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Diabetes Health Line
Newsletter 4

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What is Hemoglobin A1c? • Diabetes and Physical Activity • Chromium • Straight Scoop About Sugar on Labels • Label, Lingo, Definitions • References • Recipe Corner

What is Hemoglobin A1c?

Normal HbA1c
High HbA1c

Hemoglobin A1c is a simple lab test that shows how well you have been controlling your blood sugar. It shows the average amount of sugar in your blood over the last three months. This lab test is the only way to know how well you are controlling your diabetes over time.

All people with diabetes should have a hemoglobin A1c test at least twice a year. If your blood sugar stays too high, you should get a hemoglobin A1c test at least every three months. The three-month tests should continue until your sugar level improves. Regular hemoglobin testing can help you track your blood sugar levels over time to see if they stay close to normal or go up and down.

A healthy person without diabetes will have an A1c value between 4 and 6 percent. Your A1c should be below 8 percent if you have good control. It will be less than 7 percent if you have very good control. You should ask your health care provider how you can bring your number down if it is above 8 percent.

It is important to keep your diabetes under control. Good control will help to lower the risk of developing common problems that result from poor control. High blood sugar levels over time increase your chances for developing coronary heart disease, stroke, kidney failure, blindness and painful nerve disease.

Be aware of your hemoglobin A1c number. Ask your physician what it is. Don't settle for “it's ok.” Tell your physician you want to know the actual number, so you will know how well you are doing or how far you have to go.

Diabetes and Physical Activity

Regular physical activity improves overall health and helps protect against heart disease. It can help you lose weight or stay at a healthy weight. Physical activity fits nicely into a diabetes care plan. It helps clear glucose from the blood if insulin is available.

Most people with diabetes can exercise safely. But, there are some risks for people with diabetes. Take the following precautions to decrease your risks:

• Have a medical exam before you begin your exercise program.
• Discuss with your doctor any unusual symptoms that you experience during or after exercise.
• Check with your health care team about special precautions if you have diabetes-related complications.
• Know your blood glucose level before, during and after you exercise. Blood glucose levels can fall during and after exercise.
• Learn how to prevent and treat low blood sugar levels.
• Carry a fast acting source of carbohydrate with you such as glucose gel or tablets.
• Try to exercise with a friend, or let people know when you are going, where you are going and when you will be back.
• Check your urine for ketones if you have type 1 diabetes and your blood sugar is above 250 mg/dl. Don't exercise if you do have ketones. Exercise will increase your risk of ketoacidosis and coma.
• Always warm up and cool down (5 to 10 minutes each).
• Remember to replace body fluids. Start your workout well-watered, and drink water during the workout.
• Don't exercise outdoors when the weather is too hot and humid or too cold.
• Pay special attention to proper footwear. Inspect your feet daily and always after you exercise.

Chromium

Chromium is one of the most popular supplements used by people with diabetes. Chromium is a metal that the body needs to process carbohydrates and fats. It likely plays an important role in glucose tolerance.

Several researchers have given chromium to people with type 2 diabetes or gestational diabetes to see whether it had good effects. Some studies found chromium increased insulin sensitivity or lowered fasting glucose levels. Other studies found no effect. The studies that found effects tended to use higher doses (400 micrograms a day), use chromium picolinate instead of other kinds and involve subjects with poor diets.

Supplements, like chromium picolinate, act like drugs and should not be taken without your physician's knowledge. Supplements can interfere with the action of other proven drugs you are taking.

Chromium is found in many foods. A healthy diet is the first line of defense for people with type 2 diabetes. To get more chromium in your diet, try these chromium-rich foods:

American cheese
Bran
Wheat germ
Brewer's yeast
Whole grains
Some fruits (such as apples with skins)
Liver
Oysters
Peanuts
Some vegetables (such as carrots, spinach, mushrooms, broccoli and potatoes with skins)

Straight Scoop About Sugar on Labels

Sugars are carbohydrates, which serve as an energy source for the body. There are many types of sugars. They occur both naturally and as ingredients in many foods.

The nutrition panel on a food label lists the total amount of sugars in a serving of the food. This amount includes sugars found naturally in foods such as the sugars in milk and fruit. It also includes added sugars. The ingredient list must name all added sugars.

A food is likely to be high in sugars if one of these names appears first or second in the ingredient list, or if several names are listed.

Added Sugars in Ingredient Lists:

Label, Lingo, Definitions

References:

“Know Your HbA1c!” Thomas A. Lincoln, M.D., Diabetes Forecast, 2001.
“Chromium.” Shauna S. Roberts, Ph.D., Diabetes Forecast, 2001.
“Making Sensible Sugar Choices: Straight Scoop on Sugar.” Dayle Hayse, MS, RD, Eat Right Montana.
Reference to commercial products or trade names does not imply any recommendation or endorsement by the Cooperative Extension Service.

Recipe Corner

Popeye's Lasagna
8-12 3/4 cup servings

You'll Need:

1 jar spaghetti sauce
1 10-ounce package frozen, chopped spinach, thawed and slightly squeezed
6 lasagna noodles, uncooked
1 15-ounce container of low-fat cottage cheese
1/2 teaspoon Italian seasoning
2 cups (16 ounces) part-skim mozzarella cheese, shredded
1/4 cup parmesan cheese, shredded (optional)

1. Preheat oven to 350 degrees.
2. In a small bowl, mix the cottage cheese with the Italian seasoning and parmesan cheese.
3. In a 11 x 17 inch baking dish, spread about 1 to 1 1/2 cups of sauce in the bottom. Spread about half of the spinach over the sauce.
4. Add a layer of uncooked lasagna noodles, about 3.
5. Add about half of the cottage cheese mixture on top of the noodles.
6. Layer 1 cup of mozzarella cheese.
7. Repeat layers and pour about 1/2 cup of water over the entire dish.
8. Bake for one hour. Cover with aluminum foil if edges begin to burn.
9. Allow to sit for at least 10 minutes before serving.

Calories: 190 Carbohydrates: 17 g Protein: 15 g Dietary Fiber: 2 g Total Fat: 7 g Saturated Fat: 3.5 g Cholesterol: 20 mg Sodium: 620 mg