It’s Still National Kidney Month

And I still have pre diabetes.  It sounds like something someone made up and maybe it is, but my A1C test result is still high and getting higher despite the changes I’ve made in my eating habits.  When better than National Kidney Month to explain why this could be a problem for those of us with Chronic Kidney Disease?kidney

We’ll need a little background here (as usual).  First, what is A1C test?  According to The Mayo Clinic at http://www.mayoclinic.org/tests-procedures/a1c-test/basics/definition/PRC-20012585,

“The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications.”

I’m sure you noticed how often I rely on The Mayo Clinic for definitions.  I find their simple explanations make it easier for me (and my readers) to understand the material.  I also like that they explain in their explanations. These phrases surrounded by dashes or in parentheses further clarify whatever the new term may be.

Okay, so we can see why this needs to be tested.  Now, what does it have to do with diabetes and what is diabetes anyway? This time I looked for a medical dictionary and found one at our old friend The Free Dictionary.  It’s at http://medical-dictionary.thefreedictionary.com/Diabetes+Mellitus. The mellitus is there because that’s how members of the medical field usually refer to diabetes – as diabetes mellitus. This is what I found there,

“Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin.”

Book CoverIn What Is It And How Did I Get It? Early Stage Chronic Kidney Disease I define glucose as the main sugar found in the blood.  I go on to explain that in diabetes, the body doesn’t adequately control natural and ingested sugar.  The Free Dictionary definition shows us how the body loses control of insulin production and what it means for the glucose levels… which is what the A1C test measures.

So… PRE diabetes? What’s that?  Funny you should ask. The English teacher in me can tell you that pre is a prefix (group of letters added at the beginning of a word that changes its meaning) meaning before.  Pre diabetes literally means before diabetes which makes no sense to me because that would mean everyone without diabetes was pre diabetic.  It helped me understand when I was told pre diabetes was formerly called borderline diabetes (a much better term for it in my way of thinking).

This time I went to WebMD for a simple explanation.  In addition to learning that pre diabetes means your glucose, while not diabetic, is higher than normal, I found this interesting statement:

“When glucose builds up in the blood, it can damage the tiny blood vessels in the kidneys, heart, eyes, and nervous system.”  KIDNEYS!

You can read more about this at http://www.webmd.com/diabetes/guide/what-is-prediabetes-or-borderline-diabetes.

Well, then what’s a normal level you ask? According to my primary care physician, 4.8-6.0 is normal BUT this range needs to be adjusted for Chronic Kidney Disease patients.  I (what else?) looked this up at Lab Tests Online http://labtestsonline.org/understanding/analytes/a1c/tab/test and found more of a range:

  • A nondiabetic person will have an A1C result less than 5.7%.
  • Diabetes: A1C level is 6.5% or higher.glucose
  • Increased risk of developing diabetes in the future: A1c of 5.7% to 6.4%

My result was 6 in the emergency room last November.  During my regularly scheduled CKD yearly lab last September, it was 5.9 with a big H (for high) next to it.  The August before that it had been 6.1.  Back in January of last year, it was 6.  I seem to be staying in a very close range for over a year, but it’s still pre diabetes.

All right then, what’s normal for a CKD patient?  I don’t know.  Life Options says just keep it under 6.5 (http://lifeoptions.org/kidneyinfo/labvalues.php). The rest of the internet seems to think the A1C results need to be adjusted only if you have both diabetes and CKD.  Looks like my nephrologist and I will have to have another talk about this.

You would think the danger of an elevated A1C  would be diabetes, but I’m wondering if the damage to those tiny blood vessels may be worse.

diabetes_symptomsHave I raised questions in your mind?  Is your A1C normal?  How do you tell if different sources hold different values as normal?  Time to ask your doctor.  And time to remind you again, that I am NOT a doctor, just a CKD patient with loads of questions and a willingness to research some answers for us all. Something to consider.

Other things to consider: have you had your kidneys tested?  It’s a simple blood test and a simple urine test.  Sure you don’t have the time, but no one does.  Then again, it’s sure worth it to avoid the need for dialysis (now THAT takes time) and a transplant down the road.

You know that 59% of our country’s population is at risk for CKD, but did you know that 13 million U.S. citizens have undiagnosed CKD?  That’s scary.  Take the test.

Here’s a link to the letter I wrote for Dear Annie – a nationally syndicated column – for National Kidney Month: http://m.spokesman.com/stories/2014/mar/10/annies-mailbox-learn-risk-factors-of-kidney/ It appeared on March 10, 2014 just prior to March 13 World Kidney Day.Nima braceket

Above is a picture of Nima. She’s pointing to the bracelet I gave her that she’s wearing so that I would be with her on last year’s Greater New York Kidney Walk while I was actually ill back home in Arizona.

Until next week (and the last day of National Kidney Month),

Keep living your life!

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