Tag Archives: borderline diabetes

How managing your A1c can help you reach healthy blood sugars

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When it comes to healthy blood sugar control, the A1C is a vital measuring tool. A1c is the short name for glycosylated hemoglobin. Now, this may sound like a mouthful. It is abbreviated to the A1C to make it easier to understand.

The A1c calculated as a percentage point. Blood glucose attaches to the proteins in the red blood cells. The A1C measures the amount of sugars attached to the red blood cells. This is a normal process that occurs in both people with diabetes as well as non-diabetics.

The average red blood cell last about 120 days, the A1c can measure the blood sugar levels over the prior 6- 8 weeks.

When it comes to managing Type 2 diabetes, the A1c can is used in two ways:

To diagnose Type 2 diabetes or pre-diabetes:

  • An A1c over 6.5% on at least two separate occasions confirms a diagnosis of Type 2 diabetes mellitus
  • An A1c between 5.7- 6.4% on at least two different times is indicative of pre-diabetes
  • An A1c of less than 5.7% is normal

The A1c can also be used to measure blood sugar control:

The A1c is commonly used to monitor overall blood sugar control. It is important to know what your A1c is. I cannot tell you how many times I have been taken aback by patients who have no idea what their A1c is.

 If you are on a mission to THRIVE despite being diagnosed with Type 2 diabetes, you need to not only knowing what your A1c but also getting it under control.

What should be the target A1c in someone living with Type 2 diabetes?

About 20 years ago, there was a landmark study on people with Type 1 diabetes.  The research found that when diabetes was detected early and blood sugars well controlled, this helped to reduce the complications associated with type 2 diabetes.

To learn more about the complications associated with type 2 diabetes, and other information, you can download this free e-book, which is the first three chapters of my award-winning book.  

According to recommendations by the American Diabetes Association, the target goal for A1c should be less than 7.0%. An A1C of less than 7% correlates with sugars on average less than 140 mg/dl.

For every percentage above 7%, the blood sugars go up about 30 mg/dL. The higher the A1c, the higher the blood sugars. The higher the blood sugars, the greater the risk of complications.

So the goal for most people is to keep the A1c less than 7%

Now there may be some caveats to these recommendations-

For instance, if you over 80 years of age, then tighter blood sugar control may not be a reasonable goal. So have a discussion with your healthcare provider about what a reasonable goal should be at that point. Perhaps an A1c between 7-8% may be a more reasonable goal.

What are some factors that may affect getting the A1c to goal?

 For some suggestions on how to achieve healthy blood sugars, I recently put together a mini-course series which is a collation of prior blog articles on just that topic. To learn more click here.  

In summary, the A1c is a percentage measure of the amount of blood glucose that is attached to the red blood cells. The less the blood glucose attached to the red blood cells, the better the A1c. So we need to focus on what we need to do to achieve healthy blood sugars.

How This Simple Strategy is Helping Me Tiptoe Past Overwhelm

personal developmentRecently I’ve had a lot on my plate. Between going to several work locations as a travel physician, building my online wellness platform; working on marketing and publicity; preparing for the release of my upcoming book, plus training for a fall marathon, it’s little wonder I’m beginning to experience some overwhelm.

In an earlier article I wrote about a strategy to get past overwhelm and get back into action.

But when we try to get back into action, we tend to set big goals and we get overwhelmed again.

Let’s say your goal at the beginning of  the year was to be a svelte size 6 by the start of the summer season. But somewhere around February, you stopped exercising, stopped watching your diet. Now you are 10 lbs heavier than you were at the beginning of the year!

You’re wondering if it’s worth even trying to lose all that weight. Perhaps you’re feeling so defeated that you’ve decided you’ll wait until 2018 to set another new year resolution.

In my upcoming book, I write about ‘the stages of change’. Too often we go straight into action without too much preparation. And when we do get into action we tend to go all out. You know the slogan ‘Go BIG or go home!’  Then we find we’re having a hard time keeping up the momentum. Next we become overwhelmed!

What if there was a way to tiptoe past overwhelm so that we stay in action and on the road to producing the results we desire?

Well, there is a way, I’ve learned about. It is called the Kaizen method. It teaches how to take simple small steps. When starting out with the kaizen method, the steps are so ridiculously small, that it may seem impossible they could create longlasting change. That’s the beauty of the kaizen method. The steps seem so small initially that we may not even feel we are making any change. The key is to success in the kaizen method is to consistently build on these small steps.

You see when we set BIG goals, we trigger an alarm in an area of our brain called the amygdala.
The amygdala is part of our primitive brain and was developed in pre-historic times to protect us from harm. So if the primitive man ventured into unfamiliar surroundings, it was the amygdala that fired off alarm signals warning him to retreat back to familiar surroundings.

The amygdala fires off the same way when we venture into the unfamiliar territory of making changes. Even when we know those changes could make us healthier and happier.

No wonder we never quite seem able to sustain a weight loss goal, exercise regimen, better diabetes numbers etc. because to our brains these all represent change. And our amygdala thinks change could be bad.

By learning to take simple small steps, consistently, we can make the needed change and not alarm our amygdala!

So what could this look like?

Let’s go back to the weight loss goal example and see how we can apply the kaizen method.

Rather than focus on the short-term goal of weight loss, focus on the long-term benefits losing weight will give you.

If you are living with type 2 diabetes or borderline diabetes, perhaps you may focus on the fact that in the long-term, losing weight has been proven to help with better blood sugar control and in the case of borderline diabetes can possibly reverse it.

Think of something really small that you can start with. This is the time to get really creative. Then commit to taking a simple small step.

For instance if you want to start a walking program, don’t rush to the fitness store and spend hundreds of dollars getting geared up in the ‘latest and the greatest gadgetry’. Rather, start with something as small as walking in place at home or at work for 1 minute a day. Or maybe you want to cut down on your food intake. Rather than look for ways to immediately cut out 500 calories per day, as most nutritionists may recommend, start with simply leaving a spoonful of food on your plate.

As these simple actions become easy, add on to with more small steps. For instance walk in place for 2 minutes a day. Leave two spoonfuls on your plate.

Be consistent. Make it a habit. Celebrate your wins.

Using the kaizen method can create a snowball effect. You will notice yourself wanting to take on more as your newfound habit becomes fun.

Can you think of other aspects of your life that could benefit from using the kaizen method?

Too often we tend to focus on what needs to be fixed. This is a very narrow way of looking at our lives. Every aspect of our lives are interconnected. You spiritual health affects your emotional health as well as your physical health. How you eat, sense and feel, relate to others as well as your perception of the world affects your whole person, and ultimately your health.

Whether you are living with a chronic illness or just looking to be healthier, it is always best to take a whole person approach to wellness.  The kaizen method is just one way that allows us to focus on the small things that ultimately affect the whole.

In my upcoming coaching programs, I’ll be sharing several strategies that help to focus on the whole person when it comes to improving our overall health and wellbeing.

I’m also excited that the second edition of my book “Dr. Eno’s Guide to Living Powerfully with Type 2 Diabetes’ will soon be released.  If you would like to download a free copy of the ebook that highlights the first three chapters of my upcoming book, click here.

To your health and wellbeing,

May 2017 Awareness Topic: The Difference Between Overweight and Obesity

In the May 2017 Health Awareness Topic, I’ll discuss the difference between what it is to be obese and how this differs from being overweight. In my years of clinical practice, I have found that people do not like to describe themselves as obese. Somehow the word obese has become ‘politically incorrect’ and offensive. So people, even healthcare professionals, choose to use the word ‘overweight’ even when they really mean that a person is obese.

I recall once when I was educating a patient about the fact that her CT scan showed that she had fat in her liver and this put her at a higher risk of diabetes. She later reported me that I said she was fat!

My assertion is that if we continue to tiptoe around this issue and not address obesity for what it is we will never be able to take control of the rising obesity or type 2 diabetes and borderline diabetes epidemic. Our patients look to us to tell them the truth. Being told the truth does not have to be offensive, but it may require an uncomfortable conversation that more healthcare professionals need to get comfortable having.

The similar statistics between obesity and type 2 diabetes

If you look closely at the statistics that I started this article with you will notice that they are similar over 100 million of adult Americans are either obese or overweight. Over 100 million adult Americans have either type 2 or borderline diabetes

Body Mass Index- BMI

The body mass index (BMI) is used to define normal weight, underweight, overweight and obese conditions. For the most part, BMI correlates with the amount of fat a person has. So a higher BMI correlates with a higher risk for obesity. There are some exceptions to using the BMI exclusively. For instance a person who is muscular may have a high BMI but they are not obese.

The BMI is calculated by dividing the weight in kilograms by the height. There are many BMI calculators online. All you need to know is your height and your weight (in kilograms) and then you can plug those numbers in. For an example of a BMI calculator, click here.

Categories of BMI:

Underweight -BMI less than 18.5

Normal weight- BMI 18.5- 24.9

Overweight- BMI 25-29.9

Obesity class I 30-34.9

Obesity class II 35- 39.9

Obesity class III greater than 40

Over two-thirds of the adult population in America is either overweight or obese. Currently there are over 29 million Americans living with type 2 diabetes. There are an additional 86 million are living with borderline diabetes. The common denominator for both of these conditions is the rising obesity epidemic.

Consider this, if you have been diagnosed with borderline diabetes and commit to losing just 10% of your body weight, you can reduce your chance of developing type 2 diabetes.

The goal is to maintain a healthy and normal BMI of between 18.5 and 24.9

For people who are overweight or obese I usually get a lot of rebuttal telling me they have not had BMI in that range since they were in high school or middle school.

That’s OK. Just as it took some time to gain weight, it will also take some time to lose weight. So let’s start with that statement. You are OK.  Accept that you are overweight or obese. This statement should not be seen as  someone making a derogatory statement about you. It simply means that if you want to live a long and healthy life there is work to do. You are not alone in this obesity epidemic.  There are close to 200 million people in the United States alone. Start by developing a support system. Work closely with your healthcare professional.

Changing old habits is never easy. There are several stages to change. One thing you can start today is to start taking simple small steps every day. Taking simple small steps helps to reduce the sense of overwhelm that making big changes can cause. And because the changes seem so small in the beginning you are more likely to stick with them.

Here’s an example of a simple small step you can take on. Purchase a fitness tracker. What is the common step goal everyone says when you start counting steps? 10,000 steps! Look at that number, doesn’t ten thousand sound like a whole lot to start with? Consider this. Set a goal to walk 1000 steps on your first day. And then when you reach that goal (or exceed it) slowly increase your daily goal. Eventually you’ll reach your goal without feeling overwhelmed and along the way you’ll discover ways to increase the amount of steps you take every day.

It all starts with what I call the ABCs – Acceptance, Belief and Commitment.

For more information about the ABCs and how you can use these to start making changes in your life, you can download a free copy of the first three chapters of my upcoming book, ‘Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’ by clicking here.

To your health and wellbeing,