American Diabetes Association Endorses
Normalizing Blood Sugars for Patients with Diabetes

by Charlotte Hodge, R.N., Nurse Practitioner

The American Diabetes Association defines good blood sugar control as anything in the range from 90 to 130 before meals. Before 1995 the average patient probably had blood sugars in the low to mid 200s. 

Theoretically, everybody with access to healthcare can now achieve excellent blood sugars. The tools available to patients and physicians alike make normalizing blood sugars a reasonable goal. Patients have access to easy-to-use glucose monitoring devices, improved insulin syringes and injection devices, including insulin pumps and the availability of diabetes education and support groups. These advances have given patients the freedom to manage their blood glucose and better control their diabetes. 

Diabetes Medications

Physicians have access to many new medications for diabetes, which may be used alone or in combination.  Addressing the action of each new drug classification points out why some combinations have accumulative and 
beneficial effect:

• Sulfonylureas stimulate the pancreas to produce more insulin. Common drug names include Diabinese, Glucotrol/Glucotrol XL, Micronase, Glynase, Diabeta and Amaryl.

• Repaglinide also stimulates the release of insulin and is commonly prescribed as Prandin. 

• Biguanides improve the liver’s ability to block excessive release of glucose into the blood. A common Biguanides is Glucophage.

• Thiazolidinediones improve the action of insulin in muscle and fat to store sugars from meals.  Common drug  names include Avandia and Actose.

• Alpha-glucosidase  inhibitors slow or block the breakdown of starch and certain sugars.  Common drug  names include Precose and Glyset.

Good Blood Glucose Control Can Reduce Long-Term Complications

Patients are becoming better informed of the consequences of living with elevated blood sugars over time. The results of the 10-year Diabetes Control and Complication Trial has been widely published and distributed to professionals and the public. The study results confirmed that establishing good blood glucose control, HBA1c at or below7, can reduce the long-term complications of diabetes by up to 76%. 

HBA1c= “hemoglobin A one c” is a blood test that calculates the average blood sugar results over a 90-120 day period of time. Normal values range between 4.5-6.5 and can vary slightly depending on individual laboratory normal values. It is widely held that values over 7 regardless of the laboratory method are above the normal range. This test is unlike the blood glucose test performed at home, which gives the result, based on the blood sugar at the exact time that it was taken.

Multidisciplinary Team Approach

With the availability of new drugs, patients may be more receptive to trying different drugs in combination with diet and exercise to help fine tune their blood sugars and achieve their goals. The American Diabetes Association has recognized that a team approach to achieving and maintaining normal blood sugars is an important and necessary factor. 

A patient’s team should include their physician and Certified Diabetes Educators who can teach patients “survival skills” and help support their progress in achieving and maintaining control of their diabetes.

Charlotte Hodge RN, NP, CDE, founder and president of Diabetes Solutions, is a Registered Nurse, Nurse Practitioner and Certified Diabetes Educator who has specialized in the field of diabetes for 25 years. She has designed and provided diabetes education and programming for patients and professionals as well as business models for providers of diabetes care. She is past president of the Diabetes Teaching Nurses of So. California, a founding Board member and past president of the American Diabetes Association, Inland Empire Chapter where she has served on boards and committees at the state and national levels. The ADA nominated her as the Diabetes Educator of the Year for the state of California. The Inland Empire ADA has honored her as Volunteer of the Year. While working with Dr. Irving Spratt for 10 years she was instrumental in bringing the California Diabetes Control Program to the Inland Empire and conducting a 5-year clinical trial for Humalin insulin. She was a Regional Director of Operations for Diabetes Treatment Centers of America and the Program Director for the Diabetes Treatment Centers at both Riverside Community Hospital and later at Parkview Community Hospital, Riverside California. Charlotte has written widely for local and national publications. She has traveled extensively as an ambassador for diabetes to China and Mongolia with the People to People Program and also to Honduras and Central Mexico on various medical missions. 

Diabetes Solutions has a multidisciplinary staff of Certified Diabetes Educators who are available to work with diabetes patients in order to increase their knowledge of survival skills and their treatment plan prior to discharge from the hospital. This service is provided to patients who are hospitalized at Riverside Community Hospital. For others, outpatient classes and individual consults are available on a fee for service basis for adults, youth and Spanish speaking patients. The “Sweet Success” diabetes and pregnancy program is also offered. Free community lectures and support groups for adults and youth are available at no charge.  To receive further information and schedules, send E-Mail or call Diabetes Solutions at 788-3209. 
 

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