweating and sleepiness.

And the more often that low blood sugar events happen, the less sensitive you come to be to the onset of hypoglycemia. The diabetic hemoglobin A1C cannot tell you or your physician how often this is happening to you.

Hypoglycemia at night can go unnoticed if it happens a lot. It might be a cause of the dawn phenomenon, when you wake up with a much higher blood sugar than you measured the night before. Sensing a low blood sugar, your liver released sugar to raise it, and since you have diabetes, insulin did not sass as it would in a non-diabetic.

There are valuable risks to having many hypoglycemic episodes. The first is that you come to be less sensitive to them, and if you don't have early warnings your sugars may dip dangerously low before you are aware of it.

Hypoglycemic attacks take a toll on a diabetic heart in the long run. So older diabetics are the ones who are showing the results. Only constant blood sugar monitoring can tell you how much low blood sugars are occurring. The diabetic hemoglobin A1C cannot warn you of a hypoglycemic attack.

The Case for Not Having the Same HbA1C Target for Every Diabetic

Studies performed over several years in older diabetics are showing some surprises. They are proving that diabetic hemoglobin A1C over 7.5% to 8% does go along with higher death rates from complications.

They also show higher death rates if the HbA1C is kept at less than 6.5%. This is especially true if older diabetics have heart failure or nephropathy, what doctors call comorbidities (having two or more conditions that can cause death).

As diabetics are living longer, doctors who study and work with this aging habitancy are studying that the optimal ranges for things like Bmi, blood pressure and diabetic hemoglobin A1C need to be different from those for younger, newer diabetics.

They say that for type 2 diabetics with a history of heart failure it is best to keep the HbA1C in the middle of 7% and 7.8%, and for those with kidney disease this also seems optimal. There is no advantage in trying to lower blood sugar beyond that.

In fact, pushing for lower numbers raises the statistics for death as much as having high blood sugar. These studies are so new that the cause has not been figured out yet. But doctors who treat elderly patients think the question may be a higher number of hypoglycemic attacks. They are caused by attempting tighter blood sugar operate using medications.

Applying the same rules about good ranges in older patients as in younger ones is a big mistake. Elderly patients with a slightly higher Bmi than fits the standards survive heart attacks and other illnesses better than thin patients.

Not treating cholesterol and blood pressure with medication as aggressively in older patients is turning out to be a good idea. And the same is true for blood sugar. In aging diabetics there are smaller benefits from tight blood sugar control.

Measured against the catastrophic results of hypoglycemia, a diabetic hemoglobin A1C of 6.5% or lower is just not worthwhile. But that is only for long-term diabetics with a high risk for cardiovascular disease, who have heart failure or kidney disease.

Those who have a diabetic hemoglobin A1C below 7% by diet and rehearsal do not face the same risks and ordinarily do not have those other problems either. And there is no doubt that the closer the HbA1C is to the non-diabetic 6% level, the lower the likelihood of diabetic complications in your eyes, heart, kidneys and feet.

New diabetics need to try for the 6.5% diabetic hemoglobin A1C. And all of us with type 2 diabetes need to do our best to lower our blood sugar simply with a sensible diet that leaves out the Ages, and we need rehearsal for weight loss and cardiovascular health.

Insulin and oral medications are necessary, but the less we have to depend on them with type 2 diabetes, the better we will do as we age. It's rehearsal and eating wholesome food that will enhance the quality of our years as we live longer and longer with lasting conditions like diabetes.

Whatever you resolve to do, "be happy in the life you have chosen." (Charles Dickens).

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