In the US today, 37.3 million adults have type II diabetes, and of those, over 8.5 million were undiagnosed. What is staggering about this information is well before type II diabetes develops, pre-diabetes has been present for years, if not decades. Even more critical to the conversation about diabetes is that this disease is 100% preventable and reversible.
What is diabetes?
When you consume a carbohydrate, whether that is rice, blueberries, pasta, ice cream, or any food that supplies starch or sugar, glucose makes its way into your bloodstream after being absorbed through the intestinal wall. Fructose (fruit) must be converted to glucose in the liver, but eventually hits the bloodstream as glucose as well.
From there, your body has three fates for glucose:
Glucose is taken into your cells where it converts, with the help of some incredible biochemistry, into energy which you use to stay alive. This is most obvious and efficient in kids after they eat sugar – it is the reason they get a “sugar high”. The better your body does this, the more metabolically healthy you are. However, as we age, lose skeletal mass, become sedentary and deplete hormones, this metabolic process is less effective.
If your body has more glucose than it needs for energy, then your body has an evolutionary safeguard which allows you to store energy (glucose) for later. Your body packages 3 glucose molecules into a fat called a tri-glyceride (3 sugars). The triglyceride is now stored in a fat cell so if you run out of energy later, your body can liberate that fat and break it down into glucose for energy. This is the process by which carbs can increase body fat.
The third option is arguably the most dangerous. When glucose is not used for energy and does not get stored as fat, it is left in the bloodstream where it attaches to a red blood cell. As the red blood cell circulates throughout the vascular system, the attached sugar “scratches” the walls of the vascular system causing damage. This is why heart disease, kidney failure, neuropathy and even amputation of limbs is associated with high blood sugar. In essence, high blood sugar becomes a vascular disease.
Elevated blood sugar also increases your risk of:
- Cardiovascular disease
- Cognitive decline
Screening for diabetes
The HbA1c or hemoglobin A1c test which should be part of every annual exam, measures the percentage of red blood cells that have sugar attached. If the percentage is too high, you have pre-diabetes or diabetes. Here is the breakdown:
HbA1c < 5.7 is normal (however, anything above a 5.4, we start to pay close attention to)
HbA1c 5.7-6.4 is prediabetes (note that damage is being done to the vascular system at this point, its just less damaging that when that number increases to diabetes range)
HbA1c 6.5 or above is diabetes.
What are the early signs?
The 5 earliest signs of elevated blood sugar include:
- Fatigue after eating or in the afternoon
- Weight gain around the mid-section
- Carb or sugar cravings (even potato chips break down to sugar)
- Startling awake in the middle of the night
How do we identify diabetes risk early?
TEST! Glucose and HbA1c testing should be performed at least once a year. If HbA1c is 5.5 or over or if you have any of the symptoms above, continuous glucose monitoring will help us identify the factors that are driving glucose up.
How do we reverse diabetes?
The most evidence-based and effective methods for reversing diabetes or the risk of diabetes include:
Increasing skeletal muscle which means your cells use more glucose and less sugar stays in the bloodstream
Reducing carbohydrates to the amount your body needs for energy and no more
Improving micronutrient intake with targeted vitamins and minerals associated with glucose metabolism
Optimizing sleep as poor sleep and sleep apnea drive blood sugar up
Dialing in stress response to reduce cortisol induced blood sugar spikes.
What to do next?
Reach out if you're concerned about diabetes risk. We will implement screenings and treatment based on your unique risk factors while educating you to prevent this disease for good! Click here to contact BioLounge to set up your screening.