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Re: [IP] a1c tests

Andrew B <email @ redacted> wrote:

> Our lab does our own tests by hemochromatography  and I often check my A1c
> there. It is usually dead on balls accurate with Quest diagnostics and I have
> also used it for my rats. Retinopathy and nephropathy can progress despite
> great A1c values. 

This points out an important aspect:  good control reduces the *risk* (a special circumstance of probability) of developing complications.  Some people with excellent control develop complications, and some who never even try for good control have no complications.  

While your lab appears to have all of the pieces in the right place, I'm sorry to say that this is a great rarity.  There is a major move going on in the clinical laboratory industry to develop more and more waived laboratory tests (a waived test is one that can be done without training by someone with a seventh grade education, and that in clinical trials has demonstrated that the results are within 5% of a standard 50% of the time - the same as our home test meters, and therefore the requirement for ongoing proficiency testing is waived).  In addition, there is a big lobbying effort by the clinical lab industry to make more and more current tests waived, including some critical tests for HIV, etc.

> there are other factors less well understood in the
> progression of these diseases. the A1c is often held up as a standard for
> patients to match but it is often not the whole story. I agree that bad docs
> use this to the exclusion of everything else. a good doc will spend a few
> minutes talking to you, look at your eyegrounds, check you thyroid, check your
> thyroid, phsically examine you with their hands, perhaps talk with your spouse
> or so. check your pulse and blood pressure. Sadly most new docs don't even
> know how to examine a patient. the art of physical diagnosis is poorly taught
> in med school these days. Most docs look only at lab tests and not the
> patient. spot

Any ideas of how to counter this trend, Spot? 

Jim Handsfield
mailto:email @ redacted

The opinions expressed are mine and do not necessarily reflect those of my wife who runs this house and makes more important decisions than I do.
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