If you’re trying to better understand your situation, here’s what to look for on your bloodwork:

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We will dive into the glycated Hemoglobin (A1C) test in the next section after covering some key terminology.

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Unmanaged insulin resistance (the underlying condition in diabetics) narrows your blood vessels and thus increases your risk of developing many other ailments including heart disease, kidney disease, and nerve damage. Therefore, pre-diabetics and diabetics are encouraged to focus on monitoring three key risk factors, commonly referred to as the ABC’s:

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A – Hemoglobin A1c (HbA1c), reflects your average blood sugar over the past 3 months

B – Blood pressure

C – Cholesterol (specifically LDL, often called “bad cholesterol”)

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While individual needs will vary, the standard goal metrics for each factor are:

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Hemoglobin refers to the oxygen-carrying protein in red blood cells, which have a lifespan of about three months. When your body releases new hemoglobin into your bloodstream, some of your blood glucose attaches and forms glycated hemoglobin (called HbA1c). When your HbA1c level is tested, you get the percentage of hemoglobin molecules that have glucose attached to them. A normal HbA1c level would be under 5.6% and diabetics have a level of 6.5% or above, while pre-diabetics have a HbA1c level in between.

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If you already have pre-diabetes or diabetes, you should get your HbA1c level tested every 3 months, the average lifespan of red blood cells. If you do not have any severe health issues, you should work with your doctor to bring your HbA1c level below the ADA recommendation of 7%. If you are unable to achieve this goal through improving your diet and lifestyle, you should work with your physician to explore possible medications to help lower your blood sugar. Throughout the rest of the guide, we will discuss detailed approaches to improving your diet and exercise regimen to reduce your blood sugar levels (see Page 10 and Page 14) as well as the types of medications available.

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Monitoring your insulin sensitivity

Managing insulin sensitivity, a measurement of how effectively your body absorbs blood sugar, is crucial to avoiding the progression of diabetes or pre-diabetes. The rate of glucose uptake is dependent on how effectively your body can absorb blood sugar. The more efficient your glucose uptake, the less insulin is required to lower your blood glucose level.

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Insulin-resistant people have reduced insulin sensitivity. As a result, their cells cannot effectively use glucose from the blood, causing glucose to build up in the bloodstream and elevating blood sugar levels. When blood glucose remains too high, the smaller blood vessels are damaged, leading to ailments including heart attacks, stroke, blindness, kidney failure, and foot amputations in the future. Thus, diets high in sugar can lead to inflammation and oxidative stress in the pancreas, which can ultimately damage the cells.

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Takeaways

• At minimum, get your blood sugar or insulin sensitivity tested at least once per year.
• If your HbA1c levels exceed 6.0, we recommend getting your level tested every 3 month to examine your rate of pre-diabetes progression.
• Focus on reducing your LDL (bad cholesterol) by decreasing portion sizes of red meats and dairy products.
• Consider requesting a continuous glucose monitor from your general practitioner to check your daily blood sugar variations.