The Sugar We Need to Talk About This Month

By Dr. Nancy Yoon, Chief Medical Officer at Springfield-Greene County Health

If you’re an adult over 35 or are at a higher risk for prediabetes or type 2 diabetes, it might be time to get an A1C test. In these conditions, blood sugar levels are higher than normal. Over time, this can cause damage to the body, and increase a person’s risk for heart attacks and strokes. In the early phases of the disease, a person may not have any symptoms, so it is important to do screening tests to diagnose the condition early, before more serious complications have occurred.

An A1C test is a blood test that measures your average blood sugar levels over the past 3 months.

But what can the results of an A1C test be used for?

The A1C test is used to diagnose prediabetes and diabetes. If a person is being tested for diabetes or prediabetes, a baseline A1C test may be done.

Fortunately, the Springfield community is on top of getting an annual A1C test/screening. Springfield exceeds the state and national averages and has a near 90% compliance rate in annual testing.

However, the Springfield Community also has a high diabetes prevalence that surpasses state and national averages, making diabetes one of the top identified health issues in the Ozarks Health Commission report. The Health Department and our healthcare partners are working on addressing diabetes, along with other top priority health issues identified in the report, to better the lives of those in our community.

Who should get an A1C test?

In their 2022 Standards of Care, the American Diabetes Association has lowered the recommended age for screening adults for prediabetes and diabetes from 45 to 35 years. If an adult is overweight or obese or has other risk factors, they should also be screened for diabetes. Risk factors include having a first-degree relative with diabetes, being a member of a high-risk race or ethnic group (e.g. African Americans, Latino, Native American, Asian American or Pacific Islander), having a history of cardiovascular disease, high blood pressure, high cholesterol, polycystic ovary syndrome, physical inactivity, or HIV.

A1C levels are as follows:

· A normal A1C level is below 5.7%

o If you are in the normal range for your A1C test and you’re over 35 or have ever had gestational diabetes, you should have an A1C test at least every 3 years.

· Prediabetes level is between 5.7% to 6.4%

o If you are in the prediabetic range, a test is usually performed every 1 to 2 years but talk to your doctor about their specific recommendations for you.

· Diabetes level is 6.5% or above

o If your A1C is in the diabetes range, ask for a diabetes self-management education and support services referral from your doctor. Prescription medication may also be needed to lower your blood sugar levels. Regular follow-up appointments will also be needed to monitor your diabetes over time.

If you are asymptomatic but you are in the prediabetes or diabetes category in an A1C blood test, ask your doctor to get a second test on another day to confirm.

o Symptoms of diabetes include frequent urination, excessive thirst or hunger, fatigue, very dry skin, blurry vision, among others.

Prediabetes can often be managed with changes to diet and lifestyle. Diabetes educators and dieticians can help give specific recommendations to help manage blood sugars. There are also CDC-approved programs that have been proven to prevent or delay the progression to type 2 diabetes.

If you or someone you know is considering an A1C test and is high risk, don’t wait! Help yourself this Diabetes Awareness Month by calling your doctor and scheduling your first or annual A1C test.

For more information: American Diabetes Association (www.diabetes.org)

Standards of Care in Diabetes — 2022 (Diabetes Care December 2021, Vol.45, S1-S2).

CDC.gov.

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