Doctors used to use the fasting morning blood sugar level as a guide to managing diabetes. Now they use HBA1C.

Eating raises blood sugar levels. If it rises too high, sugar sticks to the surface of cells where it cannot be removed and is converted to a poison called sorbitol that damages the cell to cause blindness, heart attacks and kidney damage. The side effects of diabetes are caused by how high blood sugar levels rise. The rise in blood sugar after meals is so much higher than the morning blood sugar level that it is only the after-meal rise that causes cell damage.

Doctors use blood tests called hemoglobin A1C and fructosamine to measure how much sugar sticks to cells. So people with diabetes are checked once a month to measure their HBA1C. If it is high, they should change their diet and or their medication. When the HBA1C is normal, they don't need to change anything. See report #D222.

HWM Breuer. The postprandial blood glucose level - A new target for optimizing treatment of diabetes mellitus. European Heart Journal Supplements, 2000, Vol 2, Iss D, pp D36-D38.

Checked 8/9/05

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