Major Study Confirms Racial Disparities Related To Key Diabetes Indicator, Hemoglobin A1c

Major Study Confirms Racial Disparities Related to Key Diabetes Indicator, Hemoglobin A1c

Major Study Confirms Racial Disparities Related to Key Diabetes Indicator, Hemoglobin A1c

Major Study Confirms Racial Disparities Related to Key Diabetes Indicator, Hemoglobin A1c
Standard Test for Determining Blood Sugar Control in People with Diabetes Is Not Always an Accurate Measure of Blood Sugar Control and Interpretation Differs Based on Race.
Boston, MA – June 14, 2017 – T1D Exchange, an organization that is accelerating novel treatments and improving care, today published an important research study that confirms disparities between blacks and whites in hemoglobin A1c (HbA1c) levels, the standard measure used to assess blood sugar control in people with diabetes. Racial differences in HbA1c levels have been consistently reported in adults and children with type 1 diabetes (T1D) or type 2 diabetes, with non-Hispanic blacks having higher A1c levels than non-Hispanic whites. T1D Exchange researchers sought to understand whether this difference is due to worse glycemic control in blacks or the consequence of racial differences in the glycation of hemoglobin.
This study builds upon previous T1D Exchange research that identified racial disparities in glucose control, with blacks having higher HbA1c levels than whites in both children and adults. In the scientific community, differing theories have been proposed regarding these disparities; that higher HbA1c levels in blacks represents worse glycemic control; and that higher HbA1c levels could be due to race-based genetic differences in the glycation of hemoglobin at the same glucose levels. If the latter were true, it would mean that HbA1c on average is overestimating the mean glucose concentration in bla Continue reading

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Diabetes linked to memory decline in older adults

Diabetes linked to memory decline in older adults

Older adults with poorly controlled diabetes may struggle with what's known as episodic memory, the ability to recall specific events experienced recently or long ago, a study suggests.
Researchers examined results from a series of four memory tests done from 2006 to 2012 for 950 older adults with diabetes and 3,469 elderly people without the disease.
The participants who had diabetes and elevated blood sugar performed worse on the first round of memory tests at the start of the study and also experienced a bigger decline in memory function by the end of the study.
"We believe that the combination of diabetes and high blood sugar increases the chances of a number of health problems," said lead study author Colleen Pappas, an Aging researcher at the University of South Florida in Tampa.
"Our study brings attention to the possibility that worsening memory may be one of them," Pappas added by email.
While the study doesn't explore why this might happen, it's possible that elevated blood sugar damages brain cells that transmit messages in the hippocampus, a part of the brain involved in memory, Pappas said.
At the start of the study, when participants were about 73 years old on average, they all got blood tests that measure average blood sugar levels. This so-called hemoglobin A1c test measures the percentage of hemoglobin - the protein in red blood cells that carries oxygen - that is coated with sugar, with readings of 6.5 percent or above signaling diabetes.
The people without diabetes had average A1c levels of 5.6, considered a normal or healthy range. But the diabetics had Continue reading

Highs & Lows: Reevaluating Hypoglycemia in Elderly Diabetes Patients

Highs & Lows: Reevaluating Hypoglycemia in Elderly Diabetes Patients

Hypoglycemia, a misunderstood diabetes complication, not only confounds the public and patients, but many healthcare providers as well. Elderly diabetes patients with hypoglycemia are especially vulnerable to this dilemma.
Mary M. Julius, RDN, CDE, clinical coordinator of Diabetes Self Management Education and Support and a research dietician and nutritionist at the Department of Veteran’s Affairs in Cleveland, Ohio, treats an 86-year-old man who has had type 1 diabetes for 50 years. His wife passed away last August. “He said to me, ‘Mary, for the past 55 years, all I’ve had to do is sit down and breakfast would be there,’” Julius says. “’I’d sit down and lunch was there. All I had to do was eat.’ He is going to bed hungry because this is a new skill for him.”
Julius’s patient is one of many in the very complex realm of hypoglycemia, and the fact that he’s in the vulnerable population of elderly people with diabetes, it only compounds the complexities. According to Julius, missing a meal is the number one cause of hypoglycemia, and elderly patients are at a higher risk of missing a meal than the general population. These patients are already frail at baseline, and older people tend not to eat as much anyway, whether they’re just not hungry or they suffer from food insecurity, but more on that later.
Hypoglycemia remains a complication of diabetes that’s not entirely understood. There still seems to be a lack of awareness among the healthcare community and the public, even among people with diabetes. For instance, hypoglycemia just isn’t as ap Continue reading

Diabetes Blood Sugar Basics

Diabetes Blood Sugar Basics

Sometimes it’s helpful to have a basic explanation about diabetes blood sugar levels. So here’s your 101 just in time for National Diabetes Month.
I’ve complied answers to some of my clients’, friends’ and readers’ most common questions about diabetes blood sugar.
Q: What should my blood sugar level be?
A: There is no single number that is right for every person with diabetes. Your blood sugar targets should be individualized based on your health status, age, how long you’ve had diabetes, your medications, risk for low blood sugar (hypoglycemia) and other things. However, the American Diabetes Association (ADA) has these general targets.
Fasting & Before Meals: 80 – 130 mg/dl
1 – 2 Hours After Eating: < 180 mg/dl
Talk to your healthcare provider to learn your specific blood sugar targets. It’s to important to know that these targets are general targets for people with diabetes. They are not numbers for people who do not have diabetes.
Q: Why does my doctor want my A1C level to be less than 7%, but my mom’s doctor told her that he was pleased with her A1C level at 7.8%? Shouldn’t my mom and I aim for the same A1C goal?
A: Not necessarily. The ADA general target for A1C is < 7%. But just like we personalize other blood sugar targets, A1C goals should also be specific to the individual. Lowering A1C to < 7% reduces the risk of microvascular complications of diabetes such as nerve, kidney and eye problems. And if people with diabetes achieve this level of blood sugar control early in the course of the disease, their risk of heart disease is also reduced. Continue reading

A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes

A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes

Comprehensive recommendations feature notable new recommendations for people with cardiovascular disease and diabetes.
New recommendations in the 2018 edition of the American Diabetes Association’s (ADA’s) Standards of Medical Care in Diabetes (Standards of Care) include advances in cardiovascular disease risk management, including hypertension; an updated care algorithm that is patient-focused; the integration of new technology into diabetes management; and routine screening for type 2 diabetes in high-risk youth (BMI >85th percentile plus at least one additional risk factor). The Standards of Care provide the latest in comprehensive, evidence-based recommendations for the diagnosis and treatment of children and adults with type 1, type 2, or gestational diabetes, strategies to improve the prevention or delay of type 2 diabetes, and therapeutic approaches that reduce complications and positively affect health outcomes. The Standards of Care have been published in advance of a supplement to the January 2018 print issue of Diabetes Care.
The Standards of Care are the primary resource for the optimal management of diabetes, and include updated guidelines for diabetes diagnosis, and for evidence-based prevention of diabetes and diabetes-related complications.
A summary of the important changes in the 2018 edition are:
Cardiovascular disease and diabetes
Based upon the results of multiple cardiovascular outcome trials (CVOT), there are new treatment recommendations for adults with type 2 diabetes, suggesting a pathway for people with heart disease that, after lifestyle mana Continue reading

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