What is the A1c Test? (Diabetes)

Since diabetes is defined by its abnormal blood sugar levels, it makes sense that tests for diabetes measure the amount of sugar in the blood. However, blood glucose tests have a downside: they offer only a snapshot of blood glucose levels at the moment the blood is drawn, not broader information about longer-term blood sugar control. Today, a new test is displacing the blood glucose test as the standard for blood sugar measurement and control: the A1c test.

The A1c test measures the HgbA1c level in the blood. What is HgbA1c? Let’s break it down:

Hgb stands for hemoglobin, the component of red blood cells that carries oxygen from the lungs to the rest of the cells in the body.

A stands for Adult, but that term is used rather loosely. With hemoglobin, an adult is anyone over the age of six months. There are other types of hemoglobin in the blood, but in anyone older than six months, virtually all of it is Type A.

1 refers to the type of HgbA in the blood. There are several types of HgbA in the blood, but 98% of it is Type 1.

c is a sub-type of HgbA1. Here is where blood sugar enters the picture. Glucose attaches itself to hemoglobin, in particular to type c hemoglobin. In fact, two-thirds of a person’s glycated hemoglobin is HgbA1c, making this particular sub type of hemoglobin the best marker for blood glucose levels.

The more HgbA1c in the blood, the more sugar in the blood.

Advantages of the A1c test

The A1c test:

  1. Reports how well blood sugar has been controlled over the last three months, not just at the moment of the blood test.
  2. Does not require fasting, so it can be given at any time.
  3. Is not as likely as a fasting glucose test to be affected by stress or illness.
  4. Reveals prediabetes, not just diabetes, which makes it an especially useful diagnostic tool.

Like other glucose tests, home kits are available for the A1c test.

A1c Test Results

An A1c level below 5.7% is normal.

An A1c level between 5.7% and 6.4% indicates prediabetes.

An A1c level above 6.5% indicates high blood sugar.

An A1c level above 6.5% on two separate tests is diagnostic of diabetes.

Like all tests, the A1c is not foolproof. A variety of conditions, including excessive alcohol intake or anemia, can yield inaccurate results. Moreover, there are times when a diabetic needs to see a snapshot of their blood glucose level, and not just a three-month average. However, for long-term blood sugar management, the A1c has become an invaluable tool in the diabetic toolkit.

At the Regency Nursing and Rehabilitation Centers, we offer the very best of care in a patient-centered environment. This means following our residents’ health carefully, listening to them, and respecting their capabilities, while helping them to achieve maximum functionality and independence — and always maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.

Contact us by clicking here to see which of our three facilities will best meet your needs or the needs of your loved one.

5-Tips For Healthy Living With Diabetes

The American Diabetes Association statistics show that more than 25% of US seniors have diabetes, and a whopping 50% have prediabetes. In seniors, diabetes is associated with higher risk of cardiovascular disease, higher mortality rates from all causes, and reduced ability to live independently. However, despite the risks dieabetes poses, it is possible to live a healthy life with the disease.

Follow these 5 tips for healthy living with diabetes:

  1. Team Up against Diabetes

Because diabetes affects a variety of organ systems, it is important to use a medical team approach to manage the disease. A diabetic medical team includes a primary care doctor, an endocrinologist, a dentist, an ophthalmologist, and a podiatrist. Depending on the specific health concerns of the diabetic, a cardiologist or other specialist may also be required.

The National Institute of Diabetes and Digestive and Kidney Diseases recommends diabetics see their healthcare providers at least twice a year.

  1. Keep Your Blood Sugar Level in Range

It’s simple: the higher your blood sugar level, the greater your risk of complications from diabetes. It is crucial for your health to keep your blood glucose level within the range specified by your healthcare provider. This is especially important for microvascular health, the condition of small blood vessels such as those in the kidneys and the eyes; and for prevention of neuropathy, a common form of diabetes-related nerve damage that most commonly affects the eyes and feet.

  1. Watch Your Blood Pressure

High blood pressure in diabetics is associated with increased risk of kidney damage. For best health, keep your blood pressure under 130/80. High blood pressure has no symptoms, so it is important to have your blood pressure measured regularly.

Reducing salt intake and, if required, losing weight can help you control your blood pressure. Your doctor can also prescribe blood pressure medication, if necessary.

  1. Manage Your Cholesterol

Diabetes increases the risk of heart disease; keeping cholesterol levels under control is important. HDL, healthy cholesterol, should be over 40 mg/dL. LDL, unhealthy cholesterol, should be under 100 mg/dL. Triglycerides should be under 150 mg/dL.

Diabetics should have regular fasting blood tests to confirm their cholesterol levels are within range.

  1. Take Care of Your Feet

Diabetes impairs circulation and healing, which means that even minor foot problems can turn into medical emergencies.

A podiatrist is an extremely important member of a diabetes healthcare team. In addition, diabetics should wash and check their feet every day, always wear socks and shoes, and have their feet checked at every medical exam.

Diabetes is a serious disease, with the potential for major, life-altering complications, but with proper care a diabetic can live a happy, healthy life.

At the Regency Nursing and Rehabilitation Centers, we offer the very best of care in a patient-centered environment. This means following our residents’ health carefully, listening to them, and respecting their capabilities, while helping them to achieve maximum functionality and independence — and always maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.

Contact us by clicking here to see which of our three facilities will best meet your needs or the needs of your loved one.

Top 10 Facts About Diabetes

Diabetes Mellitus refers to a group of diseases in which the level of glucose (sugar) in the blood is too high. In Type 1 diabetes, previously known as juvenile diabetes, the pancreas does not produce insulin, the hormone that regulates blood sugar levels. In Type 2 diabetes, previously known as adult-onset diabetes, the pancreas produces insulin, but the body does not use it properly.

Each year 1.5 million Americans are diagnosed with diabetes. To date over 30 million Americans, approximately 10% of the population, have diabetes, primarily Type 2 diabetes. In the senior population that percentage jumps to 25%.

How serious is diabetes? It is the seventh leading cause of death in the US, with nearly 80,000 death certificates listing it as a primary cause of death in 2015. More than 250,000 death certificates listed it as a contributing cause of death.

The good news is that while genetic factors do play a role, an unhealthy lifestyle — which is in one’s own power to change — is the primary risk factor in preventing Type 2 diabetes.

In addition to causing death, diabetes brings with it a wide variety of issues that strongly impact the health and well-being of diabetics.

Here are 10 facts that demonstrate the severity of diabetes:

  1. One in every three people with diabetes is unaware that they have it.
  2. 37% of US adults have prediabetes, a condition in which the body still utilizes insulin, but not optimally.
  3. Up to 30% of prediabetics will develop diabetes within five years.
  4. People who smoke are 30 to 40% more likely to develop type 2 diabetes than people who do not smoke.
  5. Diabetes is the leading cause of foot and leg amputations, accounting for 60% of all cases.
  6. Diabetes is the leading cause of kidney failure, accounting for 44% of all cases.
  7. Diabetes is the leading cause of adult blindness.
  8. Diabetics spend $2.31 on medical care for every $1 spent by nondiabetics.
  9. One in every ten healthcare dollars is spent caring for complications of diabetes.
  10. If present trends continue, as many as one in every three American adults will have diabetes by 2050.

At the Regency Nursing and Rehabilitation Centers, we offer the very best of care in a patient-centered environment. This means doing everything we can to manage – or even better, to prevent — diabetes.

It also means maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.

Contact us by clicking here to see which of our three facilities will best meet your needs or the needs of your loved one.

The Best Diet in the World

Mediterranean diet: olive oil, cherry tomatoes, and a leafy green herbAs November draws to a close, I wanted to talk about a way of eating that has been touted as the healthiest diet in the world.

November is National Alzheimer’s Disease Awareness Month, and we’ve been covering the topic extensively on our corporate blog.

Alzheimer’s disease is progressive mental deterioration that ends in complete infirmity and eventual death. Much is still unknown about the disease, but one thing is clear:

Following the Mediterranean Diet can reduce your chances of the disease. Fringe benefits include improving your heart health, brain health, energy levels, and overall physical well being.

These are ambitious claims for a diet to make, but eating in the Mediterranean way has proven health benefits. Let’s explore the diet and see how you can incorporate it into your own life.

The Mediterranean Diet: The Healthiest Diet on Earth

About 50 years ago, researchers discovered that Italians were living longer and healthier than Americans. In fact, all the countries along the Mediterranean Sea had lower incidences of heart disease, Alzheimer’s disease, and other age-related diseases.

Today, study after study has shown that the traditional cooking in those cultures is the source of their health and longevity. Here are just some of the scientifically proven benefits of the Mediterranean Diet:

In fact, if you go back to every article we’ve written on various age-related conditions and diseases, you would probably find recommendations in sync with the Mediterranean Diet. Following this lifestyle is the single-most effective steps you can take to maintain your health long-term.

So what does the diet include?

Here are the key components of the heart-healthy eating plan:

  • Eating mostly plant-based foods. These include vegetables, fruits, whole grains, legumes, and nuts. Leafy greens are especially beneficial.
  • Substituting healthy fats, such as olive oil and canola oil, in place of butter.
  • Limiting salt, and using a rich variety of spices and herbs to flavor your food instead.
  • Eating red meat no more than once a week.
  • Eating lean meats, such as poultry, and fish around twice a week.
  • Avoiding processed foods, especially those with a lot of sugar, trans fats, and fake flavorings.
  • Exercising regularly and responsibly.

Following the Mediterranean lifestyle isn’t easy, but after a few weeks of eating real food and exercising, you’ll begin to feel much more energized. Your cholesterol levels will improve, you might lose that excess weight, and your heart will do better.

Even if you can’t give up all aspects of the standard (and unhealthy) American diet, even making some smaller changes can provide huge health benefits.

Here are some to get you started:

  • Drink flavored seltzer or water instead of cola.
  • Snack on roasted, unsalted nuts instead of potato chips.
  • Make one day a week your “vegetarian day,” and eat only fresh, plant-based foods that day.
  • Start taking a brisk, 20-minute walk every day.
  • Use canola cooking spray, instead of butter, to fry your morning omelet.
  • Visit your local farmers market and stock up on fresh, in-season fruits and vegetables. Then grab one anytime you feel the munchies.

I hope these ideas can help jump start your journey to a healthier you. Let us know in the comments what aspect of the Mediterranean diet you’re going to incorporate into your current lifestyle!

Silent Heart Attacks: Know the Risks

Do you know the signs of a heart attack? I’m guessing you do; the American Heart Association has done an admirable job raising awareness about heart health. We all know heart attacks usually come with chest pain or discomfort that lasts more than a few minutes, or goes away and comes back. Other symptoms include upper body pain or discomfort, shortness of breath, breaking out in a cold sweat, and nausea.

But did you know that you could also have  heart attack and not know it? That’s what a silent heart attack is. And like its name suggests, it comes with mild or no symptoms. You might think you have lingering indigestion, the flu, or passing nausea. Often you won’t even know you had a heart attack until a medical test for an unrelated reason reveals heart damage.

A silent heart attack can hit anyone at any time, but certain conditions can put you at higher risk.

Risk Factors for Silent Heart Attacks

A silent heart attack is not much different from a regular, “loud” heart attack. The risk factors are the same: smoking and tobacco use, family history of heart disease, high cholesterol, high blood pressure, diabetes, lack of exercise, and obesity.

And while the effects of silent heart attacks are usually mild, it leaves you at a much greater risk of having another heart attack. The subsequent heart attack can be fatal, or cause serious complications such as heart failure.

An Extra Risk for Silent Heart Attacks: Type 2 Diabetes

As I wrote in a previous article, a common complication of diabetes is diabetic neuropathy. Neuropathy is a condition involving damaged nerves. More than half of all diabetics develop some form of neuropathy. It usually causes numbness and tingling in the hands and feet, but in more severe cases, it can affect nerves all over the body.

When the disease causes damage to nerves leading to your heart, any sensations in that area will be muted. A heart attack that should cause terrible chest discomfort may instead feel like a slight twinge of heartburn. You may not notice anything unusual, chalking up any slight discomfort to normal aging. However, it’s a real heart attack and the damage can be serious.

One way to protect yourself from having a neuropathy-related silent heart attack is to monitor yourself carefully for nerve damage. If you catch the damage early, you may be able to slow it down with medication. Some signs of neuropathy are:

  • Difficulty exercising
  • Dizziness or fainting when you stand up
  • Frequent accidents or incontinence
  • A lower sex drive
  • Sweating excessively
  • Digestion problems

If you are having one or a combination of these problems for longer than one or two weeks, talk to your doctor about the possibility of neuropathy.

Symptoms of Silent Heart Attacks

Some people will not have any symptoms at all, and may never know they had a heart attack. In many cases, there are mild, short-lived symptoms that are easy to dismiss. You may feel slight pain or pressure in the center of your chest. Lasting indigestion, breaking out in a cold sweat, feeling light-headed or tired for no reason, shortness of breath, and heartburn are also signs of a heart attack. Women in particular may feel pain in the jaw, neck, or left arm.

After a silent heart attack, you may feel very tired or have heartburn for a prolonged period. You might notice swelling in your legs or sudden difficulty breathing. If something feels different, check with your doctor right away or call 911.

Peripheral Neuropathy: What You Need to Know

Peripheral neuropathy is a group of conditions involving damaged or diseased nerves. There are many different forms of peripheral neuropathy, mainly divided into two types: mononeuropathy and polyneuropathy. Mononeuropathy, like its name suggests, is when only one nerve is damaged. Polyneuropathy is when multiple nerves around the body are damaged.

One very prevalent type of chronic polyneuropathy is diabetic neuropathy. This condition occurs in diabetics, particularly those with poor blood sugar control.


The most common symptoms of PN are tingling and numbness in the hands and feet. Depending on which nerves are affected, you may also experience:

  • Sharp, throbbing, or burning pain
  • Diarrhea or constipation
  • Loss of bowel and/or bladder control
  • Sexual dysfunction
  • Low blood pressure
  • Sensitivity to touch
  • Lack of coordination and/or falling
  • Muscle weakness

Causes and Risk Factors

There’s no one cause of PN, since it’s not actually a single disease. It’s a group of disorders, and there are many different causes. Some of the triggers for neuropathy include:

  • Alcoholism
  • Autoimmune disease
  • Bone marrow disorders
  • Certain infections
  • Chemotherapy
  • Diabetes
  • Exposure to toxic substances
  • Trauma
  • Tumors
  • Vitamin deficiencies

There are also some cases of PN where no specific cause can be identified. However, knowing the common causes listed above can help identify people at risk for neuropathy. For example, more than half of all diabetics develop some sort of PN. Those whose blood sugar levels are poorly controlled are at higher risk.

People with kidney, liver, or thyroid disorders are also more likely to develop peripheral neuropathy. In addition, family history puts you at higher risk.

Prevention and Management

People at risk for damaged nerves should take steps to prevent developing neuropathy. The best way to prevent it is to manage the condition that may cause the damage. It will also help to make healthy lifestyle choices, by avoiding alcohol, eating a good diet, and exercising regularly.

If you have already been diagnosed with peripheral neuropathy, you can manage the condition with a healthy lifestyle. Quit smoking, treat injuries and wounds right away, and take care of your extremities.


People suffering from peripheral neuropathy often lose all sensation in their extremities. They can’t feel temperature or pain, so they may burn themselves without realizing. They may also develop sores from injuries or extended pressure they don’t feel.

If your foot becomes injured without you realizing it, it can become infected quickly. As mentioned above, it’s important to check for injuries regularly and treat them before they get infected. Allowing infections to fester untreated may result in limb amputations.

Another complication of peripheral neuropathy is increased risk of falls. Weakness and loss of sensations in the feet make falls more likely.

In order to avoid complications and control the condition, see your doctor right away if you are at risk for PN and you begin experiencing symptoms.

Smell Your Breath To Know If You Are Healthy

Your breath is the window into your health status.  If you have any one of the following indicators, your immediate attention is necessary.

Breath Snoring

Your mouth gets dry if you snore or sleep with it open and creates bacteria that causes morning breath.  Also, food lodged in your teeth also creates bacteria. Brush and floss before going to bed.



Breath-Gum Disease

Bacteria growing under the gum line creates leads to inflammation and infection and creates a metallic smell. The technical term for this is   periodontitis.  Smoking and not brushing/flossing regularly also creates gum disease.



Acid Reflux

This condition makes stomach acid flow the wrong way, back into the tube that connects your throat to your stomach (your esophagus). It gives off a sour smell and bring up bits of food or liquid into your mouth. The acid also damages your throat and mouth, making it  a breeding ground for more smelly bacteria.




If you are diabetic, fruity breath indicates that your body is using fat for fuel instead of sugar (glucose). Most importantly, this tells you that you’re very low on the hormone insulin.  Call your doctor.



Respiratory Infections

Colds, coughs, and sinus infections sends mucus filled with bacteria through your nose and mouth and makes your breath smell.

Breath And Your Medication

Several medicines cause bad breath because they dry out your mouth. Moreover, drugs that treat heart conditions, chemotherapy for cancer, and sleep aids, release chemicals that make your breath smell.



Saliva cleans bacteria out of your mouth. Dehydration causes insufficient saliva that causes foul odors in your mouth. Stay hydrated at all times.  Most relevant, conditions that affect the glands that make saliva,  such as  Sjögren’s syndrome and scleroderma , cause dry mouth and bad breath.


Proper mouth hygiene will keep you healthy and happy.


Diabetes and Older Adults – A Comprehensive Guide

You have probably heard a lot about diabetes. Perhaps you even have relatives and friends who have the disease. However, if diabetes has not touched you personally, chances are you may not know enough about this growing problem. Here is some information we have put together that will add to your understanding. Regency Nursing and Rehabilitation Centers provide world class care for residents with Diabetes and our caregivers are extensively trained in this area.

What is diabetes?
In short, diabetes is a condition in which the body cannot produce enough of a hormone called insulin. Insulin is necessary for the body to process sugar and turn it into fuel the body can use. Without enough insulin, the organs are starved of vital nutrients, while blood sugar levels remain too high. If the condition persists, over time, organs become damaged and function poorly.

Some common consequences of untreated or improperly treated diabetes are loss of vision, poor circulation (often leading to wounds that will not heal or even amputation), nerve damage, stroke, kidney and heart disease. Because diabetes can damage cells and weakens the body’s defense systems, it can leave the body unable to fight infections and heal itself the way nature intended. As a result, people with diabetes are also more prone to develop complications from wounds, common illnesses like the flu, pneumonia and other bacterial or viral conditions.

Who is affected?
Diabetes can occur at any age and across all ethnic groups, although African- Americans, Hispanics, Asians, and Native Americans seem to be particularly vulnerable. The most common form is Type II diabetes, also known as Adult Onset diabetes, which affects over 17 million Americans, including an ever-increasing number of older adults. In fact, about half of all seniors over the age of 60 have diabetes, although many do not even know it!

Are there other risk factors?
In addition to older age and ethnicity, there are several other well-established risk factors associated with diabetes, including:
• Obesity

• Family history of diabetes

• Heart conditions

• High cholesterol levels

• History of diabetes during pregnancy

• Lack of exercise or physical activity

Complications of diabetes
Left undiagnosed and/or untreated, diabetes may lead to serious medical complications, including:

Heart disease. Heart disease is the leading cause of diabetes-related deaths, occurring at a rate two to four times higher than for those without diabetes.

Stroke. The risk of stroke is two to four times higher in people with diabetes.*

High blood pressure. An estimated 60 to 65 percent of people with diabetes have high blood pressure.

Blindness and Kidney disease. Diabetes is the leading cause of both blindness in seniors and end-stage renal disease, often necessitating dialysis or kidney transplant.

Nervous system disease. About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage.

Amputations. More than half of lower leg amputations in the United States occur among people with diabetes.

What are the warning signs of diabetes?
Although often, in the early stages, there are no clearly identifiable symptoms, many people with diabetes may experience some of the following symptoms:

• Frequent urination

• Unusual thirst

• Extreme hunger

• Unintended weight loss

• Blurred vision

• Extreme fatigue

• Irritability

• Numbness in hands or feet

• Cuts and sores that are slow to heal

Remember, even if you do not have any of these symptoms, you should be tested regularly for diabetes, especially if you are over age 55!

Is there a cure?
While there is no known cure for diabetes, it can be controlled, given early detection, proper medical care and specific lifestyle changes. Unfortunately, diabetes often goes undiagnosed and, like all chronic conditions, diabetes will get progressively worse unless it is properly managed.

Almost two out of every three people with diabetes also have high blood pressure.

How to control diabetes
The way to control diabetes is to keep blood sugar levels as close to normal as possible. Here are several important steps to take:

1. First, see a doctor. This is the most important thing to do if you think you have diabetes. Only a doctor can accurately determine whether or not you have the disease and the best approach for treating it.

2. If diagnosed with diabetes, take your medication as prescribed. There are many excellent medications available to regulate blood sugar that can be taken under the direction of your doctor.

3. Monitor your blood sugar level regularly. Without frequent and accurate measurements, you will not know whether you need to modify your medication and/or treatment schedule in order to maintain the proper blood sugar level.

4. Watch what you eat. Eat regular meals at about the same time each day. Skipping meals or not eating frequently enough can make your blood sugar level fall. Eat a variety of foods. Limit fats, sugar, salt and alcohol.

5. Be active. Physical activity may help you feel better, control your blood sugar and weight, and even help prevent heart and circulatory problems. Always be sure to consult with your physician before increasing your activity level or starting any kind of exercise program.

If you think you have diabetes, the most important thing you can do is to see your doctor.

Managing and caring for diabetes
Early detection is the best way to keep diabetes from robbing you of a full and active life. Once diagnosed, diabetes is usually highly manageable. In fact, given the right medication, appropriate lifestyle adjustments, and the guidance of your physician, people with diabetes can generally remain productive and fully independent.

If diabetes progresses to the point where the individual alone can no longer manage it, there are home care services available that will help monitor and manage the condition. However, should the disease progress to a point where treatment for serious complications is needed, there are a number of continuing health care options and support available to match specific levels of need. These include:

Short-Term Rehabilitation Centers. Dedicated, stand-alone rehab centers, as well as many skilled nursing facilities, provide therapeutic care and specialized services often required by people dealing with diabetes and its complications. Services are typically rendered during the transition between hospital and home or alternate levels of care. Length of stays range from several days to several months, depending on the patient’s condition and his or her ability to function independently.

Long-Term Care Facilities. These facilities provide comprehensive services for people who require 24-hour skilled nursing supervision and daily care. Some offer specific diabetes management programs that include specialized care for those
in advanced stages of the disease and also treat related complications, such as complex wounds and kidney failure. Patients who suffer from kidney problems should be sure to select a long-term care facility that has nephrologist-supervised hemodialysis on site.