Diabetes type 2 is preventable.
But it can also creep up on folks silently, until a blood test discloses the increase of something called A1C, and then your doctor gets a bit squirrely about Diabetes type 2 risk. Diabetes 1 D1 results in either not enough insulin being produced to handle blood glucose. Diabetes type 2, a lifestyle response, happens when body cells increasingly ignore the glucose in the blood stream and do not clear it, resulting in detectably increased levels.
So what is A1C, how does it predict the risk of type 2 diabetes (D2), and why are such seemingly different things as sugar and white flour equally problematic?
Well, it turns out that sugar and white flour are almost chemically identical and have the same blood-glucose-spiking effect. White sugar (aka sucrose), is made up of a unit of fructose and a unit of glucose joined together. White flour (aka pulverized starch) are many glucose units joined in a branching structure like a tree. These, and other sugars are collectively known as saccharides or carbohydrates. They all end up as blood glucose that must be managed in order to avoid diabetes.
When white sugar or white flour is eaten, they enter the intestine where they are broken down into single units. These carbohydrate units are transported across intestinal cell membranes into the bloodstream, dissolving into the plasma. Glucose (geek out here) goes directly to work for the brain and body’s energy needs, whereas fructose goes to the liver for conversion into glucose or fat (uh oh). So both sugar and white flour raise blood glucose levels almost equally.
A blood sample gives a snapshot of blood glucose levels at the time the sample was taken. A more useful picture for diabetes risk is longer term, like months. When blood glucose levels remain elevated over time, it tends to attach to our hemoglobin resulting in glycated hemoglobin, aka “hemoglobin A1C” for short, or A1C for really short. Higher A1C means higher blood glucose over time and is a red flag for diabetes. Normal levels of H1C are less than 5.7%, pre-diabetes: 5.7-6.4%, and diabetic levels > 6.5%. There is a variable that can affect A1C numbers, and that’s if you have a hemoglobin variant. Your doctor can test for this.
Summary: Glucose from sugar or white flour act identically, raising glucose in the bloodstream. Insulin clears it into our cells, but if there’s a problem with that system, glucose blood levels stay high over time, sticking to hemoglobin. Hemoglobin lasts about 120 days, so levels of the glycated hemoglobin or A1C, gives a 3-4 month overview of glucose levels. Increased A1C over 5.7% indicates D2 risk.
Lifestyle choices to reduce Type 2 Diabetes risk: Reduce your consumption of refined sugars and white flour. Increase consumption of unprocessed foods. Vegetables, whole grains, and fats and proteins from plants are deemed the most health-protective. Incorporate daily movement to burn down blood glucose levels. Get your blood A1C levels tested annually so you are not taken by surprise, and adjust your lifestyle accordingly to keep it under 5.7%.
It always comes down to eat right and exercise, what a surprise.
