Diabetes, a disease that affected 23.6 million Americans in 2007, according to the American Diabetes Association, requires close monitoring of blood sugar levels. Blood sugar levels change frequently depending on what a person eats but are normally measured only a few times a day. A test called a hemoglobin A1C, or just A1C, can give more accurate measurements of long-term blood sugar control, because the test determines the average blood sugar levels over two to three months. Diabetics should aim to keep their A1C levels close to 6 percent in most cases. Diet and exercise can have significant effects on A1C levels.
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Following a calorie-restricted diet results in weight loss over time. Weight loss is an important part of diabetes management because body fat contributes to insulin resistance, which in turn raises blood sugar levels. The higher the blood sugar, the more damage that occurs to organs and tissues, raising the risks of heart disease, infection and immune problems. Even losing as little as 5 percent of body weight helps reduce A1C levels, the University of Utah reports. Controlling intake of carbohydrates, especially “empty” carbohydrates, or those with no nutritional value, such as soda, candy and other sweets, helps decrease both weight and blood sugar levels.
Exercise can also help lower A1C levels over time. Exercise increases the effectiveness of insulin, which results in more glucose entering cells and lower levels in the blood. A study reported in the Sept. 18, 2007, issue of “Annals of Internal Medicine” conducted by lead author Ronald Sigal, M.D., of Canada found that either aerobic exercise or weightlifting or a combination of the two over a 26-week period reduced A1C levels on average by 0.6 percent. Since a 1 percent drop in A1C levels can reduce heart disease by 15 to 20 percent and vascular complications by 37 percent, according to Dr. Sigal, a 0.6 percent drop can significantly reduce complications of diabetes.
While diet and exercise help reduce A1C levels, some diabetics still need to take oral diabetic medications or insulin to control blood sugar. Brittle diabetics -- those who have sudden rises and drops in their blood sugar -- should not rely on diet and exercise or periodic A1C tests to control their diabetes. Brittle diabetics need frequent blood sugar testing and medications to decrease hyperglycemia -- high levels of blood glucose -- or hypoglycemia, which is a sudden drop in blood sugar. People who take insulin should always check their glucose levels before exercising and should eat a snack if blood sugar levels are already low, advises health management website LifeClinic. People whose blood sugars are very high -- over 240 mg per deciliter -- should not exercise.