Change appears to be coming for diabetes care. The HbA1c test may not be the safest approach for diabetics to follow in preventing complications. Instead, experts are saying the average blood glucose level per individual will add clarity to diabetic patients looking to manage their disease.

A study supporting the change showed a close correlation between average glucose and HbA1c levels. So the myth, busted is: maintaining an average blood sugar is a safer approach for diabetes management -- NOT CHASING A UNIFORM HbA1c value. The fluctuation in blood sugar is what causes complications in the small vessels of the eyes, kidneys and peripheral nerve endings. For example - sustaining a blood sugar of 200 mg/dL is a lot safer than waking at 240 and ushering a boatload of sugar into your cells to drop your sugar to 80 mg/dL. It is the transfer of glucose into the cell that causes the injury to cell membranes and resulting complications.

Think of it like the movement of the ocean. High tide to low tide happens gradually, over the course of many hours throughout the day. When a storm hits - the waves become turbulent, crashing against the shore causing erosion. Is the human body any different? I'm not a doctor -- but I did stay at a Holiday Inn Express last week.

In Diabetes Care this month, researchers report that exposure to agricultural pesticides in the first-trimester increases a woman's risk of developing diabetes during pregnancy.

Researchers assessed the risk of developing gestational diabetes following pesticide exposures among over 11,200 wives of farmers enrolled in the Agricultural Health Study. Within 25 years of entering the study, 4.5% of women who became pregnant reported having gestational diabetes. Overall, 57% of women reported having mixed or applied pesticides at some time in their life, and the proportion was similar for those with and without gestational diabetes mellitus. Women who mixed or applied pesticides or repaired pesticide-related equipment during the first trimester of pregnancy had a more than twofold increased risk of developing gestational diabetes. There was no increased gestational diabetes risk among women with residential exposures to pesticides or indirect exposures during the first trimester.

With the rate of diabetes diagnosis rising, whether it is type 1, type 2 or gestational - understanding the potential effects of environmental exposure on glucose levels is critical to comprehensively addressing the core problem. The jury is still out on deciphering what environmental offense should be sentenced for the crime.