A recent patient was concerned that despite watching her diet and taking her diabetes medication, her hemoglobin A1C (HbA1c) keeps increasing.
Remember, HbA1c is a lab test showing the average blood sugar (glucose) level over the previous three months. It shows how well you are controlling your diabetes.
An elevated HbA1c greater than 5.7% indicates that diabetes is not well regulated and is accelerating aging, increasing your chances of getting painful neuropathies, kidney failure needing dialysis, cataracts, amputations, and retinopathy blindness.
What could be missed by her primary doctor?
One major cause of unregulated glycosylated hemoglobin is an unrecognized B6 deficiency.
An excellent “functional” test to check for a pyridoxine (B-6) deficiency is the xanthurenic organic acid test. An elevated xanthurenate test is a sensitive marker for a B-6 lack

When hidden zinc deficiency is present, the body cannot convert B6 to its active form, pyridoxal-5-phosphate or P5P. P5P, essential in normalizing the glycosylated hemoglobin and its deficit, indicates that improperly metabolized sugars accelerate aging, cataracts, kidney failure, heart disease, nerve damage, and more.This is the intracellular nutrient test from Doctor’s Data.

But there is more to the story.

Elevated stored phthalates (plastics) in the body interfere with zinc metabolism.

This is a Phthalate Test from Genova

This is the power of functional medicine. It is seeking to find the cause of the cause.
HbA1c —> B-6 deficiency —> Zinc deficiency —> Stored Phthalates
I have never yet met a diabetologist who even orders the above, much less knows how to interpret it.
To ignore fixing the chemistry in overtly metabolic disease is outright wrong.
Unfortunately, I have seen from reading thousands of medical records that most doctors merely resort to the one size fits all approach and medicate the disease. Rarely if ever have I read where a doctor investigated why the HA1C was elevated.
This results in a tragic waste of life and incurring an enormous and unnecessary expense and suffering.
You may be interested to know that because of the phthalate load, many folks (even without diabetes) unnecessarily get multiple diseases. These can range from Nonalcoholic steatohepatitis or NASH (a common, often “silent” liver disease), heart disease, or cancers to Parkinson’s disease, arthritis, or Alzheimer’s.
They all lead to accelerated aging because of the shared causes.
For a doctor to check your glycosylated hemoglobin A1C every three months yet, never know your zinc, and B6 levels (among many others) is plain wrong in this sophisticated era.
Your life depends on the decisions you make. Therefore, this information significantly affects whether your diabetes blinds you in future years.

References:

Depeint F, et al, Mitochondrial function and toxicity: Role of B vitamins, one-carbon transfer pathways, Chemico-Biological Interactions 163:113-32, 2006

Jain SK, et al, Pyridoxine and pyridoxamine inhibits superoxide radicals and prevents lipid peroxidation, protein glycosylation and (Na+ + K+)-ATPase activity reduction in high glucose-treated human erythrocytes, Free Rad Biol Med 30:232-37, 2001

Onarato JM, et al, Pyridoxamine, an inhibitor of glycation reactions, also inhibits lipid peroxidation reactions, J Biol Chem, 275:21177-84, 2000

Metz TO, et al, Pyridoxamine traps intermediates in lipid peroxidation reactions in vivo: evidence on the role of lipids and chemical modification of protein and development of diabetic complications, J Biol Chem 278:42012-19, 2003

Booth AA, et al, Thiamine pyrophosphate and pyridoxamine inhibit the formation of antigenic advanced glycation endproducts: comparison with aminoguanidine, Biochem Biophys Res Commun, 220:113-19, 1996

Stitt A, et al, The AGE inhibitor pyridoxine and inhibits development of retinopathy in experimental diabetes, Diabetes 51:2826-32, 2000

Laines-Cessac P, et al, Mechanisms of the inhibition of human erythrocyte pyridoxal kinase by drugs, Biochem Pharmacol 54:863-70, 1997