A recent analysis of National Health and Nutrition Examination Survey data (NHANES) found that older adults who had an HbA1c above 8% were associated with increased risks for all-cause, cardiovascular and cancer-related deaths.
The HbA1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The HbA1C test is sometimes called the hemoglobin A1c, A1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. The A1C test can be used to diagnose type 2 diabetes and prediabetes alone or in combination with other diabetes tests. An A1C test below 5.6 % is considered normal and 5.7-6.4 % is considered pre-diabetic and above 6.5 is considered diabetic.
Adults aged 65 and older with diabetes were compared to those without the complicated disease. Searching for an association between HbA1c and mortality rates, Dr. Priya Palta, PhD, associate professor of epidemiology at Johns Hopkins School of Public Health, and her colleagues analyzed data from 7,333 adults aged at least 65 years participating in NHANES III (1988-1994) and continuous NHANES (1999-2004) and linked mortality data through end of 2011.
Of 4,729 adults who died over an average 9 year period, (1,262 from CVD, 850 from cancer and 2,617 from non-CVD/noncancer causes), patients with an HbA1c of 9% or higher were 8 times more likely to die from any cause compared with patients whose HbA1c was less than 6.5%. This was followed by all-cause mortality for those with undiagnosed diabetes with an HbA1c of at least 6.5% were three times more likely to have a fatal event versus those without diabetes.
Researchers also found an elevated risk for cardiovascular-related mortality among adults with diabetes and an HbA1c of at least 9%.
The study demonstrated that enough data regarding glycemic control in older diabetes patients isn’t available.
“…the decision to aggressively treat an individual patient’s glucose levels is variable and cannot be based solely on findings from studies of general populations like ours. However, most studies so far affirm …that glycemic goals be individualized depending on the patient goals, life expectancy, and overall health status,” according to Jessica Yeh, PhD, associate director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins University, Baltimore. “With the advancement in diabetes treatment, we think future research should study the relationship between the level of HbA1c control and quality of life, functionalities, geriatric syndrome, and health care utilizations (e.g. hospitalization due to complications) in older adults.”
The study also demonstrated that maintaining glycemic control is necessary for better health and longevity. Below 7% is considered best diabetic control with drugs, but even 6.5% was linked to three fold more mortality. We need to do better than 7%, may be goal should be below 6%. That at least what I shoot for in my patients while counseling them for diabetes.
With a focus on regular exercise and managed diet, you can help your body control blood sugar swings. Adding in herbs for diabetes like Gymnema sylvestre, Neem, and Bitter Melon can help maintain your HbA1c by aiding cellular function and repair, supporting a healthy stress response, and more.
The Indian herb Gurmar, Gymnema sylvestre, translates as “destroyer of sugar” because when the leaves are chewed, it inhibits the ability to taste sweetness. Across multiple research studies, G. sylvestre has been found to target several of the factors connected with diabetes, including chronic inflammation, obesity, enzymatic defects, and pancreatic b-cell function (Leach, 2007). Gymnema’s constituents decrease the absorption of sugar from the intestine, is believed to increase the amount of insulin in the body, as well as increase the growth of pancreatic b-cells.
Neem (Azadirachta indica) is a popular Ayurvedic remedy for reducing sugar levels in people with type 2 diabetes. Neem has shown to regenerate beta-cells of pancrease in animal studies. Nimbidiol, the active constituent of neem, has shown to be a potent inhibitor of intestinal glucosidases. Diabetic patients on insulin, when given Neem extract were able to reduce insulin by 30-50%.
Bitter melon has been shown to increase peripheral glucose oxidation, glucose tolerance, and insulin signaling in induced insulin resistance models (Sridhar, et al, 2008). It can also decrease hepatic gluconeogenesis, while increasing glycogen synthesis. Bitter Melon increases insulin output from the pancreas, and provides polypeptide-P, which is an insulin-mimetic similar to bovine insulin (Krawinkel & Keding, 2006).
Many type 2 diabetics are off from their standard drug treatment after following an Ayurvedic lifestyle along with taking these herbs. They have their A1C levels in 5.3 to 6%, a perfect blood sugar control. Even type 1 diabetics are able to cut their insulin requirements more than 50% and A1C near 6%.
The magic is not in the herbs for diabetes. If you follow simple laws of Mother Nature you can beat diseases like diabetes. So eat according to your body constitution, exercise and practice yoga. Do breathing practices, get good sleep and take these herbs for diabetes under the guidance of your healthcare provider.
Sridhar MG, et al: Br J Nutr. 2008;99(4):806-12. Basch E, et al. Am J Health Syst Pharm. 2003;60:356-9)
Krawinkel, M. B., & Keding, G. B. (2006). Bitter Gourd (Momordica charantia):A Dietary Approach to Hyperglycemia. Nutrition Reviews, 64(7), 331-337. doi:10.1111/j.1753-4887.2006.tb00217.x
Leach, M. J. (2007). Gymnema sylvestre for Diabetes Mellitus: A Systematic Review. The Journal of Alternative and Complementary Medicine, 13(9), 977-983. doi:10.1089/acm.2006.6387
West Indian Med J. 2015 May 5. doi: 10.7727/wimj.2014.224. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/26716795
J Enzyme Inhib Med Chem. 2013 Oct;28(5):900-10. doi: 10.3109/14756366.2012.694877. Epub 2012 Jul 18. https://www.ncbi.nlm.nih.gov/pubmed/22803678
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