Dear Doctors: I switched to a new doctor, and she wants me to get a bunch of blood tests. One is a blood test called an A1C. She says it’s for diabetes, but I already know I’m not diabetic. I don’t need insulin, and sugar doesn’t bother me. Are all of these tests really necessary?

Dear Reader: It sounds as though your new physician is doing a complete workup to get a sense of your general health. This typically begins with your personal medical history, which includes details about your lifestyle, allergies, previous illnesses or surgeries, any medications or supplements that you’re taking, and immunizations that you have had. Information about a family history of illness, such as cancer, is also important.

In addition to a medical history and a physical exam, some doctors may also ask for blood tests, often referred to as blood work. These can include a complete blood count, which analyzes your blood and its components, and a metabolic panel, which looks at certain chemicals, enzymes and lipids in the blood. Blood tests can reveal a lot about your metabolism, immune system and organ function. They are also important tools in helping to identify a range of diseases and conditions. Any blood work you have done now will serve as a baseline against which any future changes to your health can be assessed.

While you don’t have Type 1 diabetes, which requires insulin injections or an insulin pump to keep blood sugar levels within a healthful range, you may still be at risk of developing Type 2 diabetes. That’s a condition in which the body doesn’t produce enough insulin, and the cells within the body don’t respond to insulin adequately. This results in too much glucose circulating in the blood, which poses a serious health risk. And although you say sugar doesn’t bother you, unfortunately, high blood glucose isn’t something that you can necessarily feel.

The A1C test measures your average levels of blood glucose, or blood sugar, over the previous three months. Glucose attaches to the part of the blood known as hemoglobin. The higher the level of glucose in your bloodstream, the more of it will attach to the hemoglobin. The result of an A1C test shows whether someone has prediabetes or Type 2 diabetes. It can also indicate whether or not someone living with diabetes is successfully managing the disease.

Risk factors for prediabetes and Type 2 diabetes include being overweight, storing fat in the abdomen, being sedentary and having a family history of the disease. Because the risk of developing the disease increases with age, an A1C test is often recommended for people over the age of 45.

Type 2 diabetes can adversely affect the heart and kidneys, contribute to high blood pressure, and lead to damage to the eyes, blood vessels and nerves. It also increases the risk factors of a range of chronic diseases. If you have any of these risk factors, agreeing to the A1C test would be wise.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: My older brother worked construction his whole life, and now he has bad arthritis in his left hip. He was in enough pain that he finally saw his doctor about it. Instead of a hip replacement, they want to do hip resurfacing. What is that? Will it be as effective as a hip replacement?

Dear Reader: Hip resurfacing is a type of hip replacement surgery. As with your brother, the most common reason that someone needs this type of surgery is advanced osteoarthritis. Also known as “wear-and-tear arthritis,” it is common in older adults and among certain professions. Osteoarthritis of the hip can cause pain that is severe enough to limit mobility and interfere with the activities of daily life.

To understand the difference between traditional hip replacement and hip resurfacing, we need to take a closer look at the hip joint. It’s a ball-and-socket joint, which allows for the impressive range of motion we have in our legs. The rounded top of the femur, which is the larger leg bone, forms the ball. This is known as the femoral head. It fits into a cuplike socket in the pelvis, known as the acetabulum. Both the ball and socket are covered with smooth cartilage, which allows them to glide painlessly against each other. In osteoarthritis, that cartilage gradually wears away, which makes movement painful. And when nonsurgical approaches to managing osteoarthritis pain are not successful, hip replacement surgery is often recommended.

In a traditional hip replacement, both the femoral head and the acetabulum are removed. They are then replaced with components made of plastic, ceramic and sometimes metal. But in hip resurfacing, damaged bone and cartilage from the femoral head and the acetabulum are trimmed away. The surgeon then lines the socket with a metal shell, and covers the femoral head with a smooth metal cap.

Advantages of this procedure over a total hip replacement include more rapid recovery, improved mobility and decreased risk of hip dislocation. It’s also easier to exchange implants if they wear out or fail.

However, there are some drawbacks. One is the risk of a femoral neck fracture, which occurs in a small number of hip resurfacing patients. This results in the need for a complete hip replacement. The other is something known as metal ion risk. Because hip resurfacing uses two metal components, the resulting friction can, over time, lead to the release of tiny metal molecules. This can cause pain and swelling in the surrounding tissues, which can necessitate further surgery.

The metal ions can also move throughout the body via the bloodstream, and have been associated with adverse effects to the heart, nervous system and thyroid, as well as cancer. Metal ion risk is a potential complication in traditional hip replacements that use a metal ball and a metal socket.

It’s important for your brother to talk about all of this with his surgeon. Getting a second opinion, which can help him weigh the risks and benefits of the two types of hip replacement, can be helpful as well.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: My uncle had been feeling nauseous, so he saw his doctor. He figured it was a stomach bug. After getting an MRI, he was diagnosed with advanced pancreatic cancer. He died just two months later. Needless to say, our family is in shock. Is this cancer always so dangerous? Why is it so hard to diagnose?

Dear Reader: Although pancreatic cancer accounts for just 3% of all cancers diagnosed in the United States, it’s the third leading cause of cancer-related deaths. Only lung and colorectal cancers take more lives each year. It occurs slightly more often in men than in women, and it rarely appears before the age of 45. About two-thirds of patients are at least 65 years old at the time of diagnosis.

Due to its five-year survival rate, which hovers in the range of 10%, pancreatic cancer has the highest mortality of all the major cancers. For individuals who get an early diagnosis, particularly when surgical removal of the tumor is possible, the five-year survival rate improves to about 30%. But due to a number of factors, catching this type of cancer early isn’t easy. To better understand why, let’s begin with a bit of anatomy.

The pancreas functions both as an organ and a gland. Its two main jobs are to produce enzymes that aid in digestion, and the hormones insulin and glucagon, which help maintain blood sugar control. It sits deep within the abdomen, just below the liver and behind the stomach. In a healthy adult, the pancreas is about 6 inches long and weighs just under 3 ounces. It’s flat and spongy and looks somewhat like a comma that has been tipped on its side. A rounded head tucks into the upper curve of the small intestine. The gradually tapering body traverses the abdomen and ends near the spleen. It’s because of this location, surrounded and obscured by internal organs, that pancreatic tumors are impossible to see or feel during a routine medical exam.

Making diagnosis even more difficult is the fact that in its early stages, pancreatic cancer is usually a so-called “silent” disease and causes no symptoms. It’s only when the cancer has reached an advanced stage and begun to spread throughout the body that physical effects appear. Even then, they can be similar to those of other diseases and conditions.

One of the first symptoms of pancreatic cancer is often jaundice, which is a yellowing of the skin and whites of the eyes. Other symptoms include abdominal or back pain, greasy stools, poor appetite, unintended weight loss and the persistent nausea that your uncle experienced.

Diagnosis typically begins with imaging tests, such as an MRI or CT scan, and is confirmed with a biopsy. Blood tests can be helpful in determining treatment options. Depending on the stage of the disease, treatment can include surgery, chemotherapy, radiation and, more recently, immunotherapy. There are no screening tests for pancreatic cancer at this time. However, research into developing techniques for early detection, as well as novel therapies, is ongoing.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)