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Panel Settles on Hemoglobin A1c to Diagnose Diabetes: Implications of the shift to be assessed.
Family Practice News ^ | 15 June 2009 | MIRIAM E. TUCKER

Posted on 07/02/2009 12:12:52 AM PDT by neverdem

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1 posted on 07/02/2009 12:12:52 AM PDT by neverdem
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To: austinmark; FreedomCalls; IslandJeff; JRochelle; MarMema; Txsleuth; Newtoidaho; texas booster; ...
FReepmail me if you want on or off the diabetes ping list.
2 posted on 07/02/2009 12:14:24 AM PDT by neverdem (Xin loi minh oi)
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To: neverdem

Thanks for the ping, neverdem!


3 posted on 07/02/2009 3:25:38 AM PDT by DCPatriot ("It aint what you don't know that kills you. It's what you know that aint so" Theodore Sturgeon))
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To: neverdem

speaking of A1c...found this on Quest Diagnostics’ website: http://ir.questdiagnostics.com/phoenix.zhtml?c=82068&p=irol-newsArticle&ID=1295061&highlight=


4 posted on 07/02/2009 3:29:17 AM PDT by ZinGirl (it)
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To: neverdem

Thanks, BFL


5 posted on 07/02/2009 3:53:17 AM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: neverdem

If you can’t get the numbers you want, you change the way you get the numbers. Sounds like a SHELL game. I know I have been going through this the last 15 years. You can not make MONEY if the numbers are to low.


6 posted on 07/02/2009 4:03:06 AM PDT by crazyotto
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To: crazyotto
"If you can’t get the numbers you want, you change the way you get the numbers. Sounds like a SHELL game. I know I have been going through this the last 15 years. You can not make MONEY if the numbers are to low."

Exactly. If you do some research, you'll see that they've recently lowered the numbers and now that allows them to give you a diagnose of a "high sugar" reading from that lowered threshold.

I think I also read somewhere that Canada uses a different threshhold.

I don't trust any of them.

7 posted on 07/02/2009 5:01:09 AM PDT by Matchett-PI (Obama has entered the "cracking stage" of his presidency. ~ Gagdad)
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To: crazyotto

You are, of course, free to be suspicious but more than half the diabetics in the country have not yet been diagnosed so the doctors should easily make up for you absence.


8 posted on 07/02/2009 5:08:14 AM PDT by muawiyah
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To: crazyotto

Apparently you did not read the article. The piece describes how different tests results can be interpreted to make a reasonable determination of a threshold.

The A1C has been used as a reliable indicator by my doctor as a reinforcing factor. This piece now reverses the order. The A1C becomes primary with the sugar level as a solid backup.


9 posted on 07/02/2009 5:08:16 AM PDT by bert (K.E. N.P. +12 . The boy's war in Detriot has already cost more then the war in Iraq.)
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To: Matchett-PI

Do you know your A!C level?

Has it been determined?

If not, you are likely not at risk


10 posted on 07/02/2009 5:11:08 AM PDT by bert (K.E. N.P. +12 . The boy's war in Detriot has already cost more then the war in Iraq.)
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To: neverdem

Why? I’ve long criticized the futzing with the numbers - and this change is worse, to me.

instead of sticking with an inexpensive, instant test (plasma glucose), they have shifted toward a much more expensive laboratory test that is typically not administered unless sugar problems are at least suspected. How much money did the panel receive from the med lab industry?

The HbA1C gives inferential evidence of an average blood sugar. Therefore, they are endorsing the idea that a balance of high and low-sugar spikes is NOT diabetes? I vehemently disagree with this decision!


11 posted on 07/02/2009 5:16:15 AM PDT by MortMan (Power without responsibility-the prerogative of the harlot throughout the ages. - Rudyard Kipling)
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To: bert

Think about this: The HbA1C can be “fooled” by semi-balanced highs and lows. The test is a measure of control, not variation. To me, diabetes is characterized by the variation in sugar levels.

I’m not a doctor, just a diabetic engineer. BUt I can’t say I agree with this push (much the same as I still disagree with the fundamental redefinition of the “diabetes” blood glucose ranges several years ago).


12 posted on 07/02/2009 5:19:11 AM PDT by MortMan (Power without responsibility-the prerogative of the harlot throughout the ages. - Rudyard Kipling)
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To: bert
"Do you know your A!C level? Has it been determined? If not, you are likely not at risk"

No I don't, and no it hasn't.

13 posted on 07/02/2009 5:19:11 AM PDT by Matchett-PI (Obama has entered the "cracking stage" of his presidency. ~ Gagdad)
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To: MortMan

The way my Dr explained it at first is that you (the patient) can futz the blood glucose number temporarily. The A1C will tell him how I am doing over a longer period of time—making longer term management more effective.

I still measure a couple of times a day because I need that constant metric to make sure I don’t slip off the wagon.

Whatever works to keep it down is what I favor.


14 posted on 07/02/2009 5:24:24 AM PDT by Vermont Lt (Ein Volk, Ein Riech, Ein Ein.)
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To: Vermont Lt

Yes, the daily numbers can be futzed. The two tests are complementary, in fact. My most recent HbA1C is helping to correct an issue with over-medication using insulin (it’s a long story).

However, it appears to me that they didn’t catch enough people with their plasma glucose range shift a few years ago, so they’re introducing a new way to spread the net. This way, they also include the med labs (or test kit providers) in the bonanza, too.

Yes - I’m cynical about “latest medical science”. I remember the “egg/no egg” back and forth all too vividly not to be skeptical.


15 posted on 07/02/2009 5:37:36 AM PDT by MortMan (Power without responsibility-the prerogative of the harlot throughout the ages. - Rudyard Kipling)
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To: MortMan
What is a diabetic engineer?

Newly diagnosed diabetic (A1c of 10.9).

16 posted on 07/02/2009 5:40:54 AM PDT by texas booster (Join FreeRepublic's Folding@Home team (Team # 36120) Cure Alzheimer's!)
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To: texas booster

I am an opinionated, brash, sometimes loud-mouth (i.e.: engineer) who has been diabetic for almost 13 years now (HbA1C 6.6 in May).

Control is the name of the game. Are you type I or II? (None of your business is a valid answer, BTW.)

I’m type II, but now on insulin due to lack of control or decaying insulin production (probably lack of control - honestly).


17 posted on 07/02/2009 5:43:59 AM PDT by MortMan (Power without responsibility-the prerogative of the harlot throughout the ages. - Rudyard Kipling)
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To: MortMan

Diabetes is considered a continuum, not a series of isolated events. Considering that all knowledge is to a degree imperfect, the A1C has been accepted as the best way to grasp the state of the continuum


18 posted on 07/02/2009 5:55:06 AM PDT by bert (K.E. N.P. +12 . The boy's war in Detriot has already cost more then the war in Iraq.)
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To: MortMan

I only have to get the A1c once a quarter, and my Dr doesnt even WANT me to take daily readings (I am very early in the process.)

The labs seem “reasonable” and he is not someone to run around prescribing a lot of tests. I don’t have a huge amount of reference in this. Are people getting the A1C more often than that?


19 posted on 07/02/2009 6:15:51 AM PDT by Vermont Lt (Ein Volk, Ein Riech, Ein Ein.)
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To: neverdem

While I agree with the A1c approach, the sticky part comes in with picking the target number.

As an example, blood pressure of 120/80 was considered ideal. Now it’s 115/75. I wonder how much input the pharmaceutical companies had on the new target?

The same can be asked with recommended cholesterol levels. If they’re not selling enough Zocor/Lipitor, then lower the target numbers.


20 posted on 07/02/2009 6:33:12 AM PDT by NCjim ("Lies have to be covered up, truth can run around naked." - Johnny Cash)
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