November is National Diabetes Month and millions of people are walking around with diabetes and don’t even know it.  Even worse, millions of people have gone to their primary care physician and have been told they are fine or are pre-diabetic and are just being followed rather than being proactive on addressing the problem.  If you have a blood sugar problem studies show you are at an increased risk for heart disease, stroke, neuropathy, loss of vision, kidney problems and high blood pressure just to name a few.  In addition, there are some medical researchers that are classifying Alzheimers as a consequence of diabetes.  The best part is type 2 diabetes is something that can be prevented!!

First, you need to be aware if you are at a higher risk.  The following factors may increase your chance of becoming a diabetic so you need to be screened yearly if you have one of these:

Gestational diabetes

Latino or Native American


Family history of diabetes.

The American Diabetes Association has a quick risk test you can do to see if you are at an increased risk.

Second, you need this blood test to see if you have a blood sugar problem and hint…it is NOT a fasting glucose level.

A fasting glucose test checks one spot in time how your blood sugar is.  If it is markedly elevated then you probably already have full blown diabetes.  For this reason,  I personally like the Hemoglobin A1C test better because it gives you a three month average of how your blood sugars have been doing.  It will rat you out every time and really give you the whole picture.  The optimal value of the A1C is 5.7 or less.  If you have a history of Alzheimer’s in your family I aim for 5.4 or less.  If your A1C is 6.5 or higher then you have full blown diabetes so small changes in this number means big things for your health.

Let me show you how deceiving a single glucose level can be.  For example, if you have a fasting glucose level of 130 you may be feeling good about it thinking it is not too far off from your target (80-115 would be what I would call optimal).  However, if your 3 month average blood sugar was 130 then your hemoglobin A1C would be 6.2!  Remember that 6.5 is full blown diabetes!  You can see just how close you are and you might as well get your insurance card out to go buy the diabetes medication because you are well on your way.

If your A1C is not optimal or you have a risk factor then here are 5 tips to help you avoid full blown diabetes.  Keep in mind that I start addressing blood sugars when the A1C goes above 5.8!

  1. Decrease the amount of sugar causing foods you eat:  everyone always argues that they don’t eat that many sweets.  Diabetes is not about how many sweets you eat (although high sugar diets do make it worse).  Diabetes is about how your body processes foods and there are plenty of foods that cause unsuspected rises in your own sugar.  For example: bread, potatoes, carrots, bananas, alcohol, pasta are foods that cause a higher sugar rise.  You can find which foods have a higher sugar response by looking at the glycemic index of the food.  The glycemic index is just a fancy term for how much sugar that particular food has and the tendency to produce higher sugars in your body.  You can find glycemic index charts easily on the internet.  The best foods are in the low glycemic index charts.  Here is one example of a website that has a glycemic index chart.  This doesn’t mean you can’t have a high glycemic index food but you do you need to limit the quantity and follow tip #2 below.
  2. Pair your foods with high quality protein. Adding protein to a meal provides a necessary balance to keep the sugars from getting too high.  An example of an unbalanced meal that many think is a healthy choice is a bowl of oatmeal or how about a baked potato.  These cause higher sugar rises and are often eaten alone compounding the problem.  If you eat a food that has a higher glycemic index then balance them with protein and eat smaller portion sizes.
  3. Study after study shows that exercise decreases insulin resistance.  You don’t have to hit the gym.  Just get moving!  Even 10 minutes a day can make a huge difference.
  4. Take high quality supplements that help your body become more sensitive to your own insulin. You always hear about cinnamon and chromium lowering blood sugar but honestly, I have never seen much of an improvement with these.  My favorite is berberine with my go to product being CM Core from Orthomolecular.  If I am working with insulin resistance this product can have amazing results.  A sustained release Alpha Lipoic acid can also really help (AlaMax CR by Xymogen).  There are several really good combination products and meal replacement shakes, too.  If you are above the A1C 5.9 range then I usually recommend you get some type of supplement on board to help your turn the corner in the right direction while you are working on your lifestyle.
  5. Take medication if you need it. If you have high blood sugars it can make it very difficult to lose weight which in turn keeps your blood sugars high so it can be a viscous cycle.  I don’t mess around with high blood sugars and sometimes you just have to take what I call a “bigger dog” approach and use medication to stop this cycle.  I actually like Metformin and will use it in pre-diabetes just for this purpose. If your A1C is 6.5 or higher then you need diabetes medication.  Get your sugars down, change you lifestyle.   As always, we are working on the lifestyle changes along with the medication.  When you lose the weight and change your lifestyle then it’s time to start weaning down off of the medication.
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So, next time you go to your primary care physician insist on the Hemoglobin A1C test.  They might balk at it and be aware that your insurance doesn’t really like covering this test until you already have diabetes (especially Medicare).  Always ask for the exact number so you can do your own interpretation of what they are calling normal because unless it is below that 5.7 mark it is not optimal!  Be proactive and take control over the situation and avoid the consequences of high blood sugar problems.


To your health,