Wednesday, September 9, 2015

WELLNESS WEDNESDAYS: Part 2: "I have diabetes. Please help me."

“Monitoring carbohydrate intake, whether by carbohydrate counting or experience-based estimation, remains critical in achieving glycemic control.”  
       -- from Standards of Medical Care in Diabetes 2015, American Diabetes Association

“What was your last A1C result?” 

Whenever someone asks me for help with their diabetes, their answer to this question tells me volumes about their relationship with their doctor and their health literacy about diabetes.   This is because the A1C is the most important blood test for someone diagnosed with diabetes.  Understanding its significance is, without a doubt, the key to gaining control. 

It ALWAYS bothers me when their answer is, “What’s that?”  It means their doctor has not taught them well. 

Class is now in session.  What is the A1C and what does it mean?  It is a blood test that measures one’s average daily blood sugars over the past 2-3 months.  Fasting is NOT required for this test.  Here’s the bottom line:  the higher the A1C, the higher the chance of complications from diabetes. The longer an A1C remains elevated, the greater the chance the damage may be irreversible. However, when the A1C remains stable at goal, as determined by 2 or more consecutive tests at or below the goal, it is the best test of how well controlled one’s diabetes is.  

What is the A1C goal for most people?  In non-pregnant adults, it is below 7%, according to American Diabetes Association.  In older adults, the goal may be less stringent (less than 8%).  Diabetes is diagnosed by a physician when the A1C is 6.5% or higher, so for this reason some doctors set goals for their patients lower than 7% because they want to help the patient get their blood sugar to levels as normal as possible. 

Why does all this matter?  In last week’s Wellness Wednesdays was data from Centers for Disease Control and Prevention that lays out the scope of the problem.  We have a very big problem with diabetes in this country and it is up to us, the adults, to do something about it for the sake of our children’s health. The diabetes epidemic is directly related to our obesity epidemic.  

What’s the solution?  Sugar.  Eating huge amounts of sugar has to stop.  Sugar, just like salt, is added to all kinds of foods and many people mindlessly consume foods and drinks that are toxic to their health.  When those people are parents, their choices affect their kids.  When someone has diabetes, one of the first things I talk with them about is what they drink.  Like my friend I told you about last week, her answer was that she drinks Cokes all day long!   She has made changes and you can, too.  She has now stopped drinking all sodas.  

Be mindful what you eat and drink.  Start training yourself to be a nutrition detective by looking at food labels for sugar and fiber content.  You may be very surprised by all the hidden sugars you find in what you normally eat and drink. Once you (and your kids) start cutting back on foods and drinks containing added sugars, such as high fructose corn syrup, your clothes will probably start fitting better.  Nice side effect of being a nutrition detective! 

So if you have diabetes (or prediabetes), what can you do starting today to improve your A1C? 
  1. Stop drinking sodas.  
  2. Drink water, not soda.   
  3. Eat real fruit instead of drinking fruit juice.  
  4. And please, talk with your doctor about your A1C goals.  

Do you have a question about what to eat?  Then please send me an email at and I'll pick one reader's question to feature in an upcoming issue of Wellness Wednesdays in October.  

Now, off to the kitchen for another piece of crustless spinach quiche!  

In gratitude,
Nancy Heinrich

Founder, Growing Healthy Kids, Inc.