As part of our mission here at Type 1 Strong, we advocate for the importance of diabetes testing. That broad statement can be applied to all who have either type 1 or type 2 diabetes. These 2 conditions, although different in their genesis share the common defect of hyperglycemia. The various types of diabetes testing provide the means to control blood sugar thus avoiding the cellular damage brought about by hyperglycemia over time. Simply put, the longer you have a normal blood glucose level, the healthier you will be.
The daily blood sugar monitoring that (hopefully) all type 1 diabetics is done by finger stick blood sampling or by continuous glucose monitoring (CGM) of the extracellular fluid.
We encourage use of the CGM because it gives the best picture of blood sugar over time. These devices typically provide a graphic of blood sugar trends over time that allows diabetics to judge insulin needs. The isolated finger stick method gives “snapshots” of blood glucose rather than the “movie version”, so it is not as precise.
Equally important, is the measurement of glycosylated hemoglobin, known as the “A1c” test. This type of diabetes testing uses the blood protein, hemoglobin, as a proxy for all the structures in the body that can be damaged when extra glucose is present to bind to them. If you have an elevated measure of this, you can assume that glucose has stuck to other structures as well, and is causing problems. This, and the accompanying inflammation, are thought to be the major mechanisms underlying the complications of diabetes, for both type 1 and type 2 diabetics.
Since hemoglobin is present in red blood cells it is easily collected and tested making it ideal from the patient’s stand point. The latest data from the American Society of Hematology indicates that the average life span of a red blood cell (RBC) is 120 days, therefore the A1c is an indicator of blood sugar control over that time period.
Although we focus on type 1 diabetes, there are many more type 2 diabetics in the population who are either undiagnosed or inadequately treated. For type 2 diabetics this is a failure of both diagnosis and treatment. A person with type 2 diabetes can be treated with a low carbohydrate diet and very likely cured of their insulin resistance before they progress to the stage of irreversible beta cell damage, chronic hyperglycemia and the need for insulin replacement.
The key for the type 2 diabetic is early preservation of beta cell function in order to avoid becoming insulin dependent. There is good data to suggest that insulin resistance can be diagnosed before there is measured hyperglycemia. By checking fasting and postprandial insulin levels, it is possible to determine individuals who have impaired insulin function (resistance) even in the absence of hyperglycemia.