Thank you for your reply
@pollensa and I hope you will still read what is on site. Your argument about laboratory cut-offs is at the heart of medical science seeking certainty in what is a spectrum of the human condition. I find this paradoxical when one of the so-called highly valued attributes of doctors is the ability to tolerate uncertainty !! Far better that repeated-at-intervals tests and assessment, some maybe office-based, others home-based (e.g.weight), tests that health-based interpreters are trained to assess on trends and all known factors about an individual person, might be used to gauge, in full discussion with the individual person, what might be a suitable change in lifestyle, diet etc, measures proven to effect outcome positively. That might be an ideal, of course, but hopefully would dispel the cut-off nonsense. Repeated results suggest a trend which can be addressed sensibly without agonising over figures as though it is a pass-fail exam. A change to the way health professionals are taught and trained, and how much exposure they receive from health care consumer views during those critical years, will likely involve a paradigm shift. But one has to start somewhere !!
Hello Kitedoc. Yes, I may pop on and view now and again.
Your info presented, well said. The nonsense of cut offs i.e. vary, irregularity arbitrary set, great concern, again I am minority thinking on this concern and question this situation often. I give example which is a real situation and facts, would be interested anyone out there to hear their views when a situation arises as experienced, as I am sure it must affect many others in the same way yes or no?
British yet residing spain, followed trusted the recommended guidelines UK cut off system, which included what was shown on this informative website, the site, showed
- Fasting guide level showed to be below 108mg/dl, below this indicates one is normal range. I based my results on this cut off number.
- In Spain cut off fasting is 70 to 110mg/dl. If one is in this range, you are normal range. I followed the British cut off. For over a year, 108mg/dl guide, resulted my tests fell below this cut off and were indicated normal range.
Suddenly 108mg/dl guide, changed on the website? to show it had lowered from 108mg/dl to now 100mg/dl.
That lowering of number resulted normal results that ranged generally between 89 to 103mg/dl fasting, now if numbers hit range 90mg/dl to say 100mg/dl or 101, 102, 103, now become Pre diabetic range? as I understand.
One year one can be normal, a sudden change lessening of a number 108 to 100mg/dl can make a dramatic change as guideline for one to base their results upon.
However, As my numbers are below 110mg/dl in Spain, of course, I am classified as normal range, compared to now UK nodue to change of cut off level overnight basically, I change from Normal to Pre diabetic, I do not see the good medical sense when such situations are real and facts that are taking place to suddenly become normal range to pre diabetic. I had a great surprise when I saw the 108mg/dl had been reduced to 100mg/dl fasting on the sight, and at first, I felt a typographical error had been in place, on enquiries to clarify, it seemed no error in place explanation presented.
I am not saying UK change guidelines are wrong, they simply follow decisions of recommendations, that differ say to other countries. No one is wrong, all countries follow their own rules criterias accordingly, but results in one becoming victim of these variations of cut off situations inbeween.
My question is, should such situations be in existence that a lowering of a number changes all, no doubt adds anxiety stress and unwarrented worry and disappointment, that one can feel happy due to their efforts to control, and then find overnight, they suddenly become a different category, I cannot see a sound reason as to how such a situation of lowering of number changes by the so called experts can take place with this in mind.
Differences of diagnosing A1C cut offs.
A1C New Zealand to my understanding if I am not mistaken are as follows as I read on their website and differ to other countries for example.
40mmol/mol equal to or less. 5.8%
Virtually excludes diabetes non diabetic range. No need to repeat A1C
41/49 mmol/mol equal to or less 5.9% to 6.6%
Abnormal glucose tolerance pre diabetes range. Recommended diet lifestyle changes and assess manage all CV risk factors. Repeat A1C annually, unless symptomatic in interim.
50mmol/mol equal to or greater 6.7%
Supports diagnosis f diabetes in asymoptomatic people must be confirmed on a second A1C sample after aninterval. Recommended diet lifestyle changes and assess manage CV risk factors, start regular retinal urinary microalbumin, renal function and foot screening
Whether one agrees with these cut offs or NZ is right or wrong in their viewing, at least they explain clearly and simply how their criterias function. i.e.
I find it welcoming personally, New Zealand explanations guides, leaves one with no doubt as to their range, for the fact, they clearly demonstrate and make it clear, "equal" to or less or "equal" to or greater. for example, on their cut off for diabetic, if one is sitting on the 6.7% New Zealand cut off, one would be viewed as Pre Diabetic range, if greater i.e. 6.8% or more, supports diagnosing of diabetes.
At least to indicate equal to less or greater, takes a certain doubt away for persons results, I am not saying NZ are right or wrong, only speaking about how cut off ranges compare and due to this, hence not a doctor, yet feel overall the Diabetes world industry, should perhaps,provide more clearer information readily available re cut off situation, the world should follow one strict guideline cut off for all, perhaps that would be a good start....and make a decision as to what happens if one is actually sitting on the chosen cut off, as to what category they fall into, NZ makes it very clear in their, perhaps also the guideline makers decision makers should a leaf out of the book of New Zealand regards the situation of when one is actually sitting on the cut off number whatever that may be.
Your post of information is excellent surrounding information and comments.
Mallorca.
