Why is blood sugar control so important?
Blood sugar control is the therapeutic goal for the diabetic. Poor blood sugar control is the culprit in the multiple complications that await this group. Recent research out of Johns Hopkins indicates that HBA1c is a significant predictor of these complications. An HBA1c of 7%, the goal for so called good blood sugar control, was shown to be predictive of Coronary Heart Disease. While this is sobering news for the diabetic, there is great concern for the non-diabetic as well. Limited studies cited by the Johns Hopkins Epidemiological team demonstrated that the non-diagnosed, non-diabetic has a similar risk for heart disease due to poor glycemic control.
This discussion is oppositional to the mainstream belief that cholesterol causes heart disease. The cholesterol heart disease theory misses the fact that it is sugar in the blood that sets the stage for the liver to turn it into cholesterol and triglycerides. Blood sugar acts like maple syrup in the vascular system creating a sticky environment perfect for collecting points and inflammation.
Controlling blood sugar levels for our diabetics is the province of prescription drugs not diet or lifestyle changes. There is little effort expended by the patient to achieve good glycemic control because it is so confusing and the medicine has taken the place of self-monitoring. While some may avoid items that contain sugar (the white stuff in the bowl), carbohydrates of all kind are consumed without any concern. The hard fact is that all carbohydrates become sugar to the human being, all. The diabetic individual has a particular distortion in glucose metabolism meaning that blood sugar may remain out of control as long as high carbohydrate foods are consumed. Therefore fruit, pasta, cereal, and bread will elevate blood sugars. While the diabetic may observe this, they are sometimes frustrated because fruit, pasta, cereal, and bread are thought to be healthy.
In 2002 the diabetic community spent $92 billion dollars on diabetes. The cost per person was $13,000 per year. (The non-diabetic spent $2300 per year on medical care.) With this kind of money to be made treating diabetes, is there any interest economically in offering programs that will make diabetes obsolete?
Money issues aside, as the diabetes progresses quality of life is negatively impacted. Heart disease, quality of life, and finances are pertinent issues reflective of blood sugar control. Blood sugars of 140 mg/dL are no longer good enough.
Nadine Campbell, R.N., 8/21/06
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