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Re: [IPk] microvascular complications

Tony, Why do you think they don't include weight as it is said to be a major 
risk factor? Carmel -definite no hoper grossly overweight type 1 43 yrs most 
complications developed before BG testing and HBa1c discovered ! trying to 
lose weight and thought this would happen with the pumpbut finding it 
depressingly slow---

>From: "Tony O'Sullivan" <email @ redacted>
>Reply-To: email @ redacted
>To: <email @ redacted>
>Subject: Re: [IPk] macrovascular complications
>Date: Sun, 6 Jan 2002 22:18:39 -0000
>I agree with Abigail here, the suggestion that glucose control doesn't
>matter in preventing heart disease is incorrect.
>The DCCT concentrated on microvascular complicatins because these happen 
>least to a level at which they can be detected and progression monitored)
>much more often in type 1. Heart disease is not common in young people, 
>with type 1 diabetes, so a short trial will only see a very small number of
>events in that category, and will not be able to show a difference even 
>it exists.
>Instead, to see the effect of high blood glucose on macrovascular disease
>risk (that is, heart attack, stroke, and circulation problems), we have to
>look at the bigger, more mature population with diabetes, those with type 
>Like the DCCT, the UKPDS looked at this group over a longer period of 20
>years, starting from diagnosis, so just like all of us, they were starting
>with 'primary prevention' in other words stopping the problem from
>developing when it wasn't already there.
>The UKPDS has been analysed in great detail, and many papers have been
>published. One of the recent ones picked out glucose control as an
>individual risk factor, controlling all the other risk factors like blood
>pressure and smoking, and the results of this are very significant. I've
>attached both summaries, and the UKPDS paper can be searched out in full at
>BMJ.com, but in essence it concludes that a 1% drop in HbA1c reduces the
>risk of a heart attack (myocardial infarction) by 14%, and the risk of 
>from a diabetes-related cause by 21%.
>While this study was of people with type 2, who are different in a number 
>ways, I feel that it still guides us in deciding whether it's worth
>controling our blood sugars well or not. The bottom line is, that while as
>teenagers we start concentrating entirely on glucose, as our risk of
>developing arterial disease rises, we have to start monitoring our other
>risk factors as well, not just the depressing ones we can't do anything
>about, like being male, from Ireland, having a family history OR having a
>murky past (!!), but the ones we CAN change, specifically smoking, BP and
>Here's an exercise for anyone over 30. Get hold of the latest figures for
>these, and click onto the risk calculator at :
>I like this one because it's motivating, it gives 5 and 10 year risk 
>and shows us what will happen if we redeem ourselves, (and believe me,
>no-one is beyond redemption). The HDL refers to one of several lipids
>besides cholesterol, but if you don't know yours, enter 1.
>One last thing. After you have viewed your risk level, try it again with
>diabetes clicked as No, and see what happens.
>[demime removed a uuencoded section named abstracts.doc which was 697 
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