Healthcare Delivery

Why hbA1c levels are the key to your diabetes management?

The average life of the Red Bood Cell (RBC), is around 120 days. With an estimated half-life of 2-3 months, it is a good indication of the overall health of the individual. Glucose molecules in the blood combined with hemoglobin, and through this glycation form a ketoamine that is stable and can be used as a measure of the glucose in the blood. Since 1970’s hbA1c measures have been recommended as a standard of care for diabetes management.

Why is this a better measure than the traditional fasting and Post-Prandial measures(PP)?

  1. Firstly measuring hbA1c gives us the story for 90 days. So it not a point in time investigation rather its a holistic view of the system.
  2. It is human tendency to cheat if we know that a blood sugar test is looming. I have seen my mother do that many times and there are dietary adjustments made just before the test that can give us a false negative.
  3. Thirdly the test does not require any fasting or dietary restrictions, hence the compliance is better.

For more scientific details on this method, please do read this article on the research already conducted.

While these are great reasons to conduct the test, the key to the test is to go to an accredited lab. Always insist on choosing a NABL (National Accreditation Board for Testing and Calibration Laboratories) accredited lab. I have often heard of samples getting mixed up between patients. This is mostly true of the many labs providing online services or online firms serving as aggregators.

Finally, talk to your doctor on why you should consider mapping this level. I have been doing my tests over a period of time and last few months results are below. These tests have given my physician a good indication as to why we need more aggressive intervention in my case.

Anyways do let me know if you have any questions on diabetes management and I would be happy to answer them for you.


5 tips on Diabetes Management

Diabetes is the new Malaria as far as India is concerned. With more than 80 million known Diabetics in India now and the number I believe is much higher is just that a lot of them are not aware of the condition. But as we continue to think through the strategies to manage the condition, there are many hospitals and healthcare institutions in India who have taken steps to manage the condition and working with patients to support them in handling the condition.

With this in mind I spoke to Dr Menaka Ram Prasad, Endocrinologist & Diabetologist at Apollo Sugar Clinic at Hyderabad, below are the 5 key questions that I put to her and recorded her responses on the same.

Q1. Are you seeing any improvements in diabetes management in the tier 1 cities?

Yes there are improvements as long as the patients work with the care provider on areas like diet, exercise among others.

For example at Apollo Sugar Clinic at Hyderabad we see

• In terms of Diet – 95% of our disease management program patients have an in-clinic dietitian counseling which led them to an idea on foods to be avoided

• In terms of exercise- 62% of the patients were seen to be exercising for at least 30 minutes per day post education sessions on health life style management. Apollo Sugar Diabetes counselors and educators try to bring in change and motivate patients

• Medication Adherence- 96% of patients were taking their medication regularly

• 65% of the patients were seen to be monitoring their glucose levels on a regular basis. So in effect we see that almost 60 % of the patients at our clinic adhere to the treatment regimen

So working with care providers is very important to the success of the Diabetes Management program


Q2 How are patients incorporating digital in Diabetes Management?

Digital is playing a major role in disease management overall. For example, all our patients who are enrolled in our Disease Management Program embrace with our technology to get diet counseling experience by a mobile application, health coach driven telephonic conversations at home and they don’t have to visit the clinic for a lot of these activities any more, thanks to technology.

Q3 Any common myths on Diabetes that you want to debunk?

There are plenty of myths in Diabetes management. The one I see most commonly is that people with diabetes should eat special diabetic foods. But the trust is that Diabetes patients can eat normally as long as they keep it under control, and follow medication and exercise.

The other myth is on insulin which says that taking insulin means that Diabetes Management is failing and that injecting insulin is painful, also that diabetics cannot lead a healthy lifestyle. Whereas the truth is that Insulin is also a form of medication and is not painful if injected in the right place, and can lead as active life as non-diabetic people.

On the flip side, some believe that that diabetes is not that serious disease, while the truth is that Diabetes and its complications are causing more deaths than any other disease. Diabetes education is the most important step to be taken to a patient.

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Q4 what are the common mistakes that people make in their Diabetes management strategy?

Most common mistakes made by people include:

· Irregular monitoring of Blood Sugar and ignoring hypoglycemic episodes

· Skipping meals and not following a strict diet routine

· Not exercising regularly

· Not maintaining personal hygiene

· Irregular medication pattern

· Improper storage of insulin (It has to be refrigerated and cannot left in the open)

Q5 Any best practices followed at Apollo that you would want patients to adopt?

I think the ley to Diabetes management is diet. Our Diet Counselling ensures educating the patient on:

• The Importance of physical activity for fitness as well as maintenance of sugar level

• The Importance of personal hygiene and safety to avoid other complications

• Educating people to make informed choices about food and life style changes

• Giving reliable and practical options for alternate food and information about healthy cooking methods

At APOLLO, we keep it SIMPLE

• S – Simple to follow & cook

• I – In line with current timings & recall (no drastic changes)

• M- more options given

• P – Plan your diet -be your own dietician (patient education)

• L – love what you eat

• E – Expensive stuff avoided (go for easily available options)


Dr. Menaka Ram Prasad is a Consultant Endocrinologist and Diabetologist, Apollo Sugar Clinic, Hyderabad