Re: Self-management and concepts of professionals-Jen_Jesso

October 22, 2007

No worries, I really just wanted to know if anyone knew more than we

did. Did not expect to be attacked, and thank you for your kind

question instead of an attack. Thank you for your kind information,

also; will be of assistance and I'm grateful. Ann

>

> Hi Ann,

> Maybe I am just confused, but your messages still seem extremely

vague. I'm not sure what difference it makes whether complications

might be caused by high blood glucose itself or by some mechanism that

high blood glucose enables (such as lack of oxygen, etc.). In the end,

doesn't it still come down to controlling blood glucose?

> Furthermore, I'm not sure that there is a specific study that was

done to show the relationship of A1c to complications ... I know

studies such as the DCCT were done to confirm it, but the original

idea came from observations that complications occured after insulin

was introduced, and not from any specific study, as far as I know.

> In the end, I'm not sure knowing the exact cause of complications,

even if it was known which as far as I know it isn't, would make much

difference to anyone. I view it much like the cuases of diabetes. They

are still not certain what causes type 1 diabetes. They aren't even

certain what causes type 2, just what puts people at risk of

developing it. They aren't certain what causes complications for some

people and not for others, although they know it is not just A1c now.

Diabetes research is progressing at an incredibly fast rate compared

to many other diseases. A hundred years ago all people diagnosed with

type 1 diabetes died within weeks or months of diagnosis. Fifty years

ago complications after fifteen years of diabetes were relatively

common. Twenty years ago " control " was nothing like it is now. They

are discovering new things and developing new treatments constantly.

> This is all stuff for the researchers, and I don't think it would

have much impact on how people managed diabetes knowing that high

blood sugar simply enabled some other process that caused

complications. It still comes down to focusing on keeping swings in

blood sugar (standard deviation) as small as possible, and on keeping

average blood sugar as low as possible.

> Jen

>

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