Snodger said:I've had 'bad' hba1cs and 'good' hba1cs, difficult times and easy times. I would never post the result here either way because it's private to me.
I think there are several things going on with 'poor control' and motivation. And everything I'm about to say is about T1s coz that's all I know.
1) Some people's diabetes is harder to control than others'. If you are lucky enough to be unaffected by monthly hormone changes, you don't have dawn phenomenon, and stress doesn't make your bg rise (or you have no stress) then you will find it much, much easier to manage than someone who is affected by those things. Doesn't mean you are lazy or 'poorly controlled', it means you are trying your best and it's just harder for you.
2) Some people's lifestyles make it harder to control. If your boss can send you off on an (physical, exercisey) errand at a moment's notice, if you have to do a lot of driving and need to ensure you are safe, if you are looking after kids or other people, it's going to be a lot harder than if you are sitting around on your backside (like me) with no dependents and controlling every single minute of your own day (control's so much easier for me now than when I was running around after an impossible boss).
3) I'm sure there are people on this forum who have fabulous HbA1cs, and I'm really glad for you if you do, but the majority of Type 1s - even motivated, educated Type 1s - are stuck at around 8%. Our bodies are broken, it's not our fault. You all know I'm sure about the DCCT, the huge trial that everyone references when they say 'good control leads to fewer complications'. The 'good control' group were given intensive therapy and tons of support and education all the way through the trial, but even they couldn't get to the targets they were given. Ten years after the trial ended, the educated, motivated 'good control' group's average HbA1c was back to - guess what - 8%. (they started at 8.8% so it was a slight improvement!) I have yet to find a study of T1s that shows hba1cs of under 7.5% being maintained long-term, and IMO that's because it's just not possible for most of us. (If you know of one please let me know).
So, I'm with the posters in this thread who are against the scare tactics. Being told you are controlling your disease 'poorly' and told about the horrible things that will happen to you if you don't shape up is a terrible way to motivate people. Especially if the targets are just out of your reach however hard you try.
Snodger said:I've had 'bad' hba1cs and 'good' hba1cs, difficult times and easy times. I would never post the result here either way because it's private to me.
I think there are several things going on with 'poor control' and motivation. And everything I'm about to say is about T1s coz that's all I know.
1) Some people's diabetes is harder to control than others'. If you are lucky enough to be unaffected by monthly hormone changes, you don't have dawn phenomenon, and stress doesn't make your bg rise (or you have no stress) then you will find it much, much easier to manage than someone who is affected by those things. Doesn't mean you are lazy or 'poorly controlled', it means you are trying your best and it's just harder for you.
2) Some people's lifestyles make it harder to control. If your boss can send you off on an (physical, exercisey) errand at a moment's notice, if you have to do a lot of driving and need to ensure you are safe, if you are looking after kids or other people, it's going to be a lot harder than if you are sitting around on your backside (like me) with no dependents and controlling every single minute of your own day (control's so much easier for me now than when I was running around after an impossible boss).
3) I'm sure there are people on this forum who have fabulous HbA1cs, and I'm really glad for you if you do, but the majority of Type 1s - even motivated, educated Type 1s - are stuck at around 8%. Our bodies are broken, it's not our fault. You all know I'm sure about the DCCT, the huge trial that everyone references when they say 'good control leads to fewer complications'. The 'good control' group were given intensive therapy and tons of support and education all the way through the trial, but even they couldn't get to the targets they were given. Ten years after the trial ended, the educated, motivated 'good control' group's average HbA1c was back to - guess what - 8%. (they started at 8.8% so it was a slight improvement!) I have yet to find a study of T1s that shows hba1cs of under 7.5% being maintained long-term, and IMO that's because it's just not possible for most of us. (If you know of one please let me know).
So, I'm with the posters in this thread who are against the scare tactics. Being told you are controlling your disease 'poorly' and told about the horrible things that will happen to you if you don't shape up is a terrible way to motivate people. Especially if the targets are just out of your reach however hard you try.
DannyH said:Thanks for replys and interest, in a way your keeping me doin what iam doing, right lets kick this one off.. the specialists out there can diagnose alot of things but they cannot predict which diabetic or when complications can occur.. why? they seem to have the results if your HBA1c is above this percent your have x percent geting this complication. Iam saying now its ****. yes your sugars according to the bossses should be 4/5 percent the normal average...but i still dont care what there saying that may be a true result. Let me give you an example, a type 2 with a constant result of lets say 7 percent HBA1c sounds good dont it? with a type 1 with 7 percent that to me sounds exactly the same dont it?? no its not most of the the time and iam willing to stick my neck out type 2s would probably stay in that region for most of the time to get that result...and for some type ones they would be hypoing and going abit higher, so whats best control?? well i say and i know its a type one discusion but id say type 1 why?? i feel having hypos for type 1s is generally good as long as you dont have severe ones and can control them. what i mean is your hba1c results is the amount of **** that sticks to your stuff, if your hba1c is at a constant that is sometimes high that would cause more damage surely than another diabetic that sugars sore high and come crashing down. that means the sugar hasnt got time to fix on the walls etc. and for my opinion its good in a way to hypo but it depends how strong it is, as i have 2 injections a day there very slow but not only that when you have an hypo i read somewhere your liver kidenys dump out some glucose to keep ya ticking over so even that seems a good idea... one of your organs is geting rid of of sum old s*** then it will stock pile it. jesus i can rant but a food for thought is someone that never hypos alot how can there body kick out the sugars that are sitting there for days weeks or months on end
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