Jeffrey K. King, M.D.


Mission Statement:

Provide personal, timely, compassionate, and competent care in Family Medicine.

Diabetes

This is a condition where the blood sugar (glucose) is abnormally high.  This is associated with a higher risk of heart disease, stroke, kidney problems, eye problems and nerve damage.

 

The American Diabetes Association defines diabetes as a person with one of the following:

1.  Fasting glucose 126 or greater on 2 separate occasions, OR

2.  A random glucose 200 or greater on 2 separate occasions, OR

3.  An abnormal glucose tolerance test.

4.  A hemoglobin A1c (a blood test) greater than 6.5%.

 

If you are diagnosed with diabetes, a useful test is one called a hemoglobin A1c.  Hemoglobin is a protein in your blood that carries oxygen and carbon dioxide.  Glucose binds to it permanently.  By measuring the percentage of hemoglobin that has glucose bound to it, we are able to make a rough estimate of the average blood sugar (the estimated average glucose) over the past 2-3 months.  The rough conversion is as follows:

A1C (%)   

glucose (mg/dL)

5   

 97 (76–120)   

6   

 126 (100–152) 

7   

 154 (123–185) 

8   

 183 (147–217)

9   

 212 (170–249) 

10   

 240 (193–282)

11   

 269 (217–314)

12   

 298 (240–347)

Diabetes can usually be controlled by a combination of dietary changes, exercise and pills, although some people do require insulin.  The goal A1c's, based on 2 studies in the UK are below 6.5 (American Academy of Clinical Endocrinologists) or below 7 (American Diabetes Association).  This level reduces the risk of microvascular disease (kidney and eye damage).  Recent studies in the US and Australia (the ADVANCE and ACCORD trials) have recently raised the question of whether lowering the A1c much below this is useful.