@Spiker,
I hadn't seen that observation about 95% of T1s not achieving a good enough HbA1c, and it rather horrifies me, particularly as I'm starting to realise how unpredictable bolus-ing is going to be when I have to do it. I'm having difficulty understanding it. And please, what IS the reason?
Lucy
First the NICE target is
Targets for clinical monitoring
HbA1c < 7.5 %
If increased arterial risk: HbA1c = 6.5 %
In England, the percentage of adults under 55 with T1 who achieve the 7.5% target is 34.8%
6.4% achieve less than 6.5%
The figures for the over 55s at 35.7% and 9.2% are slightly better.
I think there are a lot of reasons but thinking of Scardocs post I looked to see if I could find anything on' compliance'
The only figures I found were from a 2006 international research project from 13 countries. This including 250 T1s from the UK but the results are aggregated from all the countries involved
There were 19.4% of them who self reported compliance with their HCPs recommendations for diet, exercise, medication taking, glucose testing,
Doctors estimates were somewhat lower 7.3% for T1
There were lots of people reporting various feelings of distress and depression, with almost half defined by a WHO as having 'poor' wellbeing. There was linkage between what they termed poor adherence and psychological problems. but very few got any help with these problems.
They also noted that feelings at diagnosis seemed important, a ' poor' reaction tended to produce poorer quality of life, less adherence etc (that seems to me to be an time when people need a lot of help and support and often don't appear to get it)
http://spectrum.diabetesjournals.org/content/18/3/136.full
Other things I've read in the past are more general, ie educational level plays a part particularly arithmetical skills; you actually need a relatively high level of numeracy to calculate carbs and adjust insulin doses
The other thing is that there is a lot of evidence that people from 'higher' socioeconomic levels seem to do better on almost all measures (that's not just in the UK but I've read US and German research demonstrating that.
One last thing in the UK there are marked differences between PCTs/areas as to how many patients receive all care processes from their GPs) (edited spelling)
http://www.hqip.org.uk/assets/NCAPO...cess-and-Treatment-Targets-published-2012.pdf
(agh.............. that's not the latest report, sorry I don't think there are that big changes though)