By: Sheila Kun RN, BSN, MS, CPN, FCCP
Salesian Cooperator

If you have not heard of AIC as a tourist destination, you are not alone. AIC is not a Greek island. My journey in this week’s Care Ministry article is about my personal experience with diabetes. That is right, for those who know me, you might be surprised that my blood sugar is not at its optimal level.

Before I turned 70 five years ago, my blood sugar was totally within normal limit. I have sustained a lifestyle of daily exercise before COVID (I was going to the gym every day). Even now I maintained my exercise schedule of doing Zumba Monday through Friday after work and walk around the neighborhood for an hour on the weekend. There is no negotiation; I have incorporated my exercise routine as part of my life. On my food choices, I also followed pretty good guideline – no soda, no sweets, less carbohydrates as much as possible. My rising blood sugar level within the last five years led me to the diagnosis of diabetes type II and was put on medication regimen.

For the coming weeks, let us break down the many facets of diabetes type II as its prevalence seems unavoidable with aging. For this article, let us touch base on the topic of diabetes testing. The information below is from the May Clinic.

The A1C test is a blood test that provides information about your average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test can be used to diagnose type 2 diabetes and prediabetes. The A1C test is also the primary test used for diabetes management.

• Glycated hemoglobin (A1C) test.This blood test, which doesn’t require fasting, indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.

The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached. An A1C level of 6.5% or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 % indicates prediabetes. Below 5.7 is considered normal.

If the A1C test results aren’t consistent, the test isn’t available, or you have certain conditions that can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — your doctor may use the following tests to diagnose diabetes:

• Random blood sugar test.A blood sample will be taken at a random time. Regardless of when you last ate, a blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or higher suggests diabetes.
• Fasting blood sugar test.A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
• Oral glucose tolerance test.For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours.

A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.

Sheila’s note: as we age into our senior years, with possible weight gain and inactivity,  blood glucose levels increase. According to the insulin sensitivity theory, as we age blood glucose levels tend to increase and insulin becomes less and less effective at bringing them down. Hence the “normal level” for seniors is adjusted and may not follow the above criteria. Your doctor would be the one to help you with understanding your blood sugar level.

I am going to devote the coming weeks to better understand diabetes type II and how we can delay this condition.

Your homework from the Care Ministry this week: can you explain what AIC is?

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