Why You Really Hurt, It All Starts in the Foot by Dr. Burton S. Shuler
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Why You Really Hurt

It All Starts in the foot

by Dr. Burton S. Shuler

important blood test
The glycated hemoglobin test (often called the glycosylated hemoglobin test) or hemoglobin (A1C) is a measurement of the overall control of the diabetic for the previous two to three months. Most diabetic specialists feel it is now the single most important blood test for known diabetics. The American Diabetes Association recommends that if you are a diabetic, this test be taken every 3 months. For patients who are not yet diagnosed with diabetes, it is becoming more popular for making the initial diagnosis of Diabetes.
The fasting blood sugar (FBS) test, which is still the mostly commonly performed test for Diabetes, does not reflect the true picture of diabetic control over a long period of time. The FBS only measures the level of sugar in the blood at the moment it is taken from your finger or arm. Patients have been known to "fake" the results of their FBS by staying on their diet and medication (when they normally won't) for several days leading up to the FBS, in order to have a more normal result, when in fact their glucose (sugar) levels were out of control. You can not fake the results with a glycated hemoglobin test because it is based on 90 days, not an instant like the FBS.

HOW IT WORKS

The glycated hemoglobin test measures how much glucose is attached to hemoglobin cells, the part of the blood that carries oxygen. As the hemoglobin floats around in the blood, it picks up glucose in about the same proportion as the glucose that exists in the bloodstream. If your blood glucose is generally running high, the hemoglobin will have more "glucose coating" (glycosylization). If your glucose generally runs low, it will have less. Since the red blood cells have about a two to three month life span in the body before they are recycled, we can measure the "glucose coating" of a sample of hemoglobin. This gives you an approximate average of glucose control over the last two to three month period.

What is the goal of the glycated hemoglobin test?

Every person, whether or not he or she has diabetes, has a certain amount of glycosylization present. Because of more sugar in their blood, people with diabetes have a greater amount of glycosylization present. A low result on the glycated hemoglobin test is a good result. If your test is in the good control category, you can be satisfied that your diabetes management plan is working well. If results are in the marginal category, some fine tuning of your treatment plan may be needed. A poor result can be improved. This test gives you valuable feedback on how well you are controlling your diabetes. It can also let you know when to work on improving your diabetes management.
It's important for you to remember that normal values for the glycated hemoglobin test may vary from laboratory to laboratory, because different laboratories use different procedures to perform the measurement. Be sure to ask for the "normal" range for that particular lab. But a goal of 7 or less is what you want. It's best to have the tests done by the same laboratory so you can compare the results from one test to the next to note the progress you are making. Your physician will help you determine your goal range for glycated hemoglobin. If you are Type I or Type II diabetic, you should be having this test every 90 days; there is no reason that you should not. If your physician is not running the glycated hemoglobin test on you every 90 days ask him why.
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