By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
What do Smashing Pumpkins, Mother Theresa, Topher Grace and the Dauphin Clinic Pharmacy have in common? 1979. It was a hit song off of the Smashing Pumpkins album Mellon Collie and the Infinite Sadness. It was the year Mother Theresa won the Nobel Peace Prize. The TV Comedy "That 70's Show" that Topher Grace starred in had its last episode set December 31, 1979. Finally, the Dauphin Clinic Pharmacy was opened in 1979 by Mr. Myles Haverluck.
Think of all the things that have changed since 1979. Just today I wrote this article on a personal computer, looked up some information on Google, phoned home on my cell phone, checked my email, tele-commuted to the store in Winnipegosis and played around with Skype Video-conferencing. None of those everyday things existed or were even dreamed of in 1979. Since so many things in our everyday lives seem to be constantly changing, it shouldn't be a surprise that medical knowledge and information is always changing too. Take homocysteine. Homocysteine is an amino acid with some interesting stories to tell.
It was noticed that children with a genetic metabolic condition that gave them high homocysteine levels also got damaged blood vessels more often than we would normally expect. The scientists thought that high homocysteine levels damaged the lining of the blood vessels call the endothelieum and made blood clot more than normal. We think that many people with athererosclerosis or hardening of the arteries also have high homocysteine. We also know that if we give people B vitamins and folic acid we can reduce their homocysteine levels. The big question is if we give people high doses of B vitamins and folic acid will they have fewer heart attacks and strokes and die less often?
Well, there was a big trial in 2005 with 3749 people in it called NORVIT or the Norwegian Vitamin Trial. They gave people who had had a heart attack in the last 7 days folic acid, folic acid plus vitamin B6 or a placebo. The homocysteine levels in the folic acid groups went down. They found no change in risk of heart disease with or without the folic acid and vitamin B6. The actually found an increase in risk of heart attack in the people on high doses of Vitamin B6 and folic acid.
One reason people like me were so excited about homocysteine was that it was so easy to treat. We have good medications to reduce cholesterol called statins. We believe that if we reduce a person's cholesterol with a statin, we will reduce the chance of heart attack and stroke. Many studies have backed this up. Some of the downsides to statins is they are relatively expensive and they can cause side effects in a small number of people. If reducing someone's homocysteine reduced their chance of heart attack and stroke, that would be great because we can reduce homocysteine with B vitamins and folic acid. They are relatively inexpensive, available without a prescription and relatively free of side effects.
But the homocysteine story is a bust, right? The big NORVIT study found no benefit, right? Well the homocysteine story continues to evolve. While it is unlikely that we will recommend everyone go on folic acid and B Vitamins to reduce their homocysteine, there may be some populations that could benefit from folic acid. In an Israeli study published in the American Journal of Cardiology in September 2009 found people with early onset coronary arteries disease and who had high homocysteine levels did benefit from folic acid and B vitamins. It was a smaller study with only 492 patients in it, but the folic acid/B vitamin group did die less often. Remember, though, this was a very specific group of people with the heart condition early onset CAD and who had high homocysteine levels. So the homocysteine story continues.
So what is the take home message for most of us? Whole grains and dark green leafy vegetables. This is where B Vitamins and folic acid come from in our diet. Eat more of them. They do lots of good things for you including lowering your homocysteine levels. Today we can't say that lowering your homocysteine levels will help your heart, but the story continues to evolve. Just like the original UseNet experiments in 1979 developed into a part of the internet we enjoy today and the Dauphin Clinic Pharmacy grew from a tiny one man operation to arguably one of the best pharmacies in Canada, it will be interesting to see where the homocysteine story goes.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Friday, September 25, 2009
Friday, September 18, 2009
PROBIOTICS
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
My parents spent their 40th wedding anniversay in Wawa, Ontario. Wawa is where my dad grew up and they were there helping my grandmother move from her house into an apartment. My grandmother was ahead of her time when it came to feeding my dad the lastest super healthy foods. She insisted that he take cod liver oil, or as she called it "liquid sunshine". That provided him with both Vitamin D and Omega-3 fatty acids, which are all over the news. My grandmother also tried to get him to eat yogurt. Apparently the yogurt was made fresh at the family farm, but my dad wouldn't go near it. He still won't eat yogurt. Score another one for grandma, though. Yogurt is just one of the new "probiotics" that we are all supposed to be eating.
Probiotics are "good" microorganisms for the intestines. Probiotics contain actual tiny living things that go into your intestines, start growing and push out the "bad" microorganisms that might be there. Probiotic microbes have names like Lactobacillus, Bifidobacteria and Saccharomyces. There are more and more products in the pharmacy that are promoted as probiotics. Should we all take them? Let's have a look.
Apparently this probiotic movement is older than I thought. A Russian scientist named Elie Metchnikoff was looking at a particularily long lived group of Bulgarian mountain men. These mountain men drank a fermented milk product that had lots of lactic acid producing bacteria in it. Metchnikoff thought the bacteria in the fermented milk drink helped the immune system in the mountain men's gut. This was all going on in the late 1800's and early 1900's. So was Metchinikoff right? Well the human digestive tract is about 5 meters long from end to end and if stretched out it would cover about 2 tennis courts. And it is full of bacteria and other microbes. Our guts get colonized within hours of birth and by adulthood there are actually 10 times more bacteria cells in our guts than there are human cells in our body. The bacteria in our guts help us break down some foods, release some nutrients we otherwise couldn't get at and helps our immune system.
The immune system part surprised me. Apparently up to 75% of the body's immune system cells are in the gut. Our gut bacteria help stimulate our immune system in the prescence of bad invasive microbes and helps calm the immune system so it doesn't go attacking non-harmful things. In interesting experiments researchers took new born mice and put them into a sterile environment before bacteria got into their guts. These mice developed very badly working immune systems. However the mice were "cured" when they were then allowed to live with normal mice with normal gut microbes for a few weeks. We assume the normal gut microbes moved from the normal mice to the guts of the sterile mice.
So should everyone go to the pharmacy and buy some lactobacillus acidophillus capsules? Well, probably not. It is still a stretch from health Bulgarian mountain men and mice with no gut microbes to buying capsules at the pharmacy. However, there are some products in the pharmacy I have recommended in the past that I will share. A big warning first though. The science saying that if you take these probiotics that your condition will get better is incomplete at best. So why do I still recommend them? I do because the chance of harm from probiotics is very, very low.
I have recommended lactobacillus capsules to women who always get yeast infections after taking antibiotics for years. Apparently, there isn't any science to back up that recommendation at all. There is some evidence to support that women who get yeast infections regularily not from antibiotics who take lactobacillus capsules will get less yeast infections.
Well couldn't you just eat more yogurt. Maybe. I was surprised to learn yogurt isn't necessarily probiotic. To be probiotic the product has to be able to survive through the acid of the stomach, the bile acids of the small intestine and then be able to reproduce in the large intestine. Only yogurt may with certain types of bacteria can do that. For example the brand "Activa" reports to be made with bacteria that can survive the trip through the acid stomach.
I have recommended BioGaia for colic. Colic is when an infant cries and cries for no apparent reason. If you have an infant that may have colic, have the infant checked out by your doctor just to make sure there is nothing else wrong. BioGaia is a probiotic drop which has some evidence that it reduces how often a colicy baby cries. Now as it is hard to tell when an infant will just grow out of colic, there are some people who question if BioGaia works. However, as there is very little chance of harm with BioGaia, I have recommended it. BioGaia requires refridgeration.
TuZen is an lactobacillus capsule that is being promoted as helpful for irritable bowel syndrome (IBS). IBS is when you have diarrhea or constipation and other stomach disorder for no apparent reason. If you think you have IBS, please have your doctor rule out other causes. I have had people take TuZen and had their IBS symptoms get better. Since IBS symptoms tend to come and go in some people, it is a little controversial if TuZen works or not. What I can tell you is that TuZen is made with a special type of lactobacillus that can survive its trip through the stomach and unlike some other products it does not require refridgeration
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
My parents spent their 40th wedding anniversay in Wawa, Ontario. Wawa is where my dad grew up and they were there helping my grandmother move from her house into an apartment. My grandmother was ahead of her time when it came to feeding my dad the lastest super healthy foods. She insisted that he take cod liver oil, or as she called it "liquid sunshine". That provided him with both Vitamin D and Omega-3 fatty acids, which are all over the news. My grandmother also tried to get him to eat yogurt. Apparently the yogurt was made fresh at the family farm, but my dad wouldn't go near it. He still won't eat yogurt. Score another one for grandma, though. Yogurt is just one of the new "probiotics" that we are all supposed to be eating.
Probiotics are "good" microorganisms for the intestines. Probiotics contain actual tiny living things that go into your intestines, start growing and push out the "bad" microorganisms that might be there. Probiotic microbes have names like Lactobacillus, Bifidobacteria and Saccharomyces. There are more and more products in the pharmacy that are promoted as probiotics. Should we all take them? Let's have a look.
Apparently this probiotic movement is older than I thought. A Russian scientist named Elie Metchnikoff was looking at a particularily long lived group of Bulgarian mountain men. These mountain men drank a fermented milk product that had lots of lactic acid producing bacteria in it. Metchnikoff thought the bacteria in the fermented milk drink helped the immune system in the mountain men's gut. This was all going on in the late 1800's and early 1900's. So was Metchinikoff right? Well the human digestive tract is about 5 meters long from end to end and if stretched out it would cover about 2 tennis courts. And it is full of bacteria and other microbes. Our guts get colonized within hours of birth and by adulthood there are actually 10 times more bacteria cells in our guts than there are human cells in our body. The bacteria in our guts help us break down some foods, release some nutrients we otherwise couldn't get at and helps our immune system.
The immune system part surprised me. Apparently up to 75% of the body's immune system cells are in the gut. Our gut bacteria help stimulate our immune system in the prescence of bad invasive microbes and helps calm the immune system so it doesn't go attacking non-harmful things. In interesting experiments researchers took new born mice and put them into a sterile environment before bacteria got into their guts. These mice developed very badly working immune systems. However the mice were "cured" when they were then allowed to live with normal mice with normal gut microbes for a few weeks. We assume the normal gut microbes moved from the normal mice to the guts of the sterile mice.
So should everyone go to the pharmacy and buy some lactobacillus acidophillus capsules? Well, probably not. It is still a stretch from health Bulgarian mountain men and mice with no gut microbes to buying capsules at the pharmacy. However, there are some products in the pharmacy I have recommended in the past that I will share. A big warning first though. The science saying that if you take these probiotics that your condition will get better is incomplete at best. So why do I still recommend them? I do because the chance of harm from probiotics is very, very low.
I have recommended lactobacillus capsules to women who always get yeast infections after taking antibiotics for years. Apparently, there isn't any science to back up that recommendation at all. There is some evidence to support that women who get yeast infections regularily not from antibiotics who take lactobacillus capsules will get less yeast infections.
Well couldn't you just eat more yogurt. Maybe. I was surprised to learn yogurt isn't necessarily probiotic. To be probiotic the product has to be able to survive through the acid of the stomach, the bile acids of the small intestine and then be able to reproduce in the large intestine. Only yogurt may with certain types of bacteria can do that. For example the brand "Activa" reports to be made with bacteria that can survive the trip through the acid stomach.
I have recommended BioGaia for colic. Colic is when an infant cries and cries for no apparent reason. If you have an infant that may have colic, have the infant checked out by your doctor just to make sure there is nothing else wrong. BioGaia is a probiotic drop which has some evidence that it reduces how often a colicy baby cries. Now as it is hard to tell when an infant will just grow out of colic, there are some people who question if BioGaia works. However, as there is very little chance of harm with BioGaia, I have recommended it. BioGaia requires refridgeration.
TuZen is an lactobacillus capsule that is being promoted as helpful for irritable bowel syndrome (IBS). IBS is when you have diarrhea or constipation and other stomach disorder for no apparent reason. If you think you have IBS, please have your doctor rule out other causes. I have had people take TuZen and had their IBS symptoms get better. Since IBS symptoms tend to come and go in some people, it is a little controversial if TuZen works or not. What I can tell you is that TuZen is made with a special type of lactobacillus that can survive its trip through the stomach and unlike some other products it does not require refridgeration
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Friday, September 11, 2009
Lyme Disease
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
You know what is cool about a phone call from Hong Kong? It sounds just like a phone call from across the street. In today’s world of fax, email, Facebook, satellite phones, Skype videoconferencing, text messaging and many, many other forms of electronic communications, the overseas phone call is still almost magical to me. About a year ago a friend I grew up with called me from Hong Kong. He asked if I was going to Winnipeg in the following couple of weeks. It turned out I was, so he was asked if I could meet this guy, Allen for dinner. I said sure.
Allen was in Winnipeg because he was driving a bus for a tour company. He was taking people from a downtown hotel to the airport who were on their way to Churchill to see polar bears. Allen was originally from Texas, went to university in the eastern states and has had a variety of fascinating jobs. He had run for Congress, twice, had helped record music for a national book chain. He had played his small part as a member of the massive team that helped get Barack Obama elected president last year. He had many tales to tell. The one that came closest to my line of work involve a lime green van. Allen had driven this lime green van across the US to promote Lyme disease awareness. I have to admit, I really didn’t know much about Lyme disease, and after dinner with Allen, I quickly forgot about the story of the lime green van. However, recently Manitoba Health sent the pharmacy a Deer Tick information package. So thinking about Allen and his green van, I read it. Here is some of what it said.
Deer ticks are cousins to the wood tick that you are probably familiar with. They are smaller than wood ticks and they don’t have any white marks or streaks like wood ticks. They are of interest because deer tick can transmit Lyme disease to people. Deer ticks haven’t been in Manitoba long. Apparently they have only been identified here since 1989. Deer tick are predominantly in the south eastern part of the province and probably only 10% carry Lyme disease. Most Manitobans are unlikely to run into a deer tick. However, unlike wood ticks, deer ticks are more common in the fall. I guess that’s why Manitoba Health sent out the info package in the late summer.
Lyme disease is caused by the bacterium, Borrelia burgdorferi. Bacteria are transferred from the deer tick to the person when the tick bites and feeds on the person. This gives us our first opportunity to prevent Lyme disease. If you remove of attached within 18 to 24 hours you can reduce the risk of infection. Do not forget to check children and pets as well. Carefully remove attached ticks using tweezers. Grasp the tick's head and mouth parts as close to the skin as possible and pull slowly until the tick is removed. Do not twist or rotate the tick and try not to damage the tick (i.e., squash or crush it) during removal.
The symptoms of Lyme disease are often described as having three stages, although not all patients have symptoms of each stage. The first sign of infection is usually a circular rash called that’s been described as a “bull’s eye rash”. This rash occurs in about 70-80% of infected persons and begins at the site of the tick bite after a delay of three days to one month. Patients may also experience symptoms such as: fatigue, chills, fever, headache, muscle and joint pain, and swollen lymph nodes. If the infection goes untreated, the second stage of the disease can last up to several months with possible symptoms including: central and peripheral nervous system disorders, multiple skin rashes, arthritis, heart palpitations, extreme fatigue and general weakness. If the infection continues to go untreated, the third stage of the disease can last months to years with possible symptoms including, chronic arthritis and neurological symptoms.
The good news is since Lyme disease is caused by a bacteria, it can be treated with antibiotics. The earlier in the disease the doctor can start you on the antibiotics the better. Late stage disease may have to be treated with antibiotics for a long period of time.
I don’t want to scare anyone about Lyme disease. It is still something Manitobans are unlikely to catch. But forewarned is for-armed, and if you happen to see a lime green van driving around promoting Lyme disease awareness, talk to the driver. It could be a very interesting conversation. And phone someone you know that lives a long way away. Remember to marvel at how that familiar voice can travel so easily along those little wires.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
You know what is cool about a phone call from Hong Kong? It sounds just like a phone call from across the street. In today’s world of fax, email, Facebook, satellite phones, Skype videoconferencing, text messaging and many, many other forms of electronic communications, the overseas phone call is still almost magical to me. About a year ago a friend I grew up with called me from Hong Kong. He asked if I was going to Winnipeg in the following couple of weeks. It turned out I was, so he was asked if I could meet this guy, Allen for dinner. I said sure.
Allen was in Winnipeg because he was driving a bus for a tour company. He was taking people from a downtown hotel to the airport who were on their way to Churchill to see polar bears. Allen was originally from Texas, went to university in the eastern states and has had a variety of fascinating jobs. He had run for Congress, twice, had helped record music for a national book chain. He had played his small part as a member of the massive team that helped get Barack Obama elected president last year. He had many tales to tell. The one that came closest to my line of work involve a lime green van. Allen had driven this lime green van across the US to promote Lyme disease awareness. I have to admit, I really didn’t know much about Lyme disease, and after dinner with Allen, I quickly forgot about the story of the lime green van. However, recently Manitoba Health sent the pharmacy a Deer Tick information package. So thinking about Allen and his green van, I read it. Here is some of what it said.
Deer ticks are cousins to the wood tick that you are probably familiar with. They are smaller than wood ticks and they don’t have any white marks or streaks like wood ticks. They are of interest because deer tick can transmit Lyme disease to people. Deer ticks haven’t been in Manitoba long. Apparently they have only been identified here since 1989. Deer tick are predominantly in the south eastern part of the province and probably only 10% carry Lyme disease. Most Manitobans are unlikely to run into a deer tick. However, unlike wood ticks, deer ticks are more common in the fall. I guess that’s why Manitoba Health sent out the info package in the late summer.
Lyme disease is caused by the bacterium, Borrelia burgdorferi. Bacteria are transferred from the deer tick to the person when the tick bites and feeds on the person. This gives us our first opportunity to prevent Lyme disease. If you remove of attached within 18 to 24 hours you can reduce the risk of infection. Do not forget to check children and pets as well. Carefully remove attached ticks using tweezers. Grasp the tick's head and mouth parts as close to the skin as possible and pull slowly until the tick is removed. Do not twist or rotate the tick and try not to damage the tick (i.e., squash or crush it) during removal.
The symptoms of Lyme disease are often described as having three stages, although not all patients have symptoms of each stage. The first sign of infection is usually a circular rash called that’s been described as a “bull’s eye rash”. This rash occurs in about 70-80% of infected persons and begins at the site of the tick bite after a delay of three days to one month. Patients may also experience symptoms such as: fatigue, chills, fever, headache, muscle and joint pain, and swollen lymph nodes. If the infection goes untreated, the second stage of the disease can last up to several months with possible symptoms including: central and peripheral nervous system disorders, multiple skin rashes, arthritis, heart palpitations, extreme fatigue and general weakness. If the infection continues to go untreated, the third stage of the disease can last months to years with possible symptoms including, chronic arthritis and neurological symptoms.
The good news is since Lyme disease is caused by a bacteria, it can be treated with antibiotics. The earlier in the disease the doctor can start you on the antibiotics the better. Late stage disease may have to be treated with antibiotics for a long period of time.
I don’t want to scare anyone about Lyme disease. It is still something Manitobans are unlikely to catch. But forewarned is for-armed, and if you happen to see a lime green van driving around promoting Lyme disease awareness, talk to the driver. It could be a very interesting conversation. And phone someone you know that lives a long way away. Remember to marvel at how that familiar voice can travel so easily along those little wires.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Friday, September 04, 2009
Hemoglobin A1C Testing for Diabetes
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
I was watching PBS the other day. There was a guy telling an audience he could “cure” diabetes with the right diet. Some of what he said was reasonable. He was recommending lot of fruits and vegetables and less sugar, white bread and potatoes. I think he was exaggerating saying he could “cure” diabetes, though. The part I found really interesting was that he was talking about getting your hemoglobin A1C (HbA1C) checked. The hemoglobin A1C is a three month average of your blood sugars, and it doesn’t get enough attention.
If you are diabetic, you know you have to test your blood sugar. We have lots and lots of evidence from huge studies with funny names like DCCT and UKPDS that the closer a diabetic person keeps their blood sugar to normal values the less chance they have of getting the big four problems of diabetes.
The big four problems associated with diabetes are heart disease, kidney disease, amputation, and blindness. So, if you are diabetic you should follow your diet and exercise plan, use your medications appropriately, and test your blood sugar at home. Home blood sugar testing is one of the best ways for you to see if your diabetic plan that you developed with your health care professional is keeping your blood sugar within normal limits. And if you keep your blood sugar within normal limits, you are more likely to avoid the diabetes big four.
There is another test for blood sugar that fewer diabetics know about. It is called a hemoglobin A1C or glycosylated hemoglobin test. It sort of gives an average of how your blood sugar has been doing over the last 3 months, and should be done at least once a year. Let’s talk about how it works a little more.
Red blood cells carry oxygen in your blood. Red blood cells look like doughnuts with the hole in the middle not quite all the way through. Or another way to picture them is they look like a ball that has been pinched together in the middle. What red blood cells look like is important, because of what they do. A red blood cell picks up its load of oxygen in the lungs, goes through the heart, and drops off its oxygen at a tissue. To get to its tissue, the red blood cell must bend and squeeze to get through very narrow tubes called capillaries.
Now let’s add diabetes to the mix. If you have diabetes, you have too much sugar in your blood.
The hemoglobin A1C test checks to see how many of your red blood cells are coated with sugar. If your blood sugar control over the past 3 months has been good, your hemoglobin A1C will be good. Why does the hemoglobin A1C test 3 months worth of blood sugar control? Because red blood cells live about 3 months.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
I was watching PBS the other day. There was a guy telling an audience he could “cure” diabetes with the right diet. Some of what he said was reasonable. He was recommending lot of fruits and vegetables and less sugar, white bread and potatoes. I think he was exaggerating saying he could “cure” diabetes, though. The part I found really interesting was that he was talking about getting your hemoglobin A1C (HbA1C) checked. The hemoglobin A1C is a three month average of your blood sugars, and it doesn’t get enough attention.
If you are diabetic, you know you have to test your blood sugar. We have lots and lots of evidence from huge studies with funny names like DCCT and UKPDS that the closer a diabetic person keeps their blood sugar to normal values the less chance they have of getting the big four problems of diabetes.
The big four problems associated with diabetes are heart disease, kidney disease, amputation, and blindness. So, if you are diabetic you should follow your diet and exercise plan, use your medications appropriately, and test your blood sugar at home. Home blood sugar testing is one of the best ways for you to see if your diabetic plan that you developed with your health care professional is keeping your blood sugar within normal limits. And if you keep your blood sugar within normal limits, you are more likely to avoid the diabetes big four.
There is another test for blood sugar that fewer diabetics know about. It is called a hemoglobin A1C or glycosylated hemoglobin test. It sort of gives an average of how your blood sugar has been doing over the last 3 months, and should be done at least once a year. Let’s talk about how it works a little more.
Red blood cells carry oxygen in your blood. Red blood cells look like doughnuts with the hole in the middle not quite all the way through. Or another way to picture them is they look like a ball that has been pinched together in the middle. What red blood cells look like is important, because of what they do. A red blood cell picks up its load of oxygen in the lungs, goes through the heart, and drops off its oxygen at a tissue. To get to its tissue, the red blood cell must bend and squeeze to get through very narrow tubes called capillaries.
Now let’s add diabetes to the mix. If you have diabetes, you have too much sugar in your blood.
The hemoglobin A1C test checks to see how many of your red blood cells are coated with sugar. If your blood sugar control over the past 3 months has been good, your hemoglobin A1C will be good. Why does the hemoglobin A1C test 3 months worth of blood sugar control? Because red blood cells live about 3 months.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
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