1. Majid Ali MD, Insulin-Monitored Diabetes Reversal - Unfrealibility of Aic Test

    03:55

    from Majid Ali / Added

    I have sees several cases in which A1c test proved to be unreliable for screening for diabetes.

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    • The 411 On Your A1c

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      from Lee Memorial Health System / Added

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      Ask most people about diabetes testing and the classic finger-prick glucose test likely comes to mind. But getting an accurate picture of your blood sugar may take a deeper probe. “An A1c test which is a good indicator of what your average blood sugar has been doing over the last couple of months,” says Melanie Aracri, who is a certified diabetes educator for Lee Memorial Health System. The A1c doesn’t see blood sugar spikes after meals or snacks - it measures your glucose over time. The lifespan of a red blood cell is 120 days. By dissecting it’s memory, doctors get an average read on your blood sugar for the past three months. “It’s a calculation based on how much glucose has been attached to those red blood cells,” says Aracri. “The criteria for the A1c for pre-diabetes is 5.7 to 6.4%. And then greater than 6.4 or 6.5 is diagnosed as criteria for diabetes.” The A1c does double-duty. This average figure is used to diagnose pre diabetes and diabetes- it also helps people with treatment. By providing a bigger view of how well they’re managing their blood sugar. “Trying to get your A1c number down to a normal level so that I don’t have to take any medication,” says Julie Borkowski. Julie Borkowski is a borderline type 2 diabetic. She uses the A1c as a guide to get her to a better place. “You know try to avoid any sugar, very little carbohydrates because carbohydrates generate sugar and I’m also careful because certain fruit have sugar in it. So they have prepared a diet to get my sugar into a better level,” says Borkowski. “By more physicians doing those A1c tests, they are sending more consults to see the registered dietician, their certified diabetes educator to modify the diet,” says Aracri. The A1c is recommended twice a year for people with well-managed type 2 diabetes. This stick in time can tell you a great deal about your health. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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      • Measuring Up- a Look at Pre Diabetes

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        from Lee Memorial Health System / Added

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        It may come as a shocking revelation - as many as 90% of people who are pre-diabetic don’t know it. Finding out could provide them a window for change. “By more physicians doing those A1c tests along with your annual labs, they are sending more consults to see the registered dietitian, their certified diabetes educator,” says Melanie Aracri, who is a certified diabetes educator for Lee Memorial Health System. Someone without diabetes has a fasting blood sugar level below 100, a random blood sugar level below 140 and a three-month average blood sugar level, known as the A1c, below 5.7%. When these levels are elevated, but not high enough to meet a diabetes standard, a person is considered pre-diabetic. “The A1c for pre-diabetes is 5.7 to 6.4% is categorized as increased risk for diabetes and then greater than 6.4 or 6.5 is diagnosed as criteria for diabetes,” says Aracri. Unlike full-blown diabetes which is a life-long condition, pre-diabetes signifies a high risk, but is reversible. As more attention is placed on it’s importance, people can find out how they measure up, and make appropriate changes. “You are able to prevent going to type 2 diabetes when you’re in that pre-diabetes stage. By 10% weight loss and exercise,” says Aracri. Experts find modifying diet to reduce carb intake and getting more physically active is proving to be a turning point for their patients. “I really think they’re taking it to heart,” says Aracri. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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        • The ABC’s of Diabetes

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          from Lee Memorial Health System / Added

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          It may take work, but managing your diabetes is worth it. If the condition is well monitored, the less likely it is to cause complications. “I would hope with all the attention being focused on diabetes as of late people are being more compliant with diabetes care,” says Sharon Krispinsky, certified diabetes educator with Lee Memorial Health System. Most recognize the importance of regular blood sugar testing and the impact of weight. But managing the ABC’s of diabetes can lower chances of heart attack, stroke or other problems. The ‘A’ is for A1C. “A1C test is a very important number for patients with diabetes to know. Actually a measurement of your blood sugar control over the past two to three months,” says Krispinsky. Different from daily blood sugar tests, the A1C looks at glucose levels over the life of red blood cell. The number shows how well sugar is maintained over time and provides a picture of how well you’re managing your disease. “Ideally the A1C should be below 7%. And most endocrinologists like it approximately 6.5%,” says Krispinsky. Next up - ‘B’ is for blood pressure. If it gets too high, it makes your heart work too hard. It’s one of the tests that should be given frequently. “Absolutely the blood pressure should be checked at every physician’s appointment and ideally the blood pressure should be below 130/80,” says Krispinsky. Finally the ’C’ stands for cholesterol. LDL in particular is linked to heart attack and stroke. “With diabetes you’re at an increased risk for cardiovascular disease so one of the lab tests the physicians will be doing annually is lipid profiles; basically showing the amount of fat in the blood. They’re looking at LDL low-density lipid protein and we want those as low as possible,” says Krispinsky. Knowing your ABC’s when it comes to diabetes, means playing it smart. View More Health Matters video segments atleememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we’ve been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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          • Your Diabetes Score Card

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            from Lee Memorial Health System / Added

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            Staying on top of diabetes check-ups can keep the disease uncomplicated. “The blood sugar, as we know, is an important part of taking care of diabetes, but there’s much more to it,” says Sharon Krispinsky, a diabetes educator with Lee Memorial Health System. Consider this your diabetes scorecard: At every check-up plan on discussing a weighty issue. “If patients gain weight, their blood sugar generally goes up with type 2 diabetes. Conversely, if you lose weight with type 2 diabetes you may need less diabetes medication,” says Krispinsky. If you’re keeping score, blood pressure is another thing to watch. “Absolutely the blood pressure should be checked at every physician’s appointment. And ideally the blood pressure should be below 130/80,” says Krispinsky. Your doctor should also go over your glucose record. “Most of our meters today you can actually download your blood sugar and take your records and graphs to a physician’s office,” says Krispinsky. Every three months expect to take the A1C test. It looks for the amount of residual sugar in your red blood cells. Keeping proper levels delay or prevent serious complications. “A1C test is a very important number for patients with diabetes to know. Ideally the A1C should be below 7% and most endocrinologist like it approximately 6.5%,” says Krispinsky. Once a year, expect lipid testing. “With diabetes you’re at an increase risk for cardiovascular disease, so one of the lab tests the physicians will be doing annual is lipid profiles; basically showing the amount of fat in the blood. They’re looking at LDL low-density lipid protein and we want those as low as possible,” says Krispinsky. Urine albumin and creatinine tests look at kidney function. And don’t forget a comprehensive foot exam and eye exam. Do you find that some people don’t really get that message that it’s a whole curriculum of care? “Yeah it’s really an important message we try to educate our patients on, that there is testing that should be done every three months, six months and annually,” says Krispinsky. Paying attention now, can save your health in the long run. View More Health Matters video segments at leememorial.org/healthmatters/ Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries. Visit leememorial.org

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