I am a type II diabetic I am wantiong to understand hwo does a H1A level
correspond to a average bg reading.
29
May
H1A levels
I am a type II diabetic I am wantiong to understand hwo does a H1A level
correspond to a average bg reading.
Pimamedic wrote in message …
>I am a type II diabetic I am wantiong to understand hwo does a H1A level
>correspond to a average bg reading.
The latests, most scientific discussion I have found is at:
http://care.diabetesjournals.org/cgi/content/full/25/2/275
The mathematical equation is:
Ave bG (mg/dL) = 35.6 x HbA1c – 77.3
That assumes that your Clinical Lab uses an HbA1c calibration which
corresponds to the U.S. DCCT calibration.
Regards
Old Al
Thank You
"oldal4865" <oldal4…@yahoo.com> wrote in
news:2hgpcnFcebs0U1@uni-berlin.de:
- Hide quoted text — Show quoted text -
> Pimamedic wrote in message …
>>I am a type II diabetic I am wantiong to understand hwo does a H1A
>>level correspond to a average bg reading.
> The latests, most scientific discussion I have found is at:
> http://care.diabetesjournals.org/cgi/content/full/25/2/275
> The mathematical equation is:
> Ave bG (mg/dL) = 35.6 x HbA1c – 77.3
> That assumes that your Clinical Lab uses an HbA1c calibration which
> corresponds to the U.S. DCCT calibration.
> Regards
> Old Al
oldal4865 <oldal4…@yahoo.com> wrote on Tue, 25 May 2004 07:36:13 -0400:
> Pimamedic wrote in message …
>>I am a type II diabetic I am wantiong to understand hwo does a H1A level
>>correspond to a average bg reading.
> The latests, most scientific discussion I have found is at:
> http://care.diabetesjournals.org/cgi/content/full/25/2/275
> The mathematical equation is:
> Ave bG (mg/dL) = 35.6 x HbA1c – 77.3
Wow! Didn’t know that. Mind if I calculate a little table?
Ave bG HbA1c
80 4.4
120 5.5
160 6.7
200 7.8
250 9.1
300 10.6
400 13.4 (is this patient still alive?)
> That assumes that your Clinical Lab uses an HbA1c calibration which
> corresponds to the U.S. DCCT calibration.
> Old Al
–
Alan Mackenzie (Munich, Germany)
Email: a…@muuc.dee; to decode, wherever there is a repeated letter
(like "aa"), remove half of them (leaving, say, "a").
Alan Mackenzie <a…@muc.de> wrote in news:2jd09c.cj.ln@acm.acm:
- Hide quoted text — Show quoted text -
> oldal4865 <oldal4…@yahoo.com> wrote on Tue, 25 May 2004 07:36:13 –
0400:
>> Pimamedic wrote in message …
>>>I am a type II diabetic I am wantiong to understand hwo does a H1A
level
>>>correspond to a average bg reading.
>> The latests, most scientific discussion I have found is at:
>> http://care.diabetesjournals.org/cgi/content/full/25/2/275
>> The mathematical equation is:
>> Ave bG (mg/dL) = 35.6 x HbA1c – 77.3
> Wow! Didn’t know that. Mind if I calculate a little table?
> Ave bG HbA1c
> 80 4.4
> 120 5.5
> 160 6.7
> 200 7.8
> 250 9.1
> 300 10.6
> 400 13.4 (is this patient still alive?)
>> That assumes that your Clinical Lab uses an HbA1c calibration which
>> corresponds to the U.S. DCCT calibration.
>> Old Al
Yes they may very well be alive. I ahve seen Bg as high as 700 wiht
patient acting normal.
oldal4865 <oldal4…@yahoo.com> wrote on Tue, 25 May 2004 07:36:13 -0400:
> Pimamedic wrote in message …
>>I am a type II diabetic I am wantiong to understand hwo does a H1A level
>>correspond to a average bg reading.
> The latests, most scientific discussion I have found is at:
> http://care.diabetesjournals.org/cgi/content/full/25/2/275
> The mathematical equation is:
> Ave bG (mg/dL) = 35.6 x HbA1c – 77.3
I have constructed two spreadsheets, one looking like what my average
daily blood glucose levels would have been when I innocently scoffed
down shepherd’s pie, pasta, big bowls of muesli for breakfast, slugged
down half a pint of fresh orange juice etc.. That one frequently
exceeded 11 mmol/l (200 US). The other is based on my new careful
avoid-the-high-spikes diet. That one rarely exceeds 7.5 (135). I then
averaged the readings throughout each of the two types of day and
converted to HbA1c using the above formula. The difference is approx
0.5 — not much!
It surprised me is to find how little difference bringing the spikes
down a lot has on Hb1Ac. But it’s a logical consequence of the
arithmetic. What *does* make a large difference in HbA1c (in this
simulation of my BG behaviour) is making changes in the fasting BG
level.
What is interesting about this is the papers which have shown a linear
reduction of risk of various diabetic disorders with decreasing
HbA1c. If HbA1c actually gives the result of average BG over time —
which it would do if the glycation of the hemoglobin followed the
usual mass action law of chemical reaction in aqueous solutions —
then I can deduce that getting *fasting* BG down, and keeping it there
for long periods, will make (for me) the most dramatic reductions in
risk, i.e., reduce progressive diabetic damage the most.
I don’t know how the blood glucose of all you folk behaves, but the
behaviour I’ve observed in mine tends to drop after a meal in a few
hours to about 5.5 (100), and then takes a few more hours drifting
slowly down to to 4.5 (80). Getting down to bottom fasting level takes
a long time. As a consequence I get the lowest BG averages by having a
few meals with long enough intervals between them to get down low and
stay low for a good period of time, rather than, as is often
recommended here, having frequent smaller meals with smaller spikes.
In sum, at least with my typical BG behaviour, it looks like the thing
to aim for is excavating the valleys of the BG graph deeper, rather
than trying to minimise the spikes. And that is achieved by leaving
longer gaps between meals, i.e., fewer bigger meals rather than more
smaller meals.
It’s obvious once I think about it: the thing about spikes is they’re
spiky, i.e., steep side and pointy. Whereas the valleys between are
much more rounded. If you turned a valley upside down it would have
much more stuff in it than in a spike, a rounded hill rather than a
sharp peak. Hence the larger effect of valleys rather than peaks on
the average. Hence (for me) fewer bigger meals looks like the best way
to get low HbA1c levels.
–
Chris Malcolm c…@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205
IPAB, Informatics, JCMB, King’s Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]
On Thu, 10 Jun 2004 13:14:29 +0000 (UTC), c…@holyrood.ed.ac.uk (Chris
- Hide quoted text — Show quoted text -
Malcolm) wrote:
>oldal4865 <oldal4…@yahoo.com> wrote on Tue, 25 May 2004 07:36:13 -0400:
>> Pimamedic wrote in message …
>>>I am a type II diabetic I am wantiong to understand hwo does a H1A level
>>>correspond to a average bg reading.
>> The latests, most scientific discussion I have found is at:
>> http://care.diabetesjournals.org/cgi/content/full/25/2/275
>> The mathematical equation is:
>> Ave bG (mg/dL) = 35.6 x HbA1c – 77.3
>I have constructed two spreadsheets, one looking like what my average
>daily blood glucose levels would have been when I innocently scoffed
>down shepherd’s pie, pasta, big bowls of muesli for breakfast, slugged
>down half a pint of fresh orange juice etc.. That one frequently
>exceeded 11 mmol/l (200 US). The other is based on my new careful
>avoid-the-high-spikes diet. That one rarely exceeds 7.5 (135). I then
>averaged the readings throughout each of the two types of day and
>converted to HbA1c using the above formula. The difference is approx
>0.5 — not much!
>It surprised me is to find how little difference bringing the spikes
>down a lot has on Hb1Ac. But it’s a logical consequence of the
>arithmetic. What *does* make a large difference in HbA1c (in this
>simulation of my BG behaviour) is making changes in the fasting BG
>level.
>What is interesting about this is the papers which have shown a linear
>reduction of risk of various diabetic disorders with decreasing
>HbA1c. If HbA1c actually gives the result of average BG over time —
>which it would do if the glycation of the hemoglobin followed the
>usual mass action law of chemical reaction in aqueous solutions —
>then I can deduce that getting *fasting* BG down, and keeping it there
>for long periods, will make (for me) the most dramatic reductions in
>risk, i.e., reduce progressive diabetic damage the most.
>I don’t know how the blood glucose of all you folk behaves, but the
>behaviour I’ve observed in mine tends to drop after a meal in a few
>hours to about 5.5 (100), and then takes a few more hours drifting
>slowly down to to 4.5 (80). Getting down to bottom fasting level takes
>a long time. As a consequence I get the lowest BG averages by having a
>few meals with long enough intervals between them to get down low and
>stay low for a good period of time, rather than, as is often
>recommended here, having frequent smaller meals with smaller spikes.
>In sum, at least with my typical BG behaviour, it looks like the thing
>to aim for is excavating the valleys of the BG graph deeper, rather
>than trying to minimise the spikes. And that is achieved by leaving
>longer gaps between meals, i.e., fewer bigger meals rather than more
>smaller meals.
>It’s obvious once I think about it: the thing about spikes is they’re
>spiky, i.e., steep side and pointy. Whereas the valleys between are
>much more rounded. If you turned a valley upside down it would have
>much more stuff in it than in a spike, a rounded hill rather than a
>sharp peak. Hence the larger effect of valleys rather than peaks on
>the average. Hence (for me) fewer bigger meals looks like the best way
>to get low HbA1c levels.
Hi Chris
My philosophy is diametrically opposed.
I will still do my best to get the spikes down, and I’ve found that my
FBG and A1c have eventually followed. I also eat less more often, small
meals through the day. I must admit I’ve never worried much about the
averages, because they are so dependant on the timing of the tests.
From my reading the spikes are also causing damage, not just the A1c
levels.
You will find discussion of this point, and a different logic on the
relationship between post-prandial excursions and HbA1c at
http://www.medscape.com/viewprogram/3036_index , although there are some
other references. There doesn’t appear to have been a lot of research
specifically on post-prandial/HbA1c relationships.
For example, Slide 12:
"Is it fasting or postprandial hyperglycemia that is important?
Hemoglobin A1C measures total exposure to hyperglycemia over about a
3-month period of time. Both fasting and postprandial hyperglycemia
contribute to this. We have no evidence that there’s anything more toxic
for postprandial hyperglycemia vs fasting hyperglycemia. The relative
contributions depend on the relative degree of glycemic control. When
your HbA1C is very high, when you have a fasting glucose level over 200
mg/dL, most of the HbA1C will be due to fasting hyperglycemia. However,
earlier in the stage of diabetes, when HbA1C levels are lower, it’s
going to be the postprandial values that contribute most to HbA1C."
Cheers, Alan, T2 d&e, Australia.
Remove weight and carbs to email.
—
Everything in Moderation – Except Laughter.
Pimamedic <pimame…@nospamhotamil.com> wrote:
> I am a type II diabetic I am wantiong to understand hwo does a H1A level
> correspond to a average bg reading.
It DOESN’T !! Two different measures, no matter what the others here say
there is NO DIRECT correlation between average BG as average BG is a MYTH
and nealry IMPOSSIBLE to measure accurately !!
c…@holyrood.ed.ac.uk (Chris Malcolm) wrote in
news:ca9mrl$t0l$1@scotsman.ed.ac.uk:
> It surprised me is to find how little difference bringing the spikes
> down a lot has on Hb1Ac. But it’s a logical consequence of the
> arithmetic. What *does* make a large difference in HbA1c (in this
> simulation of my BG behaviour) is making changes in the fasting BG
> level.
If you look at the FAQ section on A1c, there are a references to a series
of papers by Henrik Mortensen describing the reaction, the forward and
reverse reaction constants, and a numerical solution to a two box model
of the reaction. The numerical model at least is relatively insensitive
to short term spikes.
–
——-
Charly Coughran
ccough…@DELETE-TO-RESPOND-UCSD.EDU
> It surprised me is to find how little difference bringing the spikes
> down a lot has on Hb1Ac. But it’s a logical consequence of the
> arithmetic. What *does* make a large difference in HbA1c (in this
> simulation of my BG behaviour) is making changes in the fasting BG
> level.
that’s because there is NO causal link between the two. Glycation (measured
by the HbA1c) is a chemical reaction which takes a while. It is therefore
logical to assume that the spike needs not only height, but duration in
order to affect the HbA1c…therefore, a spike of 10.0 reduced to 6.0
within a short period of time will produce fewer glycated cells than say a
moderate spike of 8.0 that lasts longer….
On Thu, 10 Jun 2004 13:14:29 +0000 (UTC), c…@holyrood.ed.ac.uk (Chris
Malcolm) wrote:
> I have constructed two spreadsheets, one looking like what my average
> daily blood glucose levels would have been when I innocently scoffed
> down shepherd’s pie, pasta, big bowls of muesli for breakfast, slugged
> down half a pint of fresh orange juice etc.. That one frequently
> exceeded 11 mmol/l (200 US). The other is based on my new careful
> avoid-the-high-spikes diet. That one rarely exceeds 7.5 (135). I then
> averaged the readings throughout each of the two types of day and
> converted to HbA1c using the above formula. The difference is approx
> 0.5 — not much!
Chris,
I ran into this when I was setting up my own spreadsheet. For the
calculations to be accurate you need to have a meter continually monitoring
your BG level and spitting out the readings to your spreadsheet values say
every 5 minutes of the day. Unless you have this you are going to be
subject to the vagaries of when you take a measurement and whether that is
on a peak or a trough or somewhere in between.
Say, for example, you have readings of 7.5 and 4.5. The average of these
figures is 6 but you have no way of knowing if these readings are actual
maximum and minimum readings and how the BG varies between those readings.
Depending on whether the BG peaks are narrow or broad your real average
could be anywhere between say 5 and 7.
Your calculations will be a useful guide but may be in error by +/- 0.5 or
more so don’t take them too seriously.
Cheers, John
Use au instead of invalid for emails to me.
—
"Chris Malcolm" <c…@holyrood.ed.ac.uk> wrote in message
news:ca9mrl$t0l$1@scotsman.ed.ac.uk…
> [ ... ]
> It surprised me is to find how little difference bringing the spikes
> down a lot has on Hb1Ac. But it’s a logical consequence of the
> arithmetic. What *does* make a large difference in HbA1c (in this
> simulation of my BG behaviour) is making changes in the fasting BG
> level.
> [ ... ]
That is my practical experiance as well, and I have found a logical
explanation for it, based on my observations of myself.
If my fasting BG is low, the whole day is likely to be great and life is
easy.
If my fasting BG is high, the whole day may be high or at least jogging up
and down. Sometimes I overcompensate for the high BG. Sometimes I take far
too little.
–
Have a nice day!
Bjørn BL.
Hi Alan
On Thu, 10 Jun 2004 23:45:32 +1000, Alan
<loralweightandca…@optusnet.com.au> wrote:
> Hi Chris
> My philosophy is diametrically opposed.
> I will still do my best to get the spikes down, and I’ve found that my
> FBG and A1c have eventually followed. I also eat less more often, small
> meals through the day. I must admit I’ve never worried much about the
> averages, because they are so dependant on the timing of the tests.
> From my reading the spikes are also causing damage, not just the A1c
> levels.
not in themselves… I mean, it’s not that simple.
Glycation is broadly a 2-step process, the first step having a
reversible and highly unstable intermediate, the second step
irreversible glycation. In order for the 2nd step to take place the 1st
step product must be at a high enough concentration for that chemical
species to exist for long enough in order to go onto the 2nd step.
The odd high spike isn’t going to hurt unless it is prolonged, and
this is why 2hr PP (and fasting) is important – these aren’t going to be
on the spike.
I find it easier to think of A1c as being an indicator as to what degree
bg #s have been at levels high enough and long enough to do harm.
To complicate matters still further, it seems that ‘vunerability to
irreversible glycosolation’ is itself a variable.
So, for me, I don’t watch the sugars so much as the starches. It has
worked for me up to now. But then again, I can’t ‘graze’… I’ll eat
once or twice a day. If I adopt a small and often strategy, my numbers
go all over the place… everything is such a YMMV.
–
John38 – T2 : Hb1Ac=5.5%
On Thu, 10 Jun 2004 15:25:24 +0000 (UTC), Chris Malcolm
- Hide quoted text — Show quoted text -
<c…@holyrood.ed.ac.uk> wrote:
> nos…@bogusemail.com (gman99) writes:
> >Pimamedic <pimame…@nospamhotamil.com> wrote:
> >> I am a type II diabetic I am wantiong to understand hwo does a H1A level
> >> correspond to a average bg reading.
> >It DOESN’T !! Two different measures, no matter what the others here say
> >there is NO DIRECT correlation between average BG as average BG is a MYTH
> >and nealry IMPOSSIBLE to measure accurately !!
> If it’s nearly impossible to measure accurately it can’t be a
> myth. And it’s actually quite easy to measure accurately in a by using
> a permanently attached blood glucose monitor supplying its readings to
> a data collection computer. Not much more complicated than a Holter
> heart monitor.
Average BG and degree of glycation (hb1ac) are *not* the same thing,
because all average bg is IS average BG. Glycation is glycation.
Propensity to glycation is not standard, and may vary within the
individual over time. Your bg may average 7 and yet your hb1ac is 6
whereas my average might be also be 7 but my hb1ac is 5 because I am
more resistant to glycation. This is why it is folly to say that a hb1ac
corresponds to an average – it doesn’t. It corresponds to control, and
the closer you are to 5% the less statistically likely you will have
diab. complications.
Remember that even non-diabetics can have diabetic complications for the
same kind of reasons (they glycosolate to a detrimental extent even with
bg #s in the normal range)
–
John38 – T2
On Fri, 11 Jun 2004 13:12:13 +0100, John38 <dev-n…@itconsultuk.net>
wrote:
>The odd high spike isn’t going to hurt unless it is prolonged,
That’s the crux of my difference of opinion. Can you support that
statement with some relevant definitive cites? I’ll do a little
searching of my files but I know I’ve never seen that clearly stated.
Did you read the presentation I cited?
You see, I muse on stray thoughts as a non-scientist. Try this one among
many. One thing that all the studies stress is that this is a
progressive, inexorable disease. But they don’t seem to have worked out
why it continues to progress in people who have good control and low
A1c, albeit at a slower rate. However, no-one has ever done a study on
micro-control of post-prandial spikes with testing and diet to see what
effect that has on the progression. Of course, I could be adding 2+2 and
getting 3 or 9.
I’m not really interested in the mathematical relationship between BGs
and A1c; I’m only interested in being able to read and use all my digits
in twenty years time. I seem to be missing how understanding that
relationship is going to achieve my aim.
I use this simple logic:
If, in twenty years time, it transpires that you are correct, it will
have cost me a little planning, some inconvenience, and some culinary
treats.
If, however, they discover by that time that short, sharp spikes do some
form of damage – whatever it is – I don’t want to envisage what that may
cost me. And it would hurt even more to know that I could have prevented
it. My personal feeling is that common sense implies those spikes are
causing me harm.
Overkill? Probably, but not necessarily. And it’s that "but" that is the
problem. That’s my view and that is the action I take. Your body – your
science experiment.
So I’ll continue to try to keep all the indicators within acceptable
limits: HbA1c, FBG, post-prandials (1 and 2 hr), lipids and
renal/kidney. Among others.
Cheers, Alan, T2 d&e, Australia.
Remove weight and carbs to email.
—
Everything in Moderation – Except Laughter.
Statistically the average bg correlates quite well with the a1c for the
great bulk of people. That there is variable glycation rates is no
salvation for that same bulk. It is expressed as a bell curve. The great
bulk of folk are in the great hump of the curve. For everyone whos
glycation is less for x amount of bg, there is someone who has a greater
glycation rate; when looking at the ends of the curve. An a1c can
encompass large or small swings in bg for the same average bg, but again
the great bulk of people are in the hump of the curve and average bg and
a1c reflect each other quite well. If one’s a1c is quite high then
fasting bg is high also and most of the average reflects the fasting
number over the post meal swing. If one’s a1c is low then most of the
number comes from post meal variation because the fasting number is low.
"Alan" <loralweightandca…@optusnet.com.au> wrote in message
news:p9ajc05ig64lrcpr1vu8r45hrb69esh6cv@4ax.com…
> On Fri, 11 Jun 2004 13:12:13 +0100, John38 <dev-n…@itconsultuk.net>
> wrote:
<snip>
> progressive, inexorable disease. But they don’t seem to have worked out
> why it continues to progress in people who have good control and low
> A1c, albeit at a slower rate.
hi alan,
i’ll bet you that i can answer that one – it is called aging
as we get older our b-cells get older and die. in addition, part of the
aging process is the increase of insulin resistance. non-diabetics should
also face this "progression", however, they were lucky enough to have enough
b-cells to last them their entire lives (and to over come the increasing
insulin resistance).
i am 38 years old and in excellent shape and there is _not_ a doubt in my
mind that i will be on insulin sometime in my life due to this progression.
–
poorboy
age 38 t2 diagnosed 4/2003
D & E w/ 7.5 mg actos
Chris Malcolm <c…@holyrood.ed.ac.uk> wrote on Thu, 10 Jun 2004 13:14:29
+0000 (UTC):
> I have constructed two spreadsheets, one looking like what my average
> daily blood glucose levels would have been when I innocently scoffed
> down shepherd’s pie, pasta, big bowls of muesli for breakfast, slugged
> down half a pint of fresh orange juice etc.. That one frequently
> exceeded 11 mmol/l (200 US). The other is based on my new careful
> avoid-the-high-spikes diet. That one rarely exceeds 7.5 (135). I then
> averaged the readings throughout each of the two types of day and
> converted to HbA1c using the above formula. The difference is approx
> 0.5 — not much!
> It surprised me is to find how little difference bringing the spikes
> down a lot has on Hb1Ac. But it’s a logical consequence of the
> arithmetic. What *does* make a large difference in HbA1c (in this
> simulation of my BG behaviour) is making changes in the fasting BG
> level.
Chris, who gives a damn about HbA1c? OK, that was a hysterical
rhetorical question, but an HbA1c isn’t going to do you any harm. HbA1c
is an indicator, a _mere_ indicator of how your BS has been on average.
On the other hand, high BS is might well damage you, even in short
spikes, short enough not to be "recorded" in HbA1c levels.
> What is interesting about this is the papers which have shown a linear
> reduction of risk of various diabetic disorders with decreasing HbA1c.
> If HbA1c actually gives the result of average BG over time — which it
> would do if the glycation of the hemoglobin followed the usual mass
> action law of chemical reaction in aqueous solutions — then I can
> deduce that getting *fasting* BG down, and keeping it there for long
> periods, will make (for me) the most dramatic reductions in risk, i.e.,
> reduce progressive diabetic damage the most.
HbA1c is _correlated_ with risk of disorders. If you actively try to
reduce your HbA1c, you may just be breaking that correlation rather than
reducing the risk. Think of HbA1c as the temperature gauge of a nuclear
reactor core. If the gauge tells you the core’s getting unexpectedly
hot, you investigate why – there could be serious damage in there. What
you don’t do is slam in a few control rods to reduce the temperature and
then carry on as if everything’s fine. And you certainly DON’T
"recalibrate" the gauge.
> Chris Malcolm
–
Alan Mackenzie (Munich, Germany)
Email: a…@muuc.dee; to decode, wherever there is a repeated letter
(like "aa"), remove half of them (leaving, say, "a").
Alan wrote:
> If, however, they discover by that time that short, sharp
spikes do
> some form of damage – whatever it is – I don’t want to
envisage what
> that may cost me. And it would hurt even more to know that
I could
> have prevented it. My personal feeling is that common
sense implies
> those spikes are causing me harm.
The way I see the role of post prandial spiking in
progression of DM is the process of insulin release. i.e.
eating in a way that doesn’t really cause your bg’s to go
too high post prandially BUT does cause the release of extra
insulin thereby taxing an already defective system. Similar
to the way a type 1 can "honeymoon" for a while if they
"rest" their pancreas. This theory has been bandied about
for years (along with the use of sulphs destroying
pancreatic beta cells). There have been cites, I just don’t
have any on hand.
If you are spiking, even for a short while then there will
be a larger release of insulin. General observation of the
people in the diabetic newsgroups over the years shows me
that those who ignore the short lived post prandial spikes
(as long as 2 hr PP is back to normal) have progressed
further with their DM (as in needing higher doses and more
diabetic meds eventually) than those who prefer to prevent
any spiking, small or large, whatsoever. If I tested every 5
minutes for 2 hours after a meal my bg would hardly be
different (at any time) than my pre meal test. Call me anal,
but it is better than the consequences. It has always been
my opinion that type 2 diabetes is as progressive as a
person allows it to be.
On Sat, 12 Jun 2004 08:24:57 +1000, "Ozgirl" <news_onl…@hotmail.com>
wrote:
<good info snipped>
>It has always been
>my opinion that type 2 diabetes is as progressive as a
>person allows it to be.
Hi Ozgirl
You’ll probably upset some saying that.
I hope you’re right; you may be wrong. In any case, it’s a concept I
intend to test thoroughly for the next few years.
Cheers, Alan, T2 d&e, Australia.
Remove weight and carbs to email.
—
Everything in Moderation – Except Laughter.
- Hide quoted text — Show quoted text -
On Fri, 11 Jun 2004 15:06:32 +0000, Alan Mackenzie <a…@muc.de> wrote:
>Chris Malcolm <c…@holyrood.ed.ac.uk> wrote on Thu, 10 Jun 2004 13:14:29
>+0000 (UTC):
>> I have constructed two spreadsheets, one looking like what my average
>> daily blood glucose levels would have been when I innocently scoffed
>> down shepherd’s pie, pasta, big bowls of muesli for breakfast, slugged
>> down half a pint of fresh orange juice etc.. That one frequently
>> exceeded 11 mmol/l (200 US). The other is based on my new careful
>> avoid-the-high-spikes diet. That one rarely exceeds 7.5 (135). I then
>> averaged the readings throughout each of the two types of day and
>> converted to HbA1c using the above formula. The difference is approx
>> 0.5 — not much!
>> It surprised me is to find how little difference bringing the spikes
>> down a lot has on Hb1Ac. But it’s a logical consequence of the
>> arithmetic. What *does* make a large difference in HbA1c (in this
>> simulation of my BG behaviour) is making changes in the fasting BG
>> level.
>Chris, who gives a damn about HbA1c? OK, that was a hysterical
>rhetorical question, but an HbA1c isn’t going to do you any harm. HbA1c
>is an indicator, a _mere_ indicator of how your BS has been on average.
>On the other hand, high BS is might well damage you, even in short
>spikes, short enough not to be "recorded" in HbA1c levels.
>> What is interesting about this is the papers which have shown a linear
>> reduction of risk of various diabetic disorders with decreasing HbA1c.
>> If HbA1c actually gives the result of average BG over time — which it
>> would do if the glycation of the hemoglobin followed the usual mass
>> action law of chemical reaction in aqueous solutions — then I can
>> deduce that getting *fasting* BG down, and keeping it there for long
>> periods, will make (for me) the most dramatic reductions in risk, i.e.,
>> reduce progressive diabetic damage the most.
>HbA1c is _correlated_ with risk of disorders. If you actively try to
>reduce your HbA1c, you may just be breaking that correlation rather than
>reducing the risk. Think of HbA1c as the temperature gauge of a nuclear
>reactor core. If the gauge tells you the core’s getting unexpectedly
>hot, you investigate why – there could be serious damage in there. What
>you don’t do is slam in a few control rods to reduce the temperature and
>then carry on as if everything’s fine. And you certainly DON’T
>"recalibrate" the gauge.
>> Chris Malcolm
Thanks Alan
Makes better sense than my response. The A1c, even the BGs, are readings
on instruments. They indicate a problem, but the actual harm is done in
many subtle and complex ways.
It’s like driving down the road; the speedometer tells you that you’re
driving dangerously fast, but it’s the sudden stop when you hit the tree
that does the damage.
Cheers, Alan, T2 d&e, Australia.
Remove weight and carbs to email.
—
Everything in Moderation – Except Laughter.