HGI reflects the effects of inflammation on HbA1c in a nondiabetic population of U.S. adults and may be a marker of risk associated with inflammation independent of FPG, race, and obesity.

Conditions that affect erythrocyte turnover influence HbA1c concentrations and the International Expert Committee has warned clinicians to be aware of any conditions that could affect the turnover of red blood cells. Although many forms of anemia are associated with lowering of HbA1c, iron deficiency has been shown to shift HbA1c slightly upward. The exact mechanism through which iron deficiency anemia affects HbA1c levels, however still remains unclear. The explanations provided above are merely speculations, warranting further studies to confirm and elucidate the role of these factors. As little work has been done in this field so future and large scale studies are required which may address HbA1c enhancing effect and the mechanism of increased HbA glycation in iron deficiency properly.

The reason that starvation in utero is associated with a higher risk of type 2 diabetes in later life is that the fetus prepares for its likely adult environment which is not encountered (thrifty phenotype). These epigenetic changes are due to increased gene activity and expression rather than by starvation induced changes in the DNA sequence.5

Therefore, after 33 years, I believe it is time to reinterpret Crawford’s data and conclude that the large increases in death from diabetes during nineteenth century in Ireland was due to the in utero effects of starvation during the Irish Potato Famine and not due to increases in the intake of fat and sugar.

Surprising no one who has ever listened to a fat, Black or brown, or chronically ill person:

Researchers who study Type 2 diabetes have reached a stark conclusion: There is no device, no drug powerful enough to counter the effects of poverty, pollution, stress, a broken food system, cities that are hard to navigate on foot and inequitable access to health care, particularly in minority communities.

Myth: Eating sugar causes diabetes.

Fact: Eating sugar does not cause diabetes. When you eat carbohydrates – which include sugary foods and starches – they are digested into glucose (also called sugar). Glucose is the body’s primary energy source. Glucose levels in your body are regulated by hormones; insulin lowers glucose and glucagon raises it. Diabetes is caused by an impairment in insulin secretion and/or function.