FReepmail me if you want on or off the diabetes ping list.
Thanks for ping. I had an epidural and my A1C was higher. The Doc said that could last for 3 months. Now it is back down below 7. I don’t know if taking more meds would have prevented that. I’ll check that out next time.
My doctor has been using the A1C test to track my progress for 4 years now. Nothing new to me.
I work for an Ophthalmologist and he uses this as a guide for how his diabetic patients are doing in controlling the blood sugars. We see a lot of patients with background diabetic retinopathy - please take care of yourselves!!!
A cut point of 7 is insane. Yes, let’s wait until it’s right at the red line to treat the disease.
The cut point should be 5.5 for type two diabetes.
I also hope they’re still running the fasting. A new-onset type one child or LADA patient can have an only slightly elevated A1C if it’s caught soon enough. These people can die quickly without treatment.
Gee, I always considered the A1C to be the best test. So does my doctor. As many of you know, the A1C test is the best long term progress test and daily BS measurements get us through the day to day control.
ping
If they’d used the HA1C test before I was actually diagnosed 20+ years ago they would have discovered I was diabetic. My blood sugar had been high for quite a while but my doctor assumed I wasn’t fasting when he drew the blood in the office for routine tests because I was complaining of feeling sick over a long period of time. They were in the area of 140-160 (acceptable blood sugar was higher back then. They didn’t have pre-diabetes as an official condition and if I remember what he told me was that over 190 was the absolute diagnoses of diabetes.). He thought I’d eaten less than 2 hours before since it was an hour or so after lunch (never asked). I hadn’t and in some cases I hadn’t eaten anything in 14 hours. He finally caught it when it was over 200 and spilling into my urine. When the subject of blood tests comes up I always suggest to people that they tell the doctor when they’ve eaten before they draw blood.
My new doctor at Kaiser views the HA1C as the gold standard and isn’t as concerned about the day to day readings that I take. He still believes in the day to day readings to help you stay on course but as a measure of how your doing he’s going to use the HA1C. The samples are snapshots and don’t measure what’s really going on over a longer period of time. For example the blood sugar could be staying high for longer periods of time and dropping near the time you test or it could be staying near the level you got when you test. His goal for his diabetic patients is to keep their HA1C reading below 7.0 and not have them try to push to keep it within the “normal” range. He feels that there are a number of complications that appear if you reduce the HA1C levels that low consistently.
ping
This subject is of considerable interest to me. I’m 65 and a few years ago began to have some issues that suggested I might have problems. But the numbers didn’t reflect that.
But I was suspicious so what I have been doing is to do daily fasting glucose testing in the morning. (But do use a reliable meter) I have never had a diabetic reading after eating. Oddly enough it seems higher in the morning and from what I gather the readings can vary considerably over the day. What I do know is that weight gain around the middle (over 40” for men) is a danger sign and with advancing age should be watched carefully. What I do know is that I intend to keep a very close eye on this situation and will do whatever is required. The idea that I might go blind was enough to get my attention. Then come amputations, strokes and heart attacks. Diabetes is nothing to fool around with.
The A1C is not as accurate as people think it is. For example, people with anemia have higher A1C levels, and what they need is more iron, not more dieting.
I have a bad feeling about this. Treating the numbers is NOT the same thing as treating the disease. So many people are taking drugs to lower their blood sugar numbers, when there are no long-term studies that show it results in meaningful (that is, other than just lower numbers) reductions in serious complications. (I am speaking of Type 2 diabetes here.)
The data from the major studies cited in defense of all the oral diabetic meds have been seriously misused and massaged to muster even a miniscule amount of benefit.
“If there is no benefit, why tolerate any risk?”
http://abcnews.go.com/Health/Story?id=3232247&page=1
Excellent hard science blog on health matters:
Junkfood Science
http://junkfoodscience.blogspot.com/
My first symptom was numbness in both feet, which got worse over 3 or 4 years WITHOUT a diagnosis of incipient diabetes - even though I had a fasting glucose test every year! Today, 5 years AFTER diagnosis, I managed my sugar with diet only until last August, when I started walking on a treadmill 5 or 6 days a week.
The diet is pretty informal - no measurements, but I do not consume sugar, non-diet drinks, or more than a spoonful of rice or potatoes. I occasionally have a bread heel or a taste of pasta, but only a fraction of a serving.
I eat meats - and some fats - along with full servings of vegetables, cheese, and some fruits. Fruit juices raise my glucose, and so do oranges, but most other stuff is OK.
My twice-a-day average glucose is 90 over the last 30 days, and has not been over 110 (30-day avg) since two weeks after diagnosis. My A1c has dropped from about 8.3 at diagnosis to about 5.5 over the past 3 years. But my neuropathy is still about the same “moderate to severe” and I am starting to have vision problems - age-related (70) cataracts, and possible glaucoma (more tests next week). Also, I am having some intermittent double vision. All this is new, so I can’t blame it on elevated A1c.
I have learned a few things. Each of us has our own glucose response to various carbohydrates, so don’t assume that what works for you will work for anyone else, or vice versa.
I couldn’t pass a field sobriety test, or even stay upright in a shower with my eyes closed unless I maintain contact with a wall.
I can’t walk or run on an uneven surface unless I REALLY watch every step. That’s why I now walk on a treadmill, with a very smooth surface, adjustable incline & speed, a strong bar to hold for support, and indicators for speed, incline, time, pace, heart rate, and estimated calorie usage.
“Diabetic” shoes are generally drastically overpriced JUNK! They have a fragile layer of padding and a oversized toe box to allow room for the inserts, but no shock absorption in the shoe itself. The “accommodative insert” is the critical part, but it does not absorb shock either.
Once, I started intensive walking - 45 minutes, 4+ mph, 8+ incline - I started having serious problems with wearing out my shoes from the inside. And I also had blisters on many parts of my feet - heels, several toes, and worst of all, the balls of both feet. I FINALLY got good advice from a pedorthist (makes custom inserts) - Get RUNNING shoes with good shock absorption AND room for the inserts. I settled on Nike “Structure II”, plus some high-tech socks that will NOT wrinkle. No blisters since, and I am going faster and farther than before, at a 12 incline. I’m down 50 pounds since August 1!
I will be 70 this year,
I have a very strong suspicion that this is generally true, and that the ADA is merely formalizing what has been the de facto standard for years.
Of course, diabetes research has been going at such a breakneck pace, it's not surprising that the "standards" are well behind the current practice.