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[IPk] RE:



Assuming you are not having excessive highs and excessive lows with your
BGL (and thus a non-representative/controlled HbA1C) - I should have
said (and apologies for not being very clear) that good control and
reduced risk of developing/worsening complications can be achieved just
as well at 7% as it can at 6%. Therefore you do not necessarily need to
run hypo levels to have "biochemically - excellent control' . All
clinics should look at HbA1C figures AND BG values to determine what
someone's diabetes control is like. Anyone who has to achieve lots of
hypos to get their HbA1C value down is not having what I have been
taught / experienced  - good control. This is based on the huge American
study called DCCT which according to my source contained data on pumpers
(the value she quoted was around 40%). 
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> Subject: Re: [IPk] Dusseldorf protocols
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> 
> . It is not necessarily about getting people to be near
> >hypo to achieve good hba1c. I believe anything under 6% does not show
> >any more improvement that achieving 7%.
> >
> Show improvement in what sense? Of course not show improvement in the
> long-term avoidance of complications, because that won't be able to be
> demonstrated for some time, and I don't suppose the comparative effect
> of 6
> versus 7% in that respect is worth researching at present, even if you
> could
> find a population for such a study. But I wonder if that observation
> will
> stand the test of time, as pump therapy, hopefully automated in the
> near
> future with the BG sensors which are being developed, is more widely
> used
> and lower hba1c values become the norm..
> 
> The reality is that "normal" BG is "near hypo" for an
> insulin-dependent
> diabetic. Nevertheless, consistent values in that range are required
> to
> achieve good hba1c. The value of the pump is that, with thoughtful
> management, it is the best tool available to avoid slipping into the
> hypo
> range, which I have personally found, with stress, to have the most
> disruptive effect on BG control, beyond exercise, diet and infection.
> 
> 
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