Whether diagnosing or managing diabetes, clinicians at DynaLIFE Medical Labs (DML) in Northern Alberta and Calgary Laboratory Services (CLS) have turned to one very reliable—and convenient—test: the HbA1c blood test, also known as the haemoglobin A1c or glycated haemoglobin test.
Unlike its predecessor, the glucose test, HbA1c testing requires no fasting. Because it measures glucose control and tolerance over a period of time instead of at the precise moment of testing, it is a useful test for the initial diagnosis of diabetes as well as subsequent testing to manage diabetes over time.
Physicians will provide requisitions for the HbA1c test to patients with risk factors of diabetes. The test will provide results the physician can use to then diagnose the disease if applicable.
Patients with diabetes should have the HbA1c test administered every three months or 90 days. Dr. Christopher Naugler with CLS says that there is a problem with patients who over or under utilize HbA1c testing. "Many patients don't get tested at all after their initial diagnoses, which is problematic because then we can't see trends in blood sugar control and their physician can't adjust treatments, provide ongoing diet counselling, or check for side effects such as foot and eye diseases," Naugler says. "Lab testing is an ongoing part of having diabetes. That said, there is no benefit for patients who go for testing more than four times per year. Testing more often than once every three months has no added value for the patient," Naugler says. The only exception is with pregnant women who have gestational diabetes, who may need more frequent testing during their pregnancy.
“Patients with diabetes should have their urine protein checked annually, but most don't" says Naugler. "If there is protein in the urine, sometimes treatment of the kidneys is required or the patient will be at risk of other diseases." Naugler advises those with diabetes to regularly follow up with their physician and get requisitions not only for your routine HbA1c test but also for annual urine protein and kidney function tests as well.
While the HbA1c blood test is very reliable for most patients, there are some subgroups and disorders for which the test will not be sufficient. "In any case where there's a disorder that affects the lifespan of red blood cells, which in turn affects the HbA1c in a way that's independent of glycemic control, a glucose test is a better option," says Dr. Mathew Estey with DML. In addition, Estey says that patients with cystic fibrosis, who are likely to develop cystic fibrosis-related diabetes (CFRD), require an oral glucose tolerance test instead. While the test is not as ideal, work is currently being done to find a new test that will work to help diagnose patients with CFRD.
Provincial Utilization Office
Alberta Health Services is trying to increase awareness of the importance of lab testing and address concerns of overuse and underuse through the Provincial Utilization Office, which is housed in CLS. This office provides information and logistical support to phsycians and administrators interested in improving when and why they refer their patients for lab testing. It is an excellent resource for health professionals.
University means a fresh start. You can put anything you want behind you, and instead look forward to who you want to become. Even if you aren’t moving away from home and you are entering your first year of university, many aspects of your life will still change.
It is important to remember that with the many changes university brings, your diabetes management may have to change too. A new living situation, new stressors, and new faces can cause your health to dip. But we have 3 tips to prepare you for living with diabetes in university.
Protein is a source of endless debate. Some bodybuilders say if you’re trying to bulk up, it should be the bulk of everything you eat. Others say the power of protein is overestimated. How did we get so mixed up about a few amino acids?
The fact is, it’s an essential nutrient that keeps your body functioning well by building and repairing muscle, hormones and enzymes, as well as your skin, nails and hair. But obviously there’s some confusion so I offer this to you: a protein primer.
One of the first projects funded by the Alberta Diabetes Foundation when it was founded in 1988 was the clinical research of Dr. Ray Rajotte, which it funded for 12 years. Dr. Rajotte pioneered the first-ever islet cell transplant, which was the biggest breakthrough in diabetes research since the discovery of insulin. That work, plus an expanded islet cell transplant team and the addition of anti-rejection protocol, ended up becoming the international standard of care for islet cell transplantation.
Since 2000, when the protocol was developed, Alberta Diabetes Foundation has invested in a capital campaign to build the world-class building that now houses the Alberta Diabetes Institute. Since then, the Foundation has endeavoured to continue to invest in world-class research for both type 1 and type 2 diabetes right here in Alberta.
Alberta Diabetes Foundation works in tandem with the best-in-class Alberta Diabetes Institute to allocate funding where and when it is needed most, ensuring that important diabetes research and projects do not become stalled. The Alberta Diabetes Foundation is able to fund projects, even at early stages, often filling in gaps left by traditional granting organizations. The researchers in Alberta are confident that a world without diabetes is possible and, today they are doing more than providing sustainable solutions to treating diabetes -- our researchers are on their way to a cure.
Imagine this. Recently you’ve noticed that your child hasn’t been acting quite like their usual self lately. You can’t quite pinpoint it, so you chalk it up to a rough week. But maybe that rough week turns into two. You start to think on their behaviour more and you grow more concerned; they are always asking for extra water or juice at breakfast, they seem to be constantly hungry, they’re rushing off to the bathroom more frequently, and they are tired as soon as they step in the door from school.
Although these symptoms may seem common for children who may not have had a good night’s rest or for those going through puberty, that’s not always the case. These symptoms should be taken seriously, and if you notice these in your child for a prolonged period of time, you should discuss a glycated hemoglobin (A1C) test with your doctor. An A1C test will determine your child’s average blood glucose level over the past 3 months. If your child’s A1C level is 6.5 or over, if could mean that they have Type 1 diabetes.
As a parent, your child’s Type 1 diabetes diagnosis can be earth shattering for both you and your child. So many thoughts can go through a parent’s head; why does it have to be my child? How is my child going to live with this? How am I going to be able to give my child everything they need now that they have this condition?
Every parent and child will go through this journey in their own way, but it is important to know that Type 1 diabetes is a disease that can be managed, and proper management will allow your child to live a healthy life. As for the questions, you have as a parent, we would like to help by providing you with a few answers.
Why does my child have to be diagnosed with Type 1 diabetes? Where does Type 1 diabetes come from? What could wehave done as parents to prevent it?
Type 1 diabetes is not a preventable disease. It is a mixture of genes and environment. Although scientists do not know the exact cause of Type 1 diabetes , they do know that genes and environment play a role . They have figured out that individuals who have a certain type of HLA complex (human leukocyte antigen on chromosome 6) may be susceptible to Type 1 diabetes. This complex can create an autoimmune disorder that is triggered by a viral infection.
Simply put, when your body tries to fight the viral infection, it may also attack beta cells in your pancreas—cells that make insulin. This process usually takes several years before symptoms develop. The right combination of genes (HLA complex) and environment (exposure to a viral infection) can contribute to the onset of type 1 diabetes.
How is my child going to live with this condition?
Diabetes will be a day-to-day change in you and your child’s life. Your child will require insulin injections. You might even be required to administer insulin injections for your child depending on recommendations from the doctor. You will also want to revaluate the lifestyle that you and your child live. Focus primarily on the diet and exercise your child gets. And remember to stay on top of these few daily tasks you will need to complete:
Although it may not happen everyday, your child will go through highs and lows with their diabetes. Both diabetic highs and lows are serious and can be life threatening
Symptoms of a diabetic high and low are:
Symptoms of a diabetic low also include:
You and your child’s first encounter with can be frightening. If you prepare yourself to know that symptoms and you are able to react accordingly, you can make your child feel safer in the earlier stages of this condition.
How am I going to be able to provide everything my child with everything they need to take this condition on?
The biggest change a parent can have on their child’s life is setting a great example. Your child relies on you and looks up to you. As a parent you should eat healthy, exercise, and take on proper responsibility for your own health. Your own accountability will benefit your child in the short-term and long-term. Additional support from friends and family will also help your child manage emotional and physical effects of the diabetes diagnosis. You may also consider joining a diabetes support group or participating in a run to fund diabetes research.
Advice from the following people can help ease the stress of your child’s diabetes:
As a parent, the best thing you can do for your child is simply to be there for them. Communicate with your child in a way that is supportive and will help to boost their self-esteem. Allowing your child to be open and honest with you will make treating diabetes that much easier.
No parent wants to see their children suffer. Remember that diabetes was not something that your child was marked for, and it isn’t your fault as a parent. As a family, you can work through this disease together, and put your child down a path of success.
You’ve seen the ads: “Cut out bananas and banish belly fat forever.” It seems like the world is going bananas over a simple piece of fruit.
It’s a bit strange. They’re almost identical in carbs to a delicious pear, but nobody seems to be preaching safe pear practice. So why do bananas get a bad rap? Why do people suddenly find them so un a-peel-ing?
Don’t be Split on Bananas
Many have tried to bruise the banana’s reputation by spreading the rumour that they’re loaded with carbs and sugar, instantly leading to weight gain and sending your blood sugars into a spiral. This is nothing more than a far-fetched fruit fallacy.
For one, at just 105 calories, a medium banana puts a mere 5% dent in a 2,000-calorie diet ( 1 ). Yes, bananas do contain starch and sugar, which does cause blood sugars to rise, but that doesn’t mean you should steer clear! First off, our bodies need carbs to function. Second, there is a world of difference between the sugar in fruit and that found in pop, cake or candy. Unlike sweets, bananas are rich in naturally-occurring sugar, plus 3.5 grams of fibre and a ton of nutrients needed for good health.
Bet on Bananas
Fibre—like that found in bananas—is essential for weight and blood sugar management. It helps prevent overeating by making you feel full for longer. It also helps to slow the absorption of sugar. Just-ripe bananas and other carbohydrates with a low GI value (55 or less) cause a lower and slower rise in blood glucose and insulin levels ( 3 ).
Another boast for the banana is that it packs, on average, more than 400 milligrams of heart-healthy potassium . That’s almost 10% of your recommended daily intake! Potassium is vital for normal muscle, nerve and brain function and is essential for maintaining healthy blood pressure .
Since many Canadians may not be getting enough potassium in their diet ( 2 ), bananas are a tasty way to up your daily dose
Still think bananas are to blame for all your weight woes? Here’s the truth: No one food is responsible for the number on the scale.
A diet high in fibre-rich fruits and vegetables —including bananas—is a key ingredient for a healthy body weight and reduced risk of chronic disease.
Bananas are a carbohydrate-rich food. If you're watching your blood sugars, be mindful of your portions. Otherwise, there's no monkey business when it comes to bananas. Unless you have been told to limit them by your doctor, there’s no reason to shun this simple fruit.
Some tasty tips to enjoy bananas:
1) Health Canada, Canadian Nutrient File (2015). Banana, raw . Accessed June 7, 2017 from https://food-nutrition.canada.ca/cnf-fce/serving-portion.do?id=119
2) Health Canada, Food and Nutrition (2012). Do Canadian Adults Meet Their Nutrient Requirements Through Food Intake Alone? Accessed June 7, 2017 from http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/art-nutr-adult-eng.php
3) University of Sidney, Glycemic Index Database (2017). Banana, raw. Accessed June 7, 2017 from http://www.glycemicindex.com/index.php