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  • Chromium deficiency


    Chromium deficiency is described as the consequence of an insufficient dietary intake of the mineral chromium. Chromium was first proposed as an essential element for normal glucose metabolism in 1959, and was widely accepted as being such by the 1990s. Cases of deficiency were described in people who received all of their nutrition intravenously for long periods of time. The essentiality of chromium has been challenged. The authorities for the European Union do not recognize chromium as an essential nutrient. The United States does, and identifies as Adequate Intake for adults as between 25 and 45 μg/day, depending on age and sex. Dietary supplements containing chromium are widely available in the United States, with claims for benefits for fasting plasma glucose, hemoglobin A1C and weight loss. Reviews report the changes as modest, and without scientific consensus that the changes have a clinically relevant impact.

  • Glycated hemoglobin


    Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or less commonly HgbA1c, haemoglobin A1c, HbA1c, Hb1c, etc.) is a form of hemoglobin that is bound to glucose. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. It is measured primarily to identify the three-month average plasma glucose concentration and thus can be used as a diagnostic test for diabetes and as assessment test for glycemic control in people with diabetes. The test is limited to a three-month average because the lifespan of a red blood cell is four months (120 days). However, since red blood cells do not all undergo lysis at the same time, HbA1C is taken as a limited measure of three months. HbA1c is a measure of the beta-N-1-deoxy fructosyl component of hemoglobin. The origin of the naming derives from Hemoglobin type A being separated on cation exchange chromatography. The first fraction to separate, probably considered to be pure Hemoglobin A, was designated HbA0, the following fractions were designated HbA1a, HbA1b, and HbA1c, respective of their order of elution. There have subsequently been many more sub fractions as separation techniques have improved. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as an indicator that blood sugar is increasing and that action should be taken. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy. A trial on a group of patients with Type 1 diabetes found that monitoring by caregivers of HbA1c led to changes in diabetes treatment and improvement of metabolic control compared to monitoring only of blood or urine glucose. However, a trial designed specifically to determine whether reducing HbA1c below the normal 6%, using primarily insulin and sulfonylureas (both known to easily drive blood sugar too low), would reduce the rate of cardiovascular events in type 2 diabetes found higher mortality—the trial was terminated early. The negative outcomes may well have been a result of the treatment approach, primarily insulin and sulfonylureas, utilized in the "intensive" treatment group instead of LCHF (Low-Carbohydrate High Fat diet), GlP-1 analogues & SGLT-2 inhibitors, none of which have these problems & lower cardiovascular mortality.

  • Hyperglycemia


    Hyperglycemia (also spelled hyperglycaemia or hyperglycæmia), also known as high blood sugar, is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dl), but symptoms may not start to become noticeable until even higher values such as 15–20 mmol/l (~250–300 mg/dl). A subject with a consistent range between ~5.6 and ~7 mmol/l (100–126 mg/dl) (American Diabetes Association guidelines) is considered slightly hyperglycemic, while above 7 mmol/l (126 mg/dl) is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average however, chronic levels above 10–12 mmol/L (180–216 mg/dl) can produce noticeable organ damage over time.

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