An interview with Dr. Sam Engel, associate vice president, diabetes, endocrinology and women's health, Merck Research Laboratories

    Dr. Sam Engel talks type 2 diabetes and the importance of A1C goal attainment

    What is type 2 diabetes?

    Type 2 diabetes is a chronic, progressive disease characterized by the presence of abnormally high blood sugar levels. It develops due to both genetics and lifestyle choices, and occurs as a result of the body being unable to make and/or use insulin effectively.

    What is the prevalence of diabetes in the U.S.?

    Today, more than 30 million people in the U.S. are living with diabetes, and 90-95% have type 2 diabetes. The disease is so prevalent that chances are you know someone who has diabetes. Moreover, if current trends continue, it is estimated that about one in three American adults could have diabetes by 2050.

    Why is A1C important?

    A1C, a measure of the average level of blood sugar over the past two to three months, helps you and your doctor see how well your diabetes treatment plan is working. The recommended A1C goal for many adults with type 2 diabetes is less than 7%; however, this may vary depending on the individual.

    High blood sugar levels over time can put people with diabetes at risk of many serious health problems, such as heart disease, stroke, kidney disease, blindness and nerve problems. That’s why it is important for people living with diabetes to work with their doctor to set individualized goals and develop a personalized diabetes management plan to manage the ABCs of diabetes: A for A1C, B for blood pressure and C for cholesterol.

    How successful are patients in achieving their A1C goals?

    Helping patients with type 2 diabetes achieve blood sugar control is fundamental. However, having worked in clinical practice for over two decades, I know first-hand how challenging it can be for some patients to achieve blood sugar control. In fact, about one-third of adults with type 2 diabetes are not at their A1C goal, so we have work to do.

    What other aspects of blood sugar management should patients discuss with their doctors?

    Many people with diabetes are aware of the importance of controlling high blood sugar by diet, exercise and taking medicine (if prescribed), but they may not know that their blood sugar can also get too low. This is known as hypoglycemia, which can make people feel shaky, dizzy, sweaty, faint or hungry. People with diabetes should be sure to tell their doctor if they experience any signs or symptoms of high blood sugar or low blood sugar. Changes to their meal plan, physical activity or diabetes medicine may need to be discussed.

    Do you believe that progress is being made in the fight against diabetes?

    For more than 10 years, I’ve had the privilege of working for Merck, where we are committed to helping patients with type 2 diabetes. The fight against diabetes is not an easy undertaking, but I am confident that important progress is being made and I am proud to be part of a team that is committed to helping patients with diabetes achieve their A1C goals.