DEAR DR. BLONZ: After my annual physical, I discovered that my hemoglobin A1C was in the prediabetic range, although my glucose reading was in the mid 90s. I have been cutting way back on sugar, eating fewer carbs (such as bread, rice, potatoes and pasta) and exercising more. My doctor said I could try a blood sugar supplement to see if it helps. He said they usually contain chromium, alpha lipoic acid, berberine and cinnamon.
I am interested in learning more about my test results and in hearing your thoughts on these supplements. Have there been studies on their effectiveness? -- J.L., via email
DEAR J.L.: First, some background about the hemoglobin test. Most of us are familiar with the blood glucose test, a common part of most annual exams. Informally referred to as a blood sugar test, it measures the glucose concentration in the blood at the time of the test. The blood is often drawn while fasting, depending on the test's purpose and what else is being measured.
Our blood is the main fluid delivering oxygen and nutrients to the cells, glucose being one of those; it also carries away metabolic waste products, including carbon dioxide (CO2), for eventual elimination. The body's red blood cells (RBCs), built in our bone marrow, are responsible for transporting oxygen and CO2. After they mature, RBCs are no longer metabolically active, but they retain a fragment of glucose from the moment of their maturity. RBCs are always being made and recycled: They last from 100 to 120 days before being taken out of circulation and broken down for parts.
A blood test measuring hemoglobin A1C is reflective of a two- to three-month blood glucose average. The normal A1C level is below 5.7%, while a range of 5.7% to 6.4% indicates prediabetes. The higher in that range, the greater the risk. And 6.5% or above indicates the presence of diabetes. This test can provide vital information for those at risk for diabetes and can also be used to track the success of efforts to control the condition. (Read more on the hemoglobin A1C test at b.link/atbnhb.) Dietary improvements, such as you have made, and regular exercise have been reported to help decrease the A1C level and the risk of diabetes.
Your doctor's mention of certain dietary supplements is worth considering, but I favor diet and activity as the primary course of action. Consider requesting a referral to a dietitian specializing in diabetes; research has shown how this type of personalized care can provide significant benefits.
If you are still interested in those supplements, you will find that each may be useful under certain circumstances, but you must be wary of interactions with existing health conditions and medications (or other dietary supplements) you take. There is much to consider. An excellent resource for information on dietary supplements is consumerlab.com, which does charge a fee, but provides reliable information to help you decide on dosages and brands. Stay well, and let me know how your efforts proceed.
Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to firstname.lastname@example.org. Due to the volume of mail, personal replies cannot be provided.