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I had a patient come in a couple of weeks ago with an interesting situation on his blood work that I wanted to share. And this is all surrounding blood sugar, type two diabetes, A1C, that kind of stuff.

So he had had blood done at his previous doctor's office and came in for some general wellness work. And in going through reviewing his labs I noticed that there were some tests that I normally like to see that were not included in his labs. And he was told by his previous doctor that he was pre-diabetic and they had put him on metformin. So in looking through his labs and getting the new ones to fill in the blanks he had already shown up with a fasting blood sugar of about 106 and his hemoglobin A1C was sitting at 6.0. That's why he was told he was pre-diabetic.

So in doing our labs I looked at a few other things. His triglycerides were 165, which indicates that there's probably some problem with blood sugar and we already knew that, but we looked at his fasting insuli...

So I had another patient I wanted to talk about, another interesting case. This one also has to do with blood sugar management, type 2 diabetes, that kind of stuff. So I just posted another one kind of in that genre. I figured I'd stick with the trend and throw another one of these up here.

This is an older gentleman. We've been working with him for a while. He does have a cancer history, and blood sugar is not well managed. We're running fasting blood sugars in the 150s, 140s most of the time, and that's pretty much with diet. Triglycerides tend to run in the 165, kind of 170 range. I like it below 100, so definitely not saying this is good blood sugar management. But we had seen worse on him. Hemoglobin A1C had been running in the upper sevens. Again, not where I'd like to see it, but better than it's been. We didn't have a fasting insulin, partly because I wasn't the one that ran the previous blood work, but that's kind of where we were.

Now, he had gone in for a su...

I want to talk for a minute about hemoglobin A1c. It's a kind of three month average test for, or how frequently and how high you would spike your blood sugar. We'll talk more about that in a minute. So I was dealing with a patient recently who brought lab work in from her other practitioner and said, "Oh, doc, I think it's really good news. Doctor, my other doctor said my hemoglobin A1c," or she just called it, "My A1C, came back great, he said. So I think what we're doing is working. I'm doing better." Or her hemoglobin A1c had come down from, I think it was eight something, down to 7.2, 7.1, something like that, still abnormal.

And her other doctor said, "We're doing great. We're right on target. This is where we want you to be. Don't change anything. This is perfect." Well, I had to kind of explain to her that it's not perfect at all. It's what's considered good management of a type 2 diabetic to be kind of in the upper sixes. Some doctors are okay wit...