You need tests, but you have to ask


By late January, I was attending my fourth session at Walla Walla General Hospital's prediabetes education center and feeling a little farther along in the journey. I'd shopped for low carb foods and started working out ... just barely.

I'll get to that, but first, let me say this -- if you are diabetic or even pre-diabetic, write this note and tape it to your bathroom mirror:

Your mother loves you but even she wouldn't remember to schedule your tests.

Here's the deal, according to diabetes educator Maria Lizotte. There is testing you should undergo to keep damage from diabetes at bay, but you simply cannot expect anyone else to be in charge of those. Not even your physician. "The average doctor visit is five to seven minutes," she said. "You need to remind the doctor."

So there is the HbA1C test, usually called the A1C. It's done once a year or more, and measures the blood sugar levels of the last three months.

Which is all fine and good, but if you have blood glucose that only spikes once a day -- say, after breakfast -- that won't make much of a blip on the A1C, Maria explained. If the test doesn't give a physician a true picture, those blood spikes can continue to damage blood vessels.

You'll recall that is bad. Very bad.

There is also an annual urine test with some big name -- microalbumin -- that checks for protein in your pee. A positive result from a dip-strip test indicates a kidney issue and then medicine can "stop kidney damage in its tracks," Maria said. "Before this test we didn't know you had a problem until you were almost on dialysis."

And, students, what does being tethered to dialysis often mean? Best answer -- "shortened life span." Significantly. "It's worth getting it done," she said. "The minute you're diagnosed, get it done."

And, of course, there are the eyes. It bears repeating: a person in Washington state goes blind every day from diabetes. Yet it is "totally preventable," the educator pointed out. After an exam finds the problem, the prescription is a laser treatment that zaps the endangered blood vessels without pain.

People have the idea they will know if diabetes-related vision impairment is creeping up, but it's not the case.

"I have a friend," Maria said. "She was in her car, cleaning it out, getting ready to go shopping. Then everything went black. That was the last day she saw."

How do you get that test? Yep, you ask for it. Move your lips, mention the "D" word and avoid the Big Blackout. It's a medical test, so having slim vision insurance is no excuse, either.

And, for goodness sake, take off your sock and shoes every time you visit your health care provider. Make sure he or she can see if any damage from diabetes is getting a foot hold.

So, yeah, if this is the kind of thing you want to leave up to your doctor's memory, you'll only have yourself to blame when that doesn't work out so well.

In fact, you may not have a leg to stand on, since about 85,000 people in the United States lose a lower extremity to diabetes damage every year.

Yep. It's really like that. Be responsible with the one body you've been issued.

OK, let's dust off our hands and get to work while I still have some space here.

Now we remember the process? Food goes into mouth, begins breaking down right there, the carbohydrates in the food converts to glucose (sugar), which goes into the bloodstream. Then our pancreas releases insulin, insulin unlocks the receptors in the cells, the glucose comes in and says "howdy" and -- voila -- you have energy!

Except when you're diabetic. Then your cells say, "Nah. We're just gonna stay closed and sleep. See ya."

Changing that whole blood glucose picture will show your cells who is boss. And yes, medicine does that. But only using a prescription is like only filling the gas tank and never checking the oil. Which, I am sure, is an analogy that breaks down pretty fast but you get the idea.

A lot of people think addressing diabetes means the end of culinary pleasure. Of course, there are plenty of low-carb foods that you should have only in small and infrequent doses (remember our friend, bacon? And it's addictive cousin, cheese), but there are ever so many you can have in plentiful amounts.

And once you have carb counting under your belt (har!), you have the strength to move on to looking for fiber, sodium, fat and cholesterol. And calories, which is fine as a guide, but not the gold standard for folks fighting off diabetes.

You still have to count calories to lose weight, Maria and her cohort, Lynda Bren, told us. "You want to take care of those blood vessels and fat will layer up in there, making it hard for blood to get through."

And visualizing appropriate portion sizes is a skill you'll need to hang onto forever, looks like. Darn it.

You see what I mean? You have to start learning this stuff early, because there is a very good chance you or someone you love will need the information.

I'm sorry to see I'm out of space and time for this column. My plan is to go into details next time about what I've found to work, foodwise, and how working out is ... um, working out.

Reporter Sheila Hagar is writing about prediabetes education and experiences from a personal perspective, in a series of columns, of which today's is the fourth. This series will not contain every fact about diabetes, nor should it replace medical advice from your physician.

Sheila Hagar can be reached at or 526-8322. Check out her blog at


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