Glucose is a natural sugar in the body that is used for energy. During digestion most foods are converted to a simple sugar called glucose for energy. For glucose to pass for the blood stream into cells we need a hormone called Insulin which is produced by pancreas. In Diabetes there is less Insulin production or a problem with body’s ability to use Insulin (Insulin resistance) Hence there is a high levels of glucose in the blood. If not treated it can cause complications like heart disease (blockage), heart attacks, kidney damage, stroke etc.

What should normal blood sugar levels be?

Before breakfast when you have not eaten for 8 hours or more, normal blood sugar would be between 70-105 mg/dl. However after a meal normal blood level rarely goes above 200 mg/dl.Normal blood glucose values are

• Fasting blood glucose should be less 110 mg/dl
• After meal blood glucose (2 hours) should be less than140 mg/dl

How do we diagnose Diabetes?

• Fasting blood glucose equal to or more than 126mg/dL
• Post food blood glucose (after 2 hours) equal to or more than 200mg/dL
• An A1c test (Glycosylated haemoglobin) that is equal to or greater than 6.5%.

What is an A1c test?

It is an easy test that gives a two to three month average of blood sugar. The advantage of this test is that you don’t have fast and can be done anytime. The American Diabetic Association has added it as a diagnostic test for Diabetes and Prediabetes. Diabetes is diagnosed if A1c is more than 6.5% and Prediabetes if A1c is between 5.7 – 6.4%.

Can you explain a little more on A1c?

Hemoglobin is chemical in our blood, which carries oxygen. The glycosylated hemoglobin test measures the percentage of hemoglobin molecules that have sugar attached to them. Because this percentage directly reflects the average blood sugar levels over the life of a red blood cell (that is about 90 days) this information helps you and your doctor assess your overall blood sugar levels. There are different types of glycosylated hemoglobin and each one has its own normal range and values. The most common one is Hemoglobin A1 c. It is ideal for a person with Diabetes, to have an HbA1c test done every 3 months.

How common is Diabetes in India?

India is said to be the diabetic capital in the world. At present, confirmed diabetes patients in India are 67 million, with another 30 million in prediabetes group. By 2030, India will have the largest number of patients in the world.

Does Diabetes occur in young adults?

A large chunk of the population just seems to have the genetic programming to develop the disease with age. However Type 2 Diabetes is showing up in young people. In India more and more young people are getting it due toour modern lifestyle—lots of food and little exercise speeds up the process. So people who might have developed this “old-age disease” in their 60s and 70s are now developing the disease much earlier in their 30s and 40s due to obesity and lack of exercise; sometimes in their teens or in childhood.

What are the symptoms of Diabetes or high sugar?

In early stages and in many people with high sugar there may be no symptoms at all. Only a blood sugar test will show either they are Prediabetic or Diabetic. Some other may experience symptoms such as fatigue, excessive thirst or urination or unexplained weight loss.

My doctor says I am Prediabetic. What does he mean?

It means that you are at high risk of developing diabetes. The advantage of recognizing Prediabetes is that one can prevent or delay diabetes by increasing physical activity, eating healthy foods and maintaining or losing body weight.

When we say someone is Prediabetic?

• An A1c between 5.7- 6.4%
• A fasting blood sugar between 100-125mg/dL
• Post food blood sugar between 140-200 mg/dL

Why is it important to measure blood pressure if I am diabetic?

High blood sugar combined with high blood pressure increases your risk of getting diabetic kidney disease. Kidney disease can lead to kidney failure and the need for dialysis or kidney transplant. Doctors can identify diabetic kidney disease at a very early stage, when small amounts of protein appear in the urine (microalbuminuria)

Hence it is important to monitor and control high blood pressure in a person with diabetes. Certain drugs like ACE inhibitors that lower blood pressure also lower microalbuminuria and can slow the development of kidney disease. A low protein diet may also be helpful in preventing kidney problems.

Do Diabetes and Heart Disease occur together?

Yes and very often. The risk of death due to heart attack is three times higher in diabetics as compared with non-diabetics. Life expectancy too is reduced by 30% in diabetics as compared to non diabetics.In many cases the Diabetics may not feel the chest pain (silent heart attacks) Hence it is important to proactively screen for heart disease in all diabetics and offer adequate protection.