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Diabetes includes a group of disorders of the body’s metabolism in which blood sugar levels remain high for prolonged periods of time. Approximately 90% of diabetics have Type 2 diabetes in which the body’s insulin is unable to control blood sugar levels. Although it is called the silent killer, classic symptoms include frequent hunger, thirst and urination. Diabetes affects multiple organ systems and compromises people’s quality of life in many ways. It is considered to be the seventh leading cause of death, however, when the deaths attributed to organs affected by diabetes are included, some say it is the third leading cause of death after heart disease and cancer. The American Diabetes Association stated that in 2015, over 30 million Americans had Diabetes; over 9% of the population, with 25% of seniors affected. Over 7 million of that total are undiagnosed! Sadly, over 84 million other Americans over 18 have Prediabetes and are at risk of developing Diabetes. With the cost of Diabetes in 2017 estimated to be over $300 billion and the projected increase in new diagnoses and costs over time to be astronomical, much more needs to be done. The World Health Organization considers Diabetes to be mostly preventable with increased activity, better nutrition and lower caloric intake.
My focus is on making those with Diabetes who are undiagnosed, and those who are Prediabetic, aware of their situation, so that the disease can be treated or avoided. First, there is something called a Risk Assessment test. It is a simple series of questions that you answer and add up the score. If you score is high enough, it indicates that you may be at risk. Here is the link: www.diabetes.org/are-you-at-risk/diabetes-risk-test/.
Next is tests for diabetes. In the past, a fasting blood glucose test was the standard way of measuring blood sugar. A new test is now used as well. It is called the HbA1c or A1c test, for short. It measures the percentage of hemoglobin in the bloodstream that has a sugar molecule attached (glycated). This indicates the average blood sugar for the past 2-3 months. Your physician sends you for these tests, but many people do not visit their physician on a regular basis. Everyone should know their A1c value because it tells you if you are normal, need to worry and do something (prediabetes), or need treatment, and this is a quality of life issue. A1c levels of 4-5.6% are normal. 5.7-6.4% levels indicate that there is a higher chance of developing diabetes (prediabetic), and levels of 6.5% or higher suggest diabetes. These tests are not 100% accurate and a quick look at webMD will give more information about exceptions such as those with Anemia. A high reading will usually be retested to confirm it.
If you don’t go to the doctor, or want to monitor your A1c yourself, there is good news. Home test systems are available with easy to follow directions and videos. Research has indicated that most people are able to conduct these tests at home and get accurate results. The kits are inexpensive and available online. Remember to administer the pin prick to the side of your fingertip. Not all kits are the same. I recommend following this link: www.a1cnow.com. Keep healthy! Dr. A
Diabetics, be aware that your oral health is adversely affected by Diabetes and it is very important to practice good oral hygiene and visit the Dentist regularly. When Physicians make a diagnosis of Diabetes, they want to be sure that any infections or chronic inflammatory issues are eliminated or controlled. This is because diabetics do not heal as well and infections raise blood sugar levels and worsen the individual’s diabetic condition. Although physicians routinely screen expectant mothers and routinely refer diabetic patients to Ophthalmologists, Podiatrists, Cardiologists and Endocrinologists, they do NOT routinely refer patients to Dentists. Periodontal (gum) disease is a common infection that causes chronic systemic inflammation and is more likely to be more common and worse in people with Diabetes. Diabetes and Periodontal disease are like the chicken and the egg; which came first? Over 90% of diabetic adults have perio and it destabilizes glucose control which accelerates the progress of diabetes and contributes to the many debilitating problems that worsen their quality of life. I have been working with the American Dental Association trying to persuade the American Diabetic Association to change the Standard of Care for Physicians to require them to routinely refer diabetics to Dentists and for dentists to share their diagnosis and treatment progress of mutual patients in an attempt to “defragment” healthcare. In the meantime, I would advise everyone to follow these recommendations: If you are not aware whether you have diabetes because you have not been screened by a Physician in the last two years or more, see a doctor and get tested. If not, there is a Diabetes Risk Assessment test you can google on the internet and answer the questions, add up your score and see if you are at risk. You can also test your own blood sugar with an A1c test kit available at Costco or on the internet at www.a1cnow.com. 4-5.6% is normal; 5.7-6.4% is prediabetic, and above suggests Diabetes.
If you have been diagnosed with Diabetes, see a Dentist. Get a full set of x-rays and get evaluated for gum disease. Eliminate or restore any infected teeth and treat any gum disease. You must brush AND use dental floss (or Picks, but waterpic and sonic flossers are not sufficient) daily and follow a low sugar, low carb diet if your physician suggests it. Actually, research says that eating moderate amounts of fruits are not bad for diabetics. When Dental infections and related chronic inflammation are brought under control, the blood sugar may stabilize. See the dentist 2-4 times per year and maintain good hygiene and hopefully, your overall health will improve.