Confused

Hey Russ!

To put it bluntly, unless there are some overriding reasons why you should run your BGs higher, your GP is talking rubbish :evil: I had the misfortune this week to see a GP who told me I should always keep my levels between 8 and 9 to avoid hypos. This advice is absolute nonsense.

It CAN be dangerous to reduce your BG levels too low if you end up with lots of hypos, but your HbA1c of 6 was not too low. I try to get mine in the 5s.

I am flabbergasted at the rubbish these GPs talk. Make frequent visits to this forum if you can - there are some very experienced diabetics of all types on here who give very good advice. Also, consider changing your GP to one who has a clue or asking for a referral to a specialist.

Smidge

What your doctor was quoting was a study that showed people on insulin had a better morbidity rate if their HbA1c was higher than 7 rather than lower. There was a fairly long thread on here about it. Most of us felt the study was flawed. Providing the insulin user is "safe" from dangerous hypos, how can it be better to run that much higher than a non-diabetic? On the study, what were the people actually dying from? What other factors did they have in common?
Personally, rather than using "i'll take you off insulin" as a punishment, I'd consider "if I got my diet right and my HbA1c low enough, could I come off insulin onto other simpler meds?" as a reward! You may of course wish to be on insulin, and if so that's fine, but I know other type 2's that were on insulin that got themselves off it. Fergus Crawford was one I believe, Sid Bonkers was on insulin for a while and came off, I'm sure there are others. So maybe you have a choice.
Overall, every bit of common sense says that the lower the HbA1c the better. A higher acceptable level is better for the doctors; easier to get patients there, no danger of hypos so no come backs, less people troubling them asking how to get them lower, and so on. At a time when the NHS is saying should HbA1c's be higher, the rest of the world (USA, canada, Australia, new zealand) have lower targets than we do. USA endocrinologists say below 6.5, USA diabetes association say lower than 6.0 "if safe" (or might be the other way around, but you get the picture)
Good luck!

Hey sheep

Quote your totally out of date doc this..

A recent observational UK General Practice Research Database
(GPRD) study has reported increased risk of total mortality with
lower HbA1c with lowest risk for HbA1c 7.5%, and also a 49% higher risk of total mortality with insulin treatment versus oral agents .

However, this was not verified in the NDR study, showing no
J-shaped risk curve for total mortality in patients treated with insulin or oral agents, and that the increased risk of total mortality with
insulin was due almost exclusively to an increased risk of non-CVD
mortality, and that HbA1c was not at all associated with non-CVD
mortality

Click to expand...

Comes from a Swedish Healthcare doc drawn up last year as a basis for their diabetic care. It's the doc that I base all my personal healthcare targets on. Effectively it says the UK people who did the study badly mucked up the interpretation of the data they used.

Who do you believe? A healthcare service that's based on modern 21st century studies and advocates a diet near enough all of us on the forum knows to work (some form of low starchy carb diet) or a healthcare system that hasn't bothered to update its diet in 30 or 40 years.

The full doc in English is here:

http://www.healthcare-bulletin.com/...ascular_Disease__in_Diabetes_Care_-_2011_.pdf

There is (in another study) some evidence that survivability rates are slightly better in people who maintain stable BG's (not too peaky or spiked) over those who are less stable but have a SLIGHTLY lower HbA1c

As Grazer said, I am one who has escaped the clutches of insulin , and still got Hb1Ac in 5.s .
Now on tiny amounts of gliclazide as I cant have Met (wife says I'm windy enough :lol: )

Hi. I agree your GP appears to be saying some strange things. As for ignoring food GI and eating what you like its nonsense. Although you can increase insulin to match carb intake if, for example, you doubled both you would double your swing towards a hypo or the other way; not sensible. Eating Low-GI food is good advice for everyone let alone diabetics. It's amazing what the NHS can profer as good advice. As for insulin my GP won't let me have insulin 'cos it's a last resort yet other GPs offer it very early on; it's a lottery. The NHS Diabetes and NICE guidelines are very sensible on the subject so have a look at these if you haven't already. These are aimed at NHS Diabetes professionals so by definition it's what you should be hearing from them.