Diabetics have poor handle on blood sugar, report says

WASHINGTON (AP) — A dismal two-thirds of the nation's 18 million Type 2 diabetics don't have their blood sugar under control, putting them at high risk of the disease's nastiest complications, even death. Yet most are unaware they're doing so poorly, frustrated diabetes specialists said Wednesday.

"The report, I think, is sobering," said Dr. Lawrence Blonde of the American Association of Clinical Endocrinologists, which released the latest statistics at its annual meeting.

Dr. Paul Jellinger, president of the American College of Endocrinology, was more blunt: "It's horrible."

Type 2 diabetes is the most common form of the illness, and experts estimate a third of the people who have it don't know. An additional 41 million have "pre-diabetes," an im—paired sugar tolerance that can lead to the full-blown disease.

Type 2 diabetes sneaks up on you, as the body gradually loses its ability to use insulin, a hormone crucial to converting blood sugar into energy. High glucose levels damage blood vessels and nerves — eventually leading to blindness, kidney failure, amputations of feet and legs and heart disease. Diabetes is the nation's sixth-leading killer.

Tight control of blood sugar, either through diet and exercise alone or with a variety of medications, can prevent that damage. The best measure of control: the A1C test, a way of tracking average blood-sugar levels over two or three months.

AACE, the endocrinologists' group, defines glucose control as an A1C level below 6.5. But 67 percent of Type 2 diabetics aren't meeting that goal, concludes a new AACE analysis.

The analysis is based on the A1C measurements, reported by a laboratory database, of 157,000 people in 39 states during 2003 and 2004.

The analysis didn't calculate what the average A1C level is, so there's no way to know just poorly controlled these patients are, acknowledged Blonde, head of diabetes research at the Ochsner Clinic Foundation in New Orleans.

But in the remaining states, Blonde checked a different database that showed between a fifth and a third of diabetics had A1C readings above 9 — not even minimal glucose control.

A normal A1C level is 5. While diabetes specialists differ on whether 6.5 or 7 signals good control, every point-drop lowers the risk of serious complications by 25 percent to 40 percent.