Diabetes mellitus is a complex clinical disease characterized by abnormal glucose usage. Type I diabetes is caused by autoimmune destruction of insulin-secreting cells in the pancreas. Type II diabetes is a more complex, acquired form of diabetes, with the mechanism of development variable and largely unknown. Despite what little is known about Type II diabetes, it is thought to be responsible for a burgeoning epidemic of obesity in the developed world.

    Presently, glucose control is the best short-term management of diabetes. Poor blood sugar control can result in diabetic ketoacidosis, a deadly decrease in blood pH resulting in coma. In addition, poorly controlled diabetes can cause devastating damage to many organs. Many of these pejorative effects of diabetes can be obviated with tight glycemic control.

    Hemoglobin A1C is a modified form of hemoglobin which results from frequent excess glucose in the blood.  Its rate of formation is proportional to the amount of glucose in the blood. This modification of hemoglobin is irreversible and Hemoglobin A1C persists for the duration of the lifespan of the erythrocyte. Thus, it is a reliable indicator of blood sugar control over time. Hemoglobin A1C has become vital in assessing how well diabetic patients’ blood sugar levels are managed.

Table 1: Serum Hemoglobin A1C  range

 Normal Elevated
 Hemoglobin A1C levels






Question #0001

In diabetic ketoacidosis, the body most like responds by:

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