Diabetes Hiding In Plain Sight

Okay, quick question. Do you know your A1C, like the actual number? If you just said, um... You're not alone and that's the kind of problem, the whole problem I want to talk about today because a number you don't know cannot help you and it can quietly hurt you. I'm Dr. Amit Urgen, I'm an endocrinologist at the Diabetes, Thyroid and Hormone Center of the Treasure Coast in Fort St. Lucie and Mirro Beach. Now remember, November 14th is World Diabetes Day and this year's theme from the World Health Organization and International Diabetes Federation is Early action on diabetes, which honestly, I love, because the hardest diabetes to treat is the one nobody's finding out early. So let me give you the numbers. According to the CDC's latest National Diabetes Statistics Report, about 11 million, 11 million American adults have diabetes, and they don't even know it. 11 million who have diabetes, but don't know it. That is more than one in four people with diabetes walking around, no idea. And pre-diabetes, well 115 million adults and of those only about one in five know that they have it. One in five. Imagine that. So if you lined up five people with pre-diabetes, four of them would tell you, me? Nah, I'm fine. Right? Now, so why does this happen? Because, and this is the tricky part, High blood sugar usually does not hurt, not at first, and there's no alarm bell. Your body quietly compensates for years. Now, by the time some people get diagnosed, they already have early nerve damage, or eye changes, or kidney changes. And I see that in the clinic. It's frustrating, right? Because it didn't have to go that way for you. So what are the clues? Some are classic, right? Being thirsty all the time, getting up at night to pee, blurry vision that comes and goes. This is like a late stage. And yes, you may have some cuts that won't heal, frequent yeast infections, UTIs. You know you're in big trouble. But then there are the sneaky ones people don't connect, like skin tags on the neck, darker velvety skin on the back of your neck, or in your armpits. That's called acanthosis nigricans. And it's basically insulin riding on Your skin, getting really sleepy after a carb-heavy lunch, for example. Also, belly weight, that won't budge, or fatty liver on the ultrasound. So, all of that, even a history of diabetes during pregnancy, PCOS, right? A parent or sibling with type 2 diabetes. So, if you have got a few of those, please, get tested. Don't wait. So, which tests, right? The basics are an A1C and fasting glucose. And I want to see your 5.7. to 6.4 is pre-diabetes. Now, insulin resistance starts actually way before that, but we are trying to tackle the pre-diabetics, which are, again, over 100 million people. 6.5 or above is diabetes, but you cannot diagnose diabetes just with A1C. You have to check fasting glucose. Which is 100 to 125 is pre-diabetes, 126 or above is diabetes. And we sometimes do two-hour glucose tolerance test, which also has criteria, let's say, if you hit over 200, you're diabetic, 140 to 200 by two hours after that glucose stimulation test is pre-diabetes. You have to have two out of... The three. Here's my endocrinologist add-on for you. Ask for a fasting insulin too because insulin goes up years before your blood sugar does. So your A1c may be 5.5 but your insulin may be very high which is a problem. Now your sugar can look perfect while your pancreas is basically working overtime behind the scenes. And the honest caveat I would say is that A1c isn't perfect, if you have anemia, certain blood conditions, even recent blood loss, even from person to person genetically, you can all throw it off, so it's not a very solid reliable number, just like person A with a blood sugar of 150, let's say on average, versus person B with the same average blood sugar, their A1c can be, you know, one maybe have 7.3, the other one may have 6.8. So that variability from person to person makes it difficult to just have a solid number to compare. But it is good for monitoring the progress. Is it going up? Is it going down? That's where it's really helpful. So sometimes we do, like I said, glucose tolerance test. Sometimes we do a CGM monitoring to get the real picture. So you find out If you're in that range, then now what, right? That's the good part. Early is when you have the most power. First, always saying this, move after you eat. Don't eat and sit on the couch. Don't eat and sit on the table for an hour. Even a 10-minute walk after dinner, your muscles pull sugar out of your blood without needing much insulin. If you cannot get out, just do some calf raises, right? That exercise actually pulls up a lot of sugar. Or go up and down the stairs. This is like a backdoor. And it's free, no copay, no prior authorization, right? Also, secondly, eat real food. Protein, vegetables, vegetables first, carbs last. So fewer things from just crinkly bags, let's put it that way. The third... Sleep. Now, short sleep makes you more insulin resistant the very next day, so you have to get that sleep hygiene dialed down. And fourth, this is where a supplement can make sense. Berberine, for example, works on AMP kinase, which is basically your cell's fuel gauge. In the Yin study published in Metabolism in 2008, people with newly diagnosed type 2 diabetes took berberine 500 mg three times a day. And their A1c went from about 9.5 to seven and a half in three months. Similar to metformin, in that small study, right? That's why we also use dihydroberberine in sugar MD superberberine. Why? First of all, it is once a day. It's a lot easier. It's not three times a day. And it is a form of berberine that is absorbed much better and you don't need high doses. Now the caveats, if you are on insulin or sulfonylurea, you gotta talk to your doctor first and monitor your blood sugar more strictly so you don't go low. And if you are pregnant, definitely skip it. So here's my World Diabetes Day challenge for you. Find out your number. Let us know. Put in the comments. I mean, I know it's hip-hop or whatever, but, you know, as long as you share it with yourself, you know, as long as you're comfortable, you know, you're in the diabetes channel, so everybody kind of has some sort of pre-diabetes, diabetes community. So don't be shy. Share your thoughts. Share what your numbers are. And call your doctor this week and ask for an A1C test if you didn't do it for a while. A fasting glucose and maybe fasting insulin. Then come back and tell me in the comments again what you found and, you know, I read those. I may not reply to all of them because I don't have that kind of time. I wish I did. I would love to respond to every comment. And for SugarMD Superberberine, you know, All right. our blood sugar support, there's a ton of education on SugarMDS.com. Don't wait for chapter seven. Find it early. Please fix it early before it's too late.