According to the guidelines of American College of Physicians published in the journal
Annals of Internal Medicine, doctors should aim to achieve HbA1c, also known as A1C or glycosylated hemoglobin test levels between 7 and 8 percent in most patients with type-2 diabetics. Earlier, the standard was 6.5 percent to 7 percent. The HbA1c test is a blood test that evaluates the average blood sugar levels for the last three months.
The A1C test basically measures the glucose levels in your blood by assessing the amount of glycated hemoglobin. As the glucose enters the bloodstream, it tends to bind to hemoglobin or glycates; so, the more the glucose that enters the bloodstream, the higher is the amount of glycates. Type-2 diabetes is diagnosed when A1C is over 6.5 percent, which was the standard that was set earlier based on which diabetologists would base the medications for the patients. Now, the standard has been increased to seven to eight percent making it flexible and more indivualised.
Here are the guidelines that American College of Physicians wants us to know-
- HbA1c levels should be between seven to eight percent for patients with diabetes.
- The ACP recommends that doctors should personalize goals for sugar control on the basis of patient's general health, life expectancy and other factors.
- It also recommends that doctors should prefer lower drug treatment in patients with type-2 diabetes who achieveHbA1C levels less than 6.5 percent.
According to Dr. V Mohan, Chairman - Dr. Mohan's Diabetes Specialities Centres, the new article with the changes in the HbA1c levels suggested with relaxation of values to 7-8 percent is reasonable for certain groups of patients, like old and frail people, those with severe kidney, heart or other complications and those with a possible reduced life expectancy. In young and fit people, we should still try to get HbA1c levels as low as possible even up to 6 to 6.5 percent as risk is low. Moreover HbA1c should be tailored to each individual and personalised depending on the patient's general health condition. There is no 'one size fits all' in diabetes as in many other aspects of life."
According to Dr. Deep Dutta from Center for Endocrinology Diabetes Arthritis and Rheumatism, New Delhi, "I think this is a welcome change; definitely a good and rational decision that wouldn't ensure there is no standardized measure and that the treatment will be individualized."
These guidelines will need some time to adjust in the Indian medical context. Diabetes is a disease that cannot be cured; however, it certainly can be controlled.
We suggest some health tips that every diabetic must follow-
1. Follow a balanced diet with complex carbs
Eat a variety of fruits and vegetables, lean protein and good sources of fat. Consuming complex carbs that are rich in fibre are healthier options for a diabetic. They take longer time to digest and provide a sustained source of energy. Avoid trans-fat, processed foods and refined sugar.
2. Enjoy nuts
Load up on nuts as they contain unsaturated fats, proteins and a range of vitamins and minerals that help keep your blood sugar in check. Make sure you have at least a handful or 30 grams of nuts every day.
3. Maintain regular meal timings
Blood sugar levels are best regulated when you maintain regular meal timings. Eat five-six small meals in regular intervals to ensure your blood sugar doesn't spike.
4. Physical activity is a must
Keeping yourself physically active is one of the most important aspects in maintaining diabetes. Ensure engaging in at least 30 minutes of exercise.
Make sure you are eating these foods under supervision to ensure better health!