Fair enough....I think the man was making the point that if you didn't have a CGM then you had the problem so rush out and buy one.
@pavlosn I though we have already done this?
from your study when you take out the people who have hepatitis C.
people 4 - 4.4% have the best chance of living
model 4.... 0.92
You say 'none diabetics don't get them'
I would be dancing naked in the snow if I got a 38.Please, if ever I do get to 38, don't hold me to it!
I was referring to all cause mortality and I actually sited three separate studies ( none of which I claim as my own)
But returning to your point it is important to note that the expected relative risk factor for the 4- 4,4/ group was 0,92 compared to the reference group's of 5-5,4% of 1 I.e. An expected improvement of 0.08 for a non diabetic. Within the 95% confidence level this still allows a range of relative risk factor for the lower group of 0,5 to 1,62.
In order to get to the 4-4,4% group from a 5- 5,4% starting point one has to pass through the 4,5-4,9% band and this does have a worse expected risk factor at 1.06 than the reference 5-5,4% band ( 95% confidence range for the 4,5-4,9% band 0,78-1,42)
Out of the 14099 original participants only 469 (3,3%) fell in the 4-4,4% band. The study explicitly states that a higher proportion of hepatitis C sufferers fell in this band. So as a proportion of the total sample in model 4 which excludes hepatitis C, they must represent an even smaller percentage.
So by the above:
If I was a non diabetic and somehow managed to lower my hba1c from 5-5,4% all the way to 4-4,4% I would expect to lower my expected mortality risk excluding hepatitis c by 8 per cent. But if I missed my target and ended up in the 4,5-4,9 range I would expect to increase the same risk by 6%.
But I am a diabetic.
Only a tiny percentage of non diabetics manage 4-4,4%. Is it realistic to expect me or any other diabetic to match them.
Even the reference 5-5,4% is a tough ask for most diabetics. In order to go even lower would require greatly increased medication or dietary restriction. Any additional risk associated by such increased medication or dietary restrictions is not captured by the above studies which concentrates on non diabetics.
yes, but we would need to find that study and see what and why things were said and measured, before we took at face value all diabetics should be 5-5.5 which is the range of good heart stuff@jack412
As I recall our last discussion ended prematurely by both of us being brought to line by a moderator for hijacking someone else's thread, which was probably fair enough I suppose.
The subject resurfaced in a recent discussion in the "t2 what was you reading in the morning" with a couple of members expressing disappointment with their doctors, who asked them to actually aim for higher hba1c scores.
In fact what pushed me to open the thread was the following slide
View attachment 9558
Taken from a video link you yourself posted to miked earlier today of a lecture on glucose and lipid blood test measurements.
I feel that this is an important subject, one that deserves its own thread where more people will have an opportunity to participate in the discussion.
Regards
Pavlos
4-4.4% is all-cause mortality, minus hepatitis C, a bump between that and 5.5 shows the variance within a population who die in 8 years of study, you are taking it as an absolute.
I'm struggling to see what you are trying show?
as to your "My concerns were compounded by reading stories of other non insulin dependent t2s that on recent visits to their doctors were advised to raise their hba1c scores from under 6% (42.1 mmol/mol) to the 6-6,5% (42,1-47,5) pre diabetic range. Advise that did not make sense to me but which I did not immediately dismiss because I am not a doctor and they are, so they must be basing it on some kind of evidence and research."
the diabetic got advice meant for insulin or hypo inducing meds without those meds you can have 4%
stating to take everything a dr or nurse says as right can be dangerous
Who was it that said that?
According to my nurse anyone can go hypo although in a healthy person the body makes a recovery without help. A healthy person is unlikely to go hypo so badly and so often as to affect the Hba1c whereas a person taking medication can.
It was doglas99 who said that!
Sorry squire, your post squeezed between mine and his post!
have a google for optimum control, it isn't 6.5 or 7.5,
Jackyes, but we would need to find that study and see what and why things were said and measured, before we took at face value all diabetics should be 5-5.5 which is the range of good heart stuff
We are all different and unique, depending on complications there can be no exact figure for optimum control!But does google say it's 4?
No argument from anyone that once you are above diabetic levels or even before, risk increases with Hba1c so in practical terms the advise is that you should keep it as low as possible especially if you can do it without high doses of medication.Ok I think I've got it now!
But I do and would get the complications of higher blood sugars.
I'm not diabetic!
No argument from anyone that once you are above diabetic levels or even before, risk increases with Hba1c so in practical terms the advise is that you should keep it as low as possible especially if you can do it without high doses of medication.
Even better advise would be to not become diabetic
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