Puzzling A1Cs - Decoded
It’s puzzling to know why most diabetologists use pharmacologic measures and prefer to maintain higher A1C levels in upper 7s and 8s in confirmed type-2 diabetic? And why such levels are considered as “good management” when, for pre-diabetics, the levels that range between 5.7 to 6.4 are not considered good and they are advised to bring their A1Cs within the normal range, that is under 5.7, asap?
A more perplexing question also arises: Why don’t the majority of doctors feel that combining a lifestyle approach of low carbs, high protein diet, along with exercise could be a better option than just piling medicines - one on top of the other, and further topping it up with insulin, for type-2 diabetics with higher sixes and sevens - and even in their eights and beyond?
So strange right? Let's explore the reasons behind such bizarre practices.
Most doctors are of the belief that patients with A1Cs in their upper 7s and 8s will not be able to bring down their A1C levels under 6, leave alone turning diabetes-free, one day. So it’s a waste of time and effort. They also say: “Once a Diabetic, always a Diabetic!” - It’s like asking an elephant to fly like a bird”.
Doctors feel a), it’s safer for the type-2 diabetic patients to maintain higher A1Cs that is, between 7 and mid 8s, just to safeguard them from life-threatening ‘hypos’ - which is a probability if exercise and life-style changes were to be followed along with pharmacologic measures and b), this could probably result in deaths and leading to lawsuits against the doctors as well.
As ridiculous as it may seem - some believe that it's wiser to continue using this standard approach to maintain a higher A1C levels of 7s and 8s rather than adding more medications to bring down their A1C to sixes or even lower. This, they say, is a way to cut down the financial burden (cost of medicines) on the poor diabetics.
So does it mean that compromising effective treatment just to reduce the financial burden on patients is more worthy than their overall health which is at stake?
The obvious reason which is hard to discount could be the various vested interests that are at play within the big pharma, the policy makers and the health professionals - a business which runs in billions of dollars?
Silver lining
Nowadays we find an increasing number of doctors who strongly believe in combining natural approaches (lifestyle changes) along with medicines to bring down the glucose levels in their patients.
This way you will be able to gradually cut down your meds one after the other resulting in lesser side effects as well. Eventually, you may be able to do away with meds altogether.
But be careful - monitor your glucose regularly and let your doctor know the changes you are making in your diet and physical activity. Your doctor should be onboard with you on your personal goals and targets.
Zareer Patell Blackbelt Fitness / Personal Trainer & Fitness Columnist (since 1972)
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