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The pancreas is an organ that is part of both the digestive and endocrine (controls hormone levels and helps to regulate the body) systems. The pancreas is located beside the stomach and is made up of two major types of tissues. One tissue produces hormones such as insulin (regulates glucose levels), and the other tissue produces enzymes that aid in the digestion of food. Norberg et al identified certain findings associated with later development of
Type 2 diabetes mellitus.
Source: Norberg M, Eriksson JW, et al. A combination of HbA1c, fasting glucose and BMI is effective in screening for individuals at risk of future type 2 diabetes: J Internal Medicine. 2006.
Glucose is the chief source of energy for all cells in the body. As the glucose goes through our bloodstream, it needs to be kept regulated. This is accomplished by our pancreas which produces insulin. The more glucose, or sugar, that is introduced into our body, the more insulin that is released to regulate the blood glucose level. The problem arises when our body fails to produce the insulin we need, or it doesn’t produce enough. For those individuals with diabetes, large studies have demonstrated that maintain good control reduces the risk of developing complications of diabetes.
The blood level of glucose is tightly controlled by hormones. One of these hormones, insulin, that is produced in the pancreas is less effective or not produced in sufficient quantity in individuals with diabetes. As a result, the glucose level is higher in individuals with diabetes compared to individuals without diabetes. The excess glucose can bind onto proteins including the most abundant protein in the red blood cells, hemoglobin. The combination is known as hemoglobin A1c. When the hemoglobin A1c level is increased it suggests that the diabetes is not as well controlled as it can be. Hemoglobin A1c has as its key advantage that it reflects the average control for the previous two months, known as long-term control. ADA recommends that individuals with diabetes be tested at least twice each year for those in good control and quarterly if those whose diabetes is not well controlled or whose therapy has changed.
The level of hemoglobin A1c predicts certain complications of diabetes. A level below 7.0% suggests good control. More stringent goals, i.e., a hemoglobin A1c, <6%, may further reduce complications at the cost of increased risk of hypoglycemia (episodes of too low glucose control).