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An interesting article on types.

Discussion in 'Diabetes Discussions' started by kev-w, Mar 5, 2020.

  1. kev-w

    kev-w Type 1 · Well-Known Member

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  2. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    I concur with you, it was an interesting and an informative read, especially the big difference in BG levels regarding type 1 and type 2.
    Thanks for posting.
     
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  3. porl69

    porl69 Type 1 · Well-Known Member

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    Yep, a very interesting article and thanks for posting @kev-w
     
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  4. Jaylee

    Jaylee Type 1 · Moderator
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    Fascinating article.. Though. Unless I've read this quoted below wrong?

    A majority of T2s diagnosed may not even exceed the "7.5%" A1c to start with?
    Lol, unlike the "rocketeer" of discovering the world of T1 & maintaining stability..

    & isn't the ideal target range these days 6.5%?

    "If one looks at outcomes, the proportion of the Type 2 diabetes population achieving HbA1c<7.5% stands at nearly 66%. This is testament to the work done by primary care. It is also an outcome which other countries would struggle to achieve – especially when one factors in added issues such as frailty, multi-morbidity – where higher HbA1c would be clinically appropriate.

    However, when one looks at Type 1 Diabetes, the achievement is around 30%which reflects not only the different pathophysiology, but also the need to clarify to all concerned the need to improve outcomes in this group whose pathology, treatment and care can all be fundamentally different."
     
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    #4 Jaylee, Mar 5, 2020 at 12:24 PM
    Last edited: Mar 5, 2020
  5. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    There is a huge variation in 'target ranges' depending upon T1 or T2 and whether the organisation 'setting the target' understands the amount of control gained through dietary measures such as Low Carb. So for UK a diet controlled T2D, 5.9% or lower should be the target.

    But you are correct that 6.5% (=45 mmol/mol) is the UK borderline between pre-Diabetes and Diabetes.
    The DCUK hba1cunits converter has the borderline between amber and red zones at roughly 10% (=86mmol/mol)
     
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  6. Jaylee

    Jaylee Type 1 · Moderator
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    Yep, appreciated. The closest to a normal A1c (if not bang on.) the better.. :)

    Speaking souly as a T1 the ideal target up untill (aprox.) 2015? Was 7.5% after some dodgy numbers in my teens & 20s I pulled my self inline & even achieved lower. I was getting 6to .5 on annual reviews & choused at by DSNs exclaiming I must be suffering from "too many hypos." & hand wringing that my "awareness must be going.." Not at all. & I was having no more hypo events than usual..
    Sooo, with my focus at the time on preserving my privelidge to drive, thus staying in gainful employment. I let it slip & was tested at the 7.5% mark..?

    ....... Until about 5 years back. Then they lowered the T1 pedestal for the "pat on the head." "Keep doing what you do." Award. :banghead:

    In short, I'm a little bemused at where the author of the article got the figures from..?
    "7.5%" for T1s was an old rule of thumb going back 5 years. Then in 2018 GDPR was implemented? The data protection act was certainly put into practice in the months if not a year leading up to the date.

    I would suggest not "fundamentally different" But possibly individual..

    Lol, wherever the numbers came from, these sensors have made a difference. (I fund my own.)
    I just wish my endo didn't keep postponing my appointment so I can finally get it on script. ;)
     
  7. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    The problem as I see it, is there is no context for 66% achieving a hba1c of 7.5%

    I'm guessing this is a post diagnosis number, but how long after? This doesn't seem to indicate how that number was achieved. Is it by drug therapy? And that's a whole another discussion in itself. Someone can point it out if I missed all of that. IMO - 7.5 is hardly a success story, but it could be much worse of course. 6.5% is the cut point for whether you are diabetic of not in t2.

    It is an interesting read. But stats are stats, and individual care varies greatly. Given that, I have little faith in stat based articles where numbers are the focus and somehow everyone either fits into a stat check box or doesn't. Social stigmas on these two conditions are easily forged in this manner.
     
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  8. kev-w

    kev-w Type 1 · Well-Known Member

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    That pre diabetes one's an odd one as my last hospital one was 6.1%, I say 'odd' but I say it with a smile having been T1 for 35 years :) time in range is the new big thing....
     
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  9. therower

    therower Type 1 · Well-Known Member

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    You must be a pre diabetic diabetic then.:woot::woot:
     
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  10. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    I'd agree that we don't know much about how that 65% achieved their numbers or when they did so.
    Also, it has been shown that for type 2 being compliant with the hba1c target by using insulin or sulphonureas that encourage the pancreas to produce more insulin, won't prevent adverse outcomes such as heart disease and I assume that type 2s only care about their JBA1cs if better control stops them getting diseases of their major blood vessels.
    If someone is making abnormal levels of insulin as well as having higher bgs then a better target would be to increase their insulin sensitivity as well as their bg control early on in their diagnosis and that means a dietary solution and not drugs beyond metformin .
     
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  11. kev-w

    kev-w Type 1 · Well-Known Member

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    :) Aye, but when you have the conversation with a non T1d mate "so you're at pre diabetic levels' 'yes mate' 'so why do you have so many injections when you've not got IT yet? :banghead::banghead::banghead:'
     
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  12. Jaylee

    Jaylee Type 1 · Moderator
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    "Prevention better than cure?" :p

    Yarp, I get the, "there's a pump thing that can do it all for you. You don't need to inject insulin."
    My reply is always the same. "Realy?! Could you explain what a pump does?" ;)
     
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  13. JohnEGreen

    JohnEGreen Other · Master

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    It sucks out sugar.:)
     
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  14. kev-w

    kev-w Type 1 · Well-Known Member

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    The thought of using a pump scares the four letter words out of me as far as it goes, although those 'closed loop' systems do appear to be very good.
     
  15. Jaylee

    Jaylee Type 1 · Moderator
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    The tech is pretty cool from what I've seen. & some of it comes in black. :cool: All modern & don't looks more like an MP3 player?
    Was at a T1 meet up with @Juicyj & @MeiChanski a while back. Checked out some nice kit.

    However, with what I do. I would be concerned about messing it up. Have enough trouble with chorded headphones.. :banghead:
     
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  16. porl69

    porl69 Type 1 · Well-Known Member

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    After 48 years of injecting, a pump scared the you know what out of me as well BUT it is the best thing I have done in my type 1 life :)
     
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