Guest guest Posted October 8, 2004 Report Share Posted October 8, 2004 , I disagree with your statement about bg testing 100%. First of all, by checking two hours after the beginning of a meal, I am motivating myself to hold my eating in line in order to reach my goal of a PP reading around 100. Secondly, my A1c tests do match my readings. Third, how will you know how a new food or a change in lifestyle affects you without testing? Fourth, you can find out why your wife's readings and her A1c don't match. Test when she is not presently testing. Use those strips for something worthwhile. Check at bedtime and at one and/or two hour intervals thru the night. Ditto for the day. You might be surprised at what you find! People using 24 hour monitoring have found unexpected excursions, both up and down, during those hours. Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2004 Report Share Posted October 9, 2004 > , I disagree with your statement > about bg testing 100%. That's OK, I didn't expect that many people here would agree with me but I just couldn't let the claim stand that the A1c was nothing more than the average of a lot of BG readings. The A1c test and the capillary blood glucose test measure two quite different things. The results may be correlated under certain conditions but that is just the problem, they are not correlated under ALL conditions. > First of all, by checking two hours > after the beginning of a meal, I am > motivating myself to hold my eating in > line in order to reach my goal of > a PP reading around 100. Sure, you are free to do whatever you want but that is why physicians in general prefer to be guided by the results of the A1c test because they have that under control whereas they have to assume that patients are taking readings under all kinds of different conditions, most of which are unknown to the physician or could be unreliable. I assume that your " PP reading around 100 " is some restriction that you are imposing on yourself for some reason. The usual recommendation, the one we work to, is " 90-130 mg/dl before a meal on average " and " 110-150 mg/dl before going to sleep on average " . It is the average that counts, not any individual reading. > Secondly, my A1c tests do match my > readings. Sure, but only because your condition matches the condition under which the conversion factor was empirically determined but people whose metabolism is in some other condition do not necessarily get that match. A physician has to expect to get all kinds of patients. > Third, how will you know how a new > food or a change in lifestyle affects > you without testing? OK, but that is all over in a day or so - you find out what the change does to you in a short time and that is then over and done with. We are not continuously changing lifestyles or trying out new foods! Once every five years maybe but that is it! > Fourth, you can find out why your > wife's readings and her A1c don't > match. Test when she is not presently > testing. Use those strips for something > worthwhile. Check at bedtime and at > one and/or two hour intervals thru the > night. Ditto for the day. Thanks Helen, we have been doing all those things but they do not help. BG-wise, everything looks OK to us and to the physician. My feeling is that the anaemia is giving a false A1c result but my wife's anaemia is not as bad as the literature claims it needs to be to get a false A1c result. An added problem is that my wife has veins that make it difficult to get enough blood to do the other tests necessary to find out where the problem lies. The only way to get more blood would be with an access in her neck but then she would have to go into a clinic for that. > You might be surprised at what you find! I doubt that anything will surprise me now! > People using 24 hour monitoring have > found unexpected excursions, both up > and down, during those hours. We don't have a 24-hr monitoring facility available but it might come to that eventually if the blood tests don't turn up the answer. Either that or the physician might decide that she will have to live with the 7.5% A1c reading! Regards Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2004 Report Share Posted October 9, 2004 Some people get more set in their ways than others. I try new foods almost every week, and change my exercise routine around on a regular basis. SulaBlue > > OK, but that is all over in a day or so > - you find out what the change does to > you in a short time and that is then over > and done with. We are not continuously > changing lifestyles or trying out new > foods! Once every five years maybe but > that is it! > Hrm, I forget the name of it, but there are 24 hour glucose monitors that the insert just under your skin. You keep it for 3 days then go back to the doc's office and they plug it into the computer. I don't know if this is something a normal endo would have, or if it would involve a special clinic. > We don't have a 24-hr monitoring facility > available but it might come to that > eventually if the blood tests don't turn > up the answer. Either that or the > physician might decide that she will have > to live with the 7.5% A1c reading! > > Regards > > SulaBlue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2004 Report Share Posted October 11, 2004 > Too many doctors are satisfied with > anything under 8, thereby allowing > too many diabetics to suffer bad > lives and horrid deaths. Thank you for all the information, Helen, but might you not perhaps be exaggerating just a tad there? The available data refer to two large-scale trials in the UK, one for Type 1 patients (DCCT) and another for Type 2 patients: ( http://www.diabetesuffolk.com/Complications/Introduction.asp ) Type 1: " Studies have shown that the risk of kidney damage and eye disease are more common in people with poor control. This risk rises steeply above HbA1c values of 9% and is highest if the HbA1c value is above 12%. The Diabetes Control and Complications Trial (DCCT) showed that 12% of people Type 1 diabetes who were intensively treated (tight control) developed new retinopathy changes after nine years, compared to 54% of people who were treated with conventional (less tight control) methods. Progressive retinopathy was uncommon at HbA1c levels below 7%. People with very mild retinopathy were also less likely to progress to severe retinopathy if they were well controlled. Similar observations have been made for diabetic nephropathy. " Type 2: " The United Kingdom Prospective Diabetes Study showed that high blood glucose concentrations contribute to the risk of small vessel disease in type 2 diabetes as well. The researchers examined over 4000 people with type 2 diabetes, once again looking at the effects of 'intensive' and 'conventional' treatment. Over a period of ten years, people in the intensively treated group, who had an HbA1c level of 7.0% (compared to 7.9% in the conventional treatment group) were found to have a 25% risk reduction in complications such as eye and kidney disease. " So I do not think that it is correct to suggest that having an HbA1c value just under 8% necessarily means " allowing too many diabetics to suffer bad lives and horrid deaths " - for Type 2 diabetics, having an HbA1c of 7% instead of 7.9% means reducing the risk by 25%, not eliminating it. The studies did not provided any information to suggest what the risk reduction was from having an HbA1c of 5% or 6% for ten years, that can surely only be speculation. Some patients are unable to get HbA1c under 8% for quite a number of reasons. It is not really fair to suggest that they are being " allowed to suffer bad lives and horrid deaths " . Regards Quote Link to comment Share on other sites More sharing options...
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