Many of you may have already been tested for pre-diabetes or diabetes using a marker called hemoglobin A1C (HgA1C).  This test basically allows you to know how well your blood sugars have been controlled in the last three months.  More recently, however, this test is becoming quite integral in predicting your risk of heart disease.  According to the New England Journal of Medicine, levels above 6.0%, are better than fasting glucose for predicting long-term heart disease and stroke risk.  

Scientists have known for years now that insulin resistance and diabetes have been tightly linked to cardiovascular disease, as the information is omnipresent.  This is  the one of the first studies comparing fasting glucose and HgA1C as they compare to assessing heart disease risk.

This may be so because fasting glucose is not as consistent a test.  It will vary depending on what the patient ate the night before.  It is not uncommon for patients to alter their diets slightly the night before the test in order to obtain a more favorable blood result.  They may not have that glass of wine or extra helping of dessert.  Therefore, unless they already have full blown out diabetes, their morning blood sugars may come back as normal.  

A Hemoglobin A1c, however, is a more stable marker of one’s blood sugar control.  The red blood cell has a life span of 120 days, during which glucose molecules react with hemoglobin.  This forms a “glycated hemoglobin”, another term used for HgA1C.  Those with poorer blood sugar control have a higher glycatred hemoglobin.  A normal level is below 6.0%.  

A standard American Diet will often cause spikes in blood sugar and therefore elevated the HgA1C.  This, in turn, will increase the risk for multiple complications associated with both diabetes and insulin resistance; including coronary disease, vascular disease,  heart attack, stroke, heart failure, kidney failure, blindness, erectile dysfunction, neuropathy (loss of sensation, especially in the feet), gangrene, and gastroparesis (slowed emptying of the stomach).

Now that a major journal is embracing the test for HgA1C, as opposed to a fasting glucose, as a measure of heart disease risk, I strongly believe that aside from routinely assessing its value, it is imperative to stay ahead of the curve and be proactive.  Prevent heart disease and stroke by maintaining good control of your blood sugar.  Keep the HgA1C low.  

Living Smarter, Living Longer, 

Dr. K