6 Important Questions About Diabetes

1. Since high blood glucose is dangerous, is low blood glucose healthy?

When blood glucose levels fall below 70 mg/dl, the condition is called hypoglycemia or low blood glucose. Since the primary fuel of the central nervous system (CNS) is glucose, low blood glucose can dramatically impair CNS function. Hypoglycemia can lead to dizziness, confusion, slurred speech, blurred vision and sleepiness (Gulve 2008).

2. What is glycosylated hemoglobin and the HbA1c test?

Glycosylation is the process of adding sugar units to a molecule. When glucose links to or sticks to the hemoglobin of red blood cells (called glycosylated hemoglobin), it may impair the function of other molecules in nerve cells, retina cells and blood vessels. The amount of sugar stuck to these cells indicates how much sugar has been around for the preceding 3 months, as red blood cells live for about this long. This is what the HbA1c measurement assesses. The normal range of HbA1c is 4.0%–5.9%, while in poorly controlled diabetes it is at 8.0% or above, and about 7.0% in persons with well-controlled diabetes (Mathur 2009). The benefit of measuring HbA1c in studies and clinical medicine is that it gives a more realistic view of what is happening over the course of several months.

3. What are the risk factors for diabetes?

According to the American Heart Association (2008), the risk factors for diabetes are family history, race (Asians, Hispanics, Native Americans, and Africans have higher risk), overweight/obesity, age (the older the person, the higher the risk), hypertension, heavy alcohol consumption over time, cigarette smoking and a history of gestational diabetes (developing diabetes during pregnancy or delivering a baby who weighs over 9 pounds). It is consequential to note that moderate alcohol consumption (one drink per day for women and two drinks per day for men) may lower the risk of diabetes (Collazo-Clavell 2009).

4. Will eating too many simple sugars cause diabetes?

Not directly. Type 1 diabetes is a genetic disorder in which the body is unable to produce insulin. Type 2 diabetes is highly affected by lifestyle factors and a family history of diabetes. Simple sugars, also called simple carbohydrates, contain one or two sugar molecules and are found in table sugar, sweets, cookies and cakes. They supply calories but do not provide healthy fiber, vitamins or minerals. Eating too many simple sugars may lead to overweight and obesity, which then will become a risk factor for type 2 diabetes.

5. Can people with diabetes eat sweets and chocolates?

Yes, if these foods are eaten as part of a healthy meal plan and combined with exercise (American Diabetes Association 2010). The American Diabetes Association encourages people with diabetes to eat a healthy diet that is high in whole-grain foods, fruits and vegetables but low in trans fat and saturated fat. The organization suggests moderation in sugar and salt intake.

6. Please explain insulin resistance and glucose intolerance.

Insulin resistance occurs when the body fails to respond properly to the insulin it already produces. This may lead to a condition referred to as “glucose intolerance,” in which the body has blood sugar levels that are higher than normal (in the prediabetes range; see Figure 1) but not high enough to be classified as diabetes.