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Re: [IP] A1C question

email @ redacted wrote:
>  An endo talked at our last
> support group meeting and said that if your a1c was 6 or 10 and your bgs go up
> and down, then the a1c result is irrelevant.  I was surprised by this
> statement because I thought the DCCT showed that a low a1c prevented
> complications.  According to this endo, it is NOT the low a1c, but the
> consistency of relatively normal bgs.  If this is indeed the case, then why
> are most endos (mine for one) only interested in that a1c result and not very
> interested in those day to day bgs.  The endos and we should be concentrating
> on the bgs and NOT the a1c.  Again, if this is true, then the a1c is not very
> important in the BIG picture.  I want to prevent those complications and my
> a1c is good at 6.0, but I do have alot of fluctuation from exercise.  Am I
> just as likely to have the complications as someone with an a1c of 10.0?

I don't know if anyone really knows the answer to this, but I CAN tell
you that my A1c does not reflect my actual BGs, and gives a falsely good
picture of my control. My A1c always implies an AVERAGE BG that is lower
than any of my actual BGs, tested any time of the day or night -- there
is no way it can be correct.

So I ignore the A1c -- it's meaningless -- and concentrate on keeping my
BGs as close to normal as I can. That doesn't mean normal all the time,
not by a long shot, but in the end, I think you have to be fatalistic --
you do the best you can, and then don't worry about it -- SOMETHING is
going to kill you in the end, anyway!

As far as endos only concentrating on A1c, I agree, they do that, but
then I don't think they know everything there is to know about DM -- all
they can do is read statistics, and statistics tend to wash out
individual differences. They also say nothing about factors that aren't
factored in!  So, yes, the group with the lowest average A1c DID have
fewer complications, but that doesn't say anything about any given
individual -- and it doesn't say anything about the RANGE of BGs anyone
was experiencing.  

Seems like common sense to me that if non-DMers don't have diabetic
complications, then keeping one's BGs as close to those of non-DMers as
possible would HAVE to be a positive thing to do -- and there still
aren't any guarantees!

Good luck!


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Natalie A. Sera, with all her ducks in a row!
Type Weird, "official" insulin start-up next Wednesday!
mailto:email @ redacted

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