By Dr. Rendemo Shitiri
DIABETES mellitus(DM) is a group of metabolic disease in which there are high blood sugar levels over a prolonged period. Symptoms of Diabetes include frequent urination, increased thirst and increased hunger. If left untreated, Diabetes can cause many complications. Acute complications can include Diabetes ketoacidosis, non-ketotic hyperosmolar coma or even death. Serious chronic complications include heart disease, stroke, chronic kidney failure, Diabetic foot ulcers and damage of the eyes.
There are three main types of Diabetes mellitus:-
1. Type 1 DM – Results from the pancreas failure to produce insulin. Earlier it was known as insulin-dependent DM (IDDM) or juvenile diabetes. The cause is unknown.
2. Type 2 DM – A condition in which cells fails to response to insulin properly. This type is also known as non-insulin dependent DM ( NIDDM ) or adult onset DM. The primary cause is excessive body weight and not enough exercise.
3. Gestational diabetes – occurs in pregnant women with no previous history of Diabetes develops high blood sugar. This type becomes normal after delivery.
PREVENTION AND TREATMENT
Maintaining a healthy diet, regular physical exercise, a normal body weight and avoiding use of tobacco. Control of blood pressure and proper foot care are important for people with the disease. Regular blood sugar monitoring along with HbA1c levels ( Glycosylated hemoglobin ) are important.
What is HbA1c or glycosylated hemoglobin ?
HbA1c is a form of hemoglobin that is measured to identify the three months average plasma glucose concentration. The test is limited to a three months average because the life span of Red blood cells is about four months only.
What is the normal level of HbA1c ?
In healthy people HbA1c levels should be less than 6% of total hemoglobin. Normal range 4-6%. HbA1c level of 6.5% signals that Diabetes is present. HbA1c levels should be kept below 7%.Studies have demonstrated that the complications of Diabetes can be delayed or prevented if HbA1c levels are kept below 7%. It is recommended that treatment of Diabetes be directed at keeping the individual HbA1c levels as close to normal as possible (<6%) without episodes of hypoglycemia ( Low blood sugar levels ).
When should HbA1c levels be tested?
- Known Diabetic – Fasting blood sugar along with HbA1c levels should routinely measured every three months.
- People with family history with elevated blood sugar.
- If you are curious.
How a person can lower HbA1c levels ?
Following Diabetes management plan can help lower your HbA1c levels such as
- Dietary modifications
- Physical activity
- Following proper medications of your Doctor
- A combination of the above.
A normal or only slightly elevated HbA1c levels is an indicator that your Diabetes is under control. If HbA1c levels remains increased following treatment your Doctor can change your medications.
HbA1c levels can be measured by many instruments in laboratories but recently a new machine called D-10 is found to accurately measure HbA1c levels.D-10 is a fully automated system from Bio-Rad Laboratories, USA that combines both Diabetes monitoring & abnormal hemoglobin testing on a single platform. The D-10 High performance liquid chromatography ( HPLC ) system sets a new standard of performance for comprehensive hemoglobin testing.
1. HbA1c or glycosylated hemoglobin for monitoring of Diabetes mellitus.
2. Hemoglobin variant analysis for testing Hemoglobinopathies or inherited abnormal hemoglobin disease such as thalassaemia , Hemoglobin E disease, sickle cell disease etc.
In conclusion measurement of HbA1c in monitoring of Diabetes mellitus is of immense importance to avoid serious complications.
