1/20 diabetics due from hypoglycaemia?

isjoberg

Well-Known Member
Messages
268
Type of diabetes
Type 1
i was looking up stats on deaths from diabetes, and two things struck me:
1) couldn't find any official statistics as it's normally the actual death rather than diabetes listed as the cause (e.g. Drowning after hypo) and the body continues to release glucose after death so you can never 100% say it was from hypos
2) supposedly according to a (I think) 2011 study, 1/20 diabetics die from hypos???

Second point really blew me away! And why isn't this information more available?
 

fletchweb

Well-Known Member
Messages
408
Type of diabetes
Prefer not to say
Treatment type
Other
i was looking up stats on deaths from diabetes, and two things struck me:
1) couldn't find any official statistics as it's normally the actual death rather than diabetes listed as the cause (e.g. Drowning after hypo) and the body continues to release glucose after death so you can never 100% say it was from hypos
2) supposedly according to a (I think) 2011 study, 1/20 diabetics die from hypos???

Second point really blew me away! And why isn't this information more available?

It's pretty scary isn't it. I've mentioned this before and I'm sure I'll mention it many times in the future because I often repeat myself too many times LOL - I was refereed to an Endocrinologist a few years ago because my Doctor thought I didn't have sufficient control. My A1Cs were in the mid 7s. My Doctor was and I suppose still is (I don't know, haven't seen him in 3 years) an advocate of tight control. My endo wasn't of that school of thought and said just keep on with the mid 7 A1Cs - he told me many of the studies that Doctors quote in support of tight control had been discontinued because of the high mortality of its subjects who died from hypos.
I'm not a conspiracy freak but I can't help but wonder if the tight control philosophy hasn't been perpetuated by the pharmaceutical industry as it increases sales of diabetes management products.
If I could establish A1C levels like those of a non diabetic without the risk of death from hypos I certainly would - but the risk is just too great and so far (51 years of type 1 with no complications) I'm not going to stress out with A1cs in the nid 7s.
And it saddens me to see doctors who seem to instill a type of \obsessive compulsive disorder on their diabetes patients to do what it takes to have perfect A1cs as a defensive measure against complications.
And like I said before you can show me the charts that show risk of complications and A1C levels but having a stats background - there are so many variables in play - there may not even be a direct correlation but it makes for a **** nice looking chart.
I'm not an expert, I could be very very wrong in my suspicions - but I don't think I am :). Historically this old adage seems to ring true particulary in the health industry - the Conventional wisdom of today is often the Tom Foolery of tomorrow.
 

Winnie53

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2,374
Type of diabetes
Type 2
Treatment type
Diet only
My friend died from a hypo. I get it.

That said, tight control makes sense for those with type 2 diabetes so long as they're not using insulin or a diabetes medication that forces the pancreas to make more insulin. Hypo's aren't a problem for them. This also can be accomplished with diet and exercise alone. So quite rewarding to do so. I know. I'm one of those people.

@fletchweb I'm impressed that you don't have any complications. What's your secret? What's your diet like? Do you take any nutritional supplements? How physically active are you? :)
 

fletchweb

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My friend died from a hypo. I get it.

That said, tight control makes sense for those with type 2 diabetes so long as they're not using insulin or a diabetes medication that forces the pancreas to make more insulin. Hypo's aren't a problem for them. This also can be accomplished with diet and exercise alone. So quite rewarding to do so. I know. I'm one of those people.

@fletchweb I'm impressed that you don't have any complications. What's your secret? What's your diet like? Do you take any nutritional supplements? How physically active are you? :)

I'm very physically active @Winnie53 and have been all my life - some would say I'm extreme - wilderness canoe expeditions where you push it to the limit, rock climbing, long distance cycling - minimal insulin in those situations unfortunately it's difficult to live that way all the time. When I was in my late teens I'd push myself to near exhaustion but I'm 55 now and still capable although the day will come where my activity levels will drop because of age.

I do those things because I feel absolutely wonderful when I do it. I kind of clued in on the idea studying indigenous populations of North America back in my University days (that was 30 years ago). I have friends and relatives (in-laws) who are Indigenous North Americans who find themselves in trouble because of the high carb over-processed western diet that they have grown up on Their ancestors had low carb - high protein diets - but today a very large portion of their population have either Type 1 or Type 2 diabetes.

We tend not to learn much from past cultures and practices and in my opinion, there is much to learn from the past. I site North American Indigenous people as an example but it likely applies to people of several different ethnicitys.

I don't have it figured out - to strip it down to the basics I do what makes me feel good and when I deviate from that I feel rather ******. Fortunately I've been doing that since I was a kid so it wasn't like I had to make any significant changes in my life.
The only time I found myself in trouble health wise was when my kids were toddlers and out of convenience my level of physical activity diminished and my traditional diet was replaced by fast food. That was a 5 year period 20 years ago and fortunately I was able to get back on track.

So I'm a firm believer of low carb high protein diets combined with physical activity. And yes - I do occasionally have chips with gravy, deep fried battered fish - but not everyday - just once in a while and of course my insulin consumption significantly increases to compensate for that.

I tried Vitamin D3 this winter because I live in a northern climate but the stuff I'm taking is made from Flax and that gives me serious gas and I'm not sure if it has been beneficial so I stopped taking it.

I don't know what it's like to be Type 2 but the type 2s that I personally know got in trouble because of their high carb high calorie diets and their conditions radically improved when they went to low carb combined with an increased in cardio vascular activities.

So maybe that has contributed to my success with a lack of complications - I can't say with absolute certainty but I suspect it has played on the positive side of things.

Mental Health is also very important - and I think my optimism and trying to live a simple life has maybe contributed too.
Or it could all be in my head and I could have been dealt some good genes. I've been working on my family tree and have it as far back as 1806 - in spite of the times most of my ancestors lived to be very old, On my dad side of the family they were coal miners in Yorkshire and they all lived in to their 8os - I knew my Great Grandfather, my dad is currently in his 80s - unfortunately my mom died young at 68 but she was an exception.

A lot of this is speculation and theory and probably will remain so.

I hope I haven't cursed myself :)
 

Winnie53

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2,374
Type of diabetes
Type 2
Treatment type
Diet only
Very cool. :)

I've tried making diet alone work. I eat very healthy - (low carb high fat in the 50 g range with a nice mix of animal and plant foods) - but my glucose levels creep up if I'm not physically active. Thanks for filling in the details. I enjoy meeting people with diabetes who are thriving. :)
 

tim2000s

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8,934
Type of diabetes
Type 1
Treatment type
Other
My endo wasn't of that school of thought and said just keep on with the mid 7 A1Cs - he told me many of the studies that Doctors quote in support of tight control had been discontinued because of the high mortality of its subjects who died from hypos.
Fletchweb, we've mentioned this before. You are quoting REALLY BAD SCIENCE here. None of the studies that have been done were stopped due to high mortality from subjects dying from hypos.

The one study that was ended early was the ACCORD study in 2008, which looked at Cardio Vascular Disease in Type 2 diabetes and treated one cohort normally and the other cohort intensively. The statistics that were published showed that as Hba1C levels lowered, mortality increased. This is not the same as people dying of hypos. Of the intensively treated cohort, 92% were taking Avandia, a drug that has since had its license revoked in most of the world in 2010 due to the significantly increased risk of heart failure that it introduced.

Two studies directly counter these theories. DCCT and EDIC. The DCCT study demonstrated that a lower Hba1C level was directly correlated with reduced relative risk of complications compared to a non-diabetic and approached the same level when you got below 6.5%. As the data from the ACCORD study was analysed, the link that was found between Hypoglcyaemia and Death was not what was expected, nor what you are describing. Hypoglycaemia correlated with death where Hba1C levels were higher than 7%, not lower.

The EDIC study, which followed up with 90% of the participants showed that for a large proportion of the intensively treated group, cardiovascular events were reduced, along with plenty of other complications, well beyond the end of the DCCT study.

Intensive blood glucose control reduces risk of
  • any cardiovascular disease event 42% reduced risk
  • nonfatal heart attack, stroke, or death from cardiovascular causes 57% reduced risk
I'm very pleased for you that you've achieved 51 years with no complications with your A1C in the 7s. That's fantastic, but I do think you are constantly overstating the risk of death from hypos for those who are achieving levels well below yours, which I don't think is helpful. If people are achieving Hba1Cs around 6% without severe hypos, the risk of death from hypoglycaemia simply isn't high.

If we look at the numbers the OP presented, if 1 in 20 type 1 diabetics die from Hypos, I assume this is annually), that would be a net reduction in people living with type 1 of about 22,500 a year in the US (1.25mn people in 2014, with 40k new diagnoses). Given that the number of T1s is increasing, this seems to be incorrect.
 
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fletchweb

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Fletchweb, we've mentioned this before. You are quoting REALLY BAD SCIENCE here. None of the studies that have been done were stopped due to high mortality from subjects dying from hypos.


If we look at the numbers the OP presented, if 1 in 20 type 1 diabetics die from Hypos, I assume this is annually), that would be a net reduction in people living with type 1 of about 22,500 a year in the US (1.25mn people in 2014, with 40k new diagnoses). Given that the number of T1s is increasing, this seems to be incorrect.
I'm not telling anyone to do anything - I don't want that responsibility, I'm just relating my life story, I hope I didn;t offend anyone, that certainly was not my intent ... I think it's time I probably shut up and go on my way....
Cheers
 

tim2000s

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Type of diabetes
Type 1
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I'm not telling anyone to do anything - I don't want that responsibility, I'm just relating my life story, I hope I didn;t offend anyone, that certainly was not my intent ... I think it's time I probably shut up and go on my way....
Cheers
As it happens, your dietary and exercise approach isn't that far from mine, I just target a lower average glucose level. I've also been fortunate not to have major issues with severe lows.