Re: Amputation: was-Diabetic Foot Syndrome

[Guest guest]

At 09:07 AM 1/9/06 -0500, wrote:

>The last # I read (can't remember where) was that 50% of the amputations

>in the US are the result of diabetic complications.

Wouldn't you think *that* would make a test for DM (an A1c) included as

routine for *every* annual physical? NOT!

Nora

[Guest guest]

My endo said that they don't use the A1c for diagnosis. I guess the

reason is that a person can have a normal A1c and still have diabetes,

if he/she has lots of lows to bring down the average. Sue

>

> Wouldn't you think *that* would make a test for DM (an A1c) included as

> routine for *every* annual physical? NOT!

[Guest guest]

Sue wrote:

>My endo said that they don't use the A1c for diagnosis. I guess the

>reason is that a person can have a normal A1c and still have diabetes,

>if he/she has lots of lows to bring down the average. Sue

>

>

Sue

That begs the question as to why they rely so heavily on the A1c once

someone is diagnosed Diabetic. Surely the same principle applies, hence

the SMBG way is the right one.

--

Rob

T2 Metformin; Multi Vits with Minerals; Soya Lecithin;

Effexor XL

[Guest guest]

>

>

>My endo said that they don't use the A1c for diagnosis.

>

Then what do they use?

[Guest guest]

At 05:35 PM 1/9/06 -0500, Sue wrote:

>My endo said that they don't use the A1c for diagnosis. I guess the

>reason is that a person can have a normal A1c and still have diabetes,

>if he/she has lots of lows to bring down the average. Sue

My understanding is that the process has little to do with averaging lows

and highs. Once glucose molecules attach themselves to a red blood cell,

they stay there until the red cell dies... usually in 3 months. That is why

A1cs are done every 3 months and not more often.

Nora

[Guest guest]

One of my sisters had an A1c of 6 a while back, so her doctor must use

that to NOT diagnose her. Yet I know that her BG's go over 200 several

hours after some meals. I just figured that she must have some lows, or

she would probably have a higher A1c. I told her she needs to ask for a

Glucose Tolerance Test, but she says she's already had one. Never mind

that it was years ago. Sue

>

> My understanding is that the process has little to do with averaging

> lows

> and highs. Once glucose molecules attach themselves to a red blood

> cell,

> they stay there until the red cell dies... usually in 3 months. That

> is why

> A1cs are done every 3 months and not more often.

[Guest guest]

I assume the Glucose Tolerance Test. Sue

>>

>> My endo said that they don't use the A1c for diagnosis.

>

> Then what do they use?

[Guest guest]

> My understanding is that the process has little to do with averaging lows

> and highs. Once glucose molecules attach themselves to a red blood cell,

> they stay there until the red cell dies... usually in 3 months. That is why

> A1cs are done every 3 months and not more often.

Yes, but it gives an average of how much damage was done over the length of

time. More damage when

high, less when low, so the total amount of damage is an average.

BUT, the idea that A1c tests cover 3 months has been found incorrect, since it

was based on the

idea that red blood cells don't repair themselves. They do repair themselves

though, if slowly,

so the effective length an A1c covers is more like 3 or 4 WEEKS.....

Ted Quick

[Guest guest]

At 10:30 PM 1/9/06 -0800, Ted Quick wrote:

>BUT, the idea that A1c tests cover 3 months has been found incorrect,

>since it was based on the idea that red blood cells don't repair

>themselves. They do repair themselves though, if slowly, so the effective

>length an A1c covers is more like 3 or 4 WEEKS.....

About 75% of the A1c is weighted towards the last 3 or 4 weeks. But if the

post-prandial peaks are brief, then the red blood cells shed the attached

glucose molecules and *do* repair themselves somewhat. My A1c's didn't

fully reflect my high BG levels for two A1c's running (a total of 6 months

at least). Then the % jumped suddenly. Of course, I had been tracking it

all along and knew what was going on but could not convince my health care

provider of the fact that BG levels were much higher than the A1c's showed.

She thought I was " obsessing. " ( Got a referral to an endocrinologist

who did listen. ;o) Longer travel for me (150 miles round trip) but

definitely better results!

Nora

[Guest guest]

I don't know that it matters what it is CALLED (diabetes or normal),

but I would take it as a wake-up call. Her handling of carbohydrates

is not the best and most likely being conservative NOW may save her

from worse problems later.

I wish I had known what I know now with respect to my husband because

he had an abnormal test several years ago and on retest they said he's

" normal " . If we had known what to do at the time (low carb diet and

exercise and maybe more supplements) I would have put him on a low

carb diet long ago to try to avoid worse problems.

>

> One of my sisters had an A1c of 6 a while back, so her doctor must use

> that to NOT diagnose her. Yet I know that her BG's go over 200 several

> hours after some meals. I just figured that she must have some lows, or

> she would probably have a higher A1c. I told her she needs to ask for a

> Glucose Tolerance Test, but she says she's already had one. Never mind

> that it was years ago. Sue

[Guest guest]

Ted Quick wrote:

>Yes, but it gives an average of how much damage was done over the length of

time. More damage when

>high, less when low, so the total amount of damage is an average.

>

>BUT, the idea that A1c tests cover 3 months has been found incorrect, since it

was based on the

>idea that red blood cells don't repair themselves. They do repair themselves

though, if slowly,

>so the effective length an A1c covers is more like 3 or 4 WEEKS.....

>

>

Ted

Where did you read that the HbA1c only covers 3-4 weeks?

Try the link below.

http://medweb.bham.ac.uk/easdec/prevention/what_is_the_hba1c.htm

Dated June 2005

--

Rob

T2 Metformin; Multi Vits with Minerals; Soya Lecithin;

Effexor XL