Have the rules changed again, or am I out of date?

[markd]

I've been very happy with my OneTouch Ultra, until I dropped it once too often. I bought an Accuchek Aviva Nano, since my local Boots didn't have stock of the OneTouch,c or I'd probably have not changed.

Looking at my graph, the change in meter doesn't seem to have made any difference, BUT the strips are more easily available and cheaper (locally, that is, no need to buy online). I just picked up a new tub of 50 strips from Boots (only £12-98!!!) and have been reading the included paperwork.

Up to now, I've been operating under the assumption that normal non-diabetic fasting range was 3.5 - 5.5.

The insert with the strips quotes normal non-diabetic range of 3.5 - 5.3; is this peculiar to Roche, or have I been misleading myself this last couple of years?

Mark

 

[hanadr]

5.3 or 5.5? That's well within the range of variability of the meter. If you keep below either, there's very little difference.

 

[markd]

I'm not so much concerned about my levels - fasting still stays in the mid-4s.

It's just that the Roche 'normal' is different to what I had been working to.

mark

 

[Dobbs]

boy, Mark, I wish I had your worries!

 

[hanadr]

Mark
Normal ie non-diabetic blood sugars are much lower than most people think. In Dr. Bernstein's diabetes solution, He states that he tests non-diabetic visitors to his office and almost always finds the reading 85( translates to 4.7). He also now says that an ideal Hb A1c is probably aound 4.2%.
The numbers quoted for diabetics come from many sources, some are nothing whatever to do with health. One set of numbers( i think Bg 7 among them) was instigated in the USA to protect people from a formal diagnosis of diabetes, which might cancel their medical insurance. Some of the others are based on what is thought "achievable". Very few studies have ever been done on non-diabetic people.
I believe that there's one somewhere done by Abbott Diabetes Care in Germany. I encountered it and haven't been able to find it again.
I personally don't go by the DUK guidelines and keep to a target of "under 6 at all times" .WELL Almost
Hana

 

[markd]

boy, Mark, I wish I had your worries!

Thanks!

Well, I am 'only' prediabetic, so my numbers are should be read in that context, losing over 100 pounds in weight helps a hell of a lot, I can say.

Mark

 

[Debloubed]

Mark
He also now says that an ideal Hb A1c is probably aound 4.2%.

Hana

this advice scares me on an 'experts' forum - 4.2 is too low for a Type 1 Diabetic to have as an average or Hba1c. It could be ok for a type 2, but this needs to be made clear.

 

[catherinecherub]

It scares me too and I am a Type 2 and I am hypo aware at around 4.5. I also find it odd to aim for non diabetic numbers when you are a diabetic. :shock: :shock:

I

 

[kegstore]

There might be some additional confusion here - HbA1c uses a different scale to blood glucose testing, so an HbA1c of 4.2 is not the same as a blood glucose level of 4.2 mmol/l.

Sorry to be stating the obvious but it does make a difference that is easily overlooked. One of the reasons the HbA1c scale is changing I suppose...

 

[hanadr]

Bernstein is a T1 diabetic of about 60 years standing and writes that his own HbA1c is consistently 4.5%.
I think the fear of Hypo is emphasised too much( I know saying this isn't politically correct on this forum) and that if people keep lower, the sensation of hypo awareness will adjust downwards. And as a T2, mainly diet controlled, nowadays, I don't get hypo. In fact rarely under 5, however, when first diagnosed, and using gliclazide, I did experience hypo. I was sensing it at just about 4. One doctor told me that non-diabetics at that level would just feel hungry.
It's actually more difficult to keep right down without insulin or sulphonylurea.
This is where the "doctrine of small numbers" comes in to its own. By using minimal carbs and minimal insulin, hypo becomes less likely and less dangerous if it happens.
I personally am more scared of the effects of consistent HYPER! this is known to be a serious risk and leads to complications.

 

[Debloubed]

Bernstein is a T1 diabetic of about 60 years standing and writes that his own HbA1c is consistently 4.5%.
I think the fear of Hypo is emphasised too much( I know saying this isn't politically correct on this forum) and that if people keep lower, the sensation of hypo awareness will adjust downwards. And as a T2, mainly diet controlled, nowadays, I don't get hypo. In fact rarely under 5, however, when first diagnosed, and using gliclazide, I did experience hypo. I was sensing it at just about 4. One doctor told me that non-diabetics at that level would just feel hungry.
It's actually more difficult to keep right down without insulin or sulphonylurea.
This is where the "doctrine of small numbers" comes in to its own. By using minimal carbs and minimal insulin, hypo becomes less likely and less dangerous if it happens.
I personally am more scared of the effects of consistent HYPER! this is known to be a serious risk and leads to complications.

Hana, your opinons are of course your perogative (as are mine!) but my fear stems from your post not being specific about type 1 or 2 as I don't think that the experts forum is the place for yours or anyone elses (Bernstein included!) advice as I can tell you from first hand experience that hypo's are hideous to experience and as the 'expert' advice that I am given from NHS diabetes specialists are that averaging in the 4 region is not advisable, perhaps you should post your Bernstein info on the discussion area of this forum? Just my opinion of course

 

[noblehead]

This is where the "doctrine of small numbers" comes in to its own. By using minimal carbs and minimal insulin, hypo becomes less likely and less dangerous if it happens.

:shock: :? :roll:

 

[cugila]

How many more times on this Forum do we have to go through the business of Diabetic's and Hypoglycaemia....Low Blood Sugar.

I posted this in an answer to someone in another Forum. I have edited to remove the other posters name. I think it is relevant. The information from a certain poster regarding numbers and a T1's can be dangerous and I will not leave this unsaid.......AGAIN ! Nobody posting dangerous information on this Forum will remain unchallenged !

Here is my post:

No problem *****. My pleasure. Nothing much else to do at the moment. Always willing to help a fellow Diabetic. This information is specifically about Diabetic's, not non Diabetic's, although there is references to ND's.

I notice you say " never knowingly suferred from a hypo." That's just it **** sometimes the individual is the last person to notice, others might though. Your wife never told you that you are a miserable 'git, akward, argumentative ?' Mine used to sometimes....was that because I was in hypo land.....? Could just have been me I suppose...

I as you know am a Type 2. I start to get hypo symptoms at around 4.5 mmol/l, feeling shaky, when typing posts my spelling gets atrocious, (noticed that in other posters and wondered about them ?), feeling generally c**p ! That is basically what should happen. The beginnings of hypoglycaemia, low blood sugars.

Now my hypo awareness is good so that is about right. I have, if I have ignored or been somewhere I can't address those symptoms quickly dropped as low as 2.3 mmol/l. I may have dropped lower, I don't know. I would need a CGM to tell me that. I can assure you you don't want to be there....not a nice place. So, I always carry GlucoTabs, jelly Baby's and Full Strength Coke to remedy, then a small 'carby' snack to stabilise once my level is back to near normal.

If your Bg levels are consistentently very low, as in close to 4 mmol/l or even lower then what usually happens is you lose the hypo awareness. The warning signs. This, I presume is what some low carbers and others have done as they insist they NEVER feel anything. They obviously believe that. As I have stated with the list of symptoms, can anybody, truthfully, hand on heart honestly say, I have never had any one of those symptoms. If you answer No, never, I'm sorry, but that is just rubbish ! They may or may not be due to a hypo, but never....I don't think so !

Joking apart about a Saturday night out, you cannot possibly have gone through life without having at least one of those symptoms at some time. You ever ranted at one of my posts ****..... .

That's not to say that they are always because of low Bg levels, only testing at the time would show that. It doesn't in any way shape or form make it a sensible thing to be doing ! Low Bg at those levels can and does impair your cognitive ability, I know from my own experience. There have been studies which confirm this. People who ignore them are doing themselves no favours. It is not sensible to be running very low numbers all the time, it has a cause and an effect !

We have many T1's who say they feel great at 1.9 or some similar figure. Now for a T1 as I am sure you are aware that can be life threatening....they can suddenly go into a sleep, a coma and simply never wake up again unless they get some assistance. The numbers need to be slightly higher for a few weeks so that they get back the awareness.

For a T2, it isn't life threatening, as the body will dump Glucose into the system and elevate your levels again, 'liver dump.' However it COULD be life threatening to you or someone else if you are driving and your ability is impaired, in effect some people can behave as if they were drunk.

I have been on the phone sometimes and been asked if I was OK, checked my Bg and it was 2 - 3 mmol/l....Eeek ! I sometimes don't notice the effect it is having, other people might though and probably thought I had had one too many ! So that is why I refuse to accept anybody telling me that those low levels are safe.

I am not alone, speak to any Endocrinologist worth the name and they will concur with the argument. It is dangerous to go too low. It is unhealthy for the body. As for those who say I know better, well you ignore Medical advice about this subject and you are storing up trouble for yourself. This is nothing whatsoever to do with diet advice. That is wrong in some cases, this isn't.

As for Bg testing, not sure how many times a day you test ? I am testing at the moment something like 10 times a day, I have to for the reasons I stated earlier. Now that level of testing is showing me all sorts of numbers I never realised I was having, so the frequency will have great effect on you knowing just what your actual levels are. Test, test, test !

Here are some links just picked at random from my database. There are many more, some unfortunately are suscription only so I will not post them, mainly from true Endocrinology websites. Rssearch is where the information comes from Now, it is up to you whether you believe them or not, I am just the messenger.....

http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/
http://www.diabetes1.org/news/Reversing ... nawareness
http://www.netdoctor.co.uk/diseases/fac ... garlow.htm

There are many many more, you can cross reference any of them, they all say the same or similar.
If you or anybody else still insists they have not been in hypo land......well, who am I to argue !

Cheers ****. Must go, people to help......

Ken.

 

[cugila]

Further to that previous post for anybody to tell a T1 that the lower the number the better is living in 'cloud cuckoo land'. That is dangerous information. Misleading. False. Any description you like !

Let's be clear about something here. If somebody tells a T1 that it is better to run the numbers lower, lower the better just because some amateur called Bernstein says so, I am told that this man is totally hypo unaware.....has been for years.....enough said ! I'm sorry, I will never heed that advice. What has been said fly's in the face of ALL informed medical opinion.

I have seen first hand what the results of failing to heed the correct advice regarding Bg numbers and T1's. It ended in a death of a young man. He died because of a hypo, I posted about it here a while ago. It upset some because it was graphic and brutal. I make no apologies for that. It was meant to shock. Death is shocking !

Somebody here needs to find it and read it again. That Death could so easily have been prevented if he had heeded the Medical advice and not listened to ill informed rubbish from well meaning friends who knew nothing about the real horrors of hypoglycaemia.

 

[Debloubed]

blimey Cugila, I don't agree with you very often but I couldn't agree more with your last post! I've said it before and I will say it again - Hypo's SUCK! I know I will have more and that just makes me want to cry when I think of the really bad ones I've had that have affected my family and friends. BUT I am who I am and I have diabetes and I refuse to feel sorry for myself and do what I can every day to stay at my magic number 6

 

[TheTartanPimpernel]

Can anyone point in the direction of Bernstein having published any of his base data which would withstand, or has withstood, analysis by a peer group review?

I read his tome - then quickly binned it. Anecdotal and as far as I could ascertain unsubstantiated; cherry picked to suit his undoubtedly money spinning ambitions. I wonder how many medics could (or indeed would) cherry pick those patients who elect to try and control their diabetes and present this as a norm; quietly discarding those who elect not to follow this mechanistic, monastic approach (and happily survive) and all of those who decide try but have sufficient sense to drop out and gain a life.

Its not, or at least should not, be all about rigidly adhering to tight control. In certainty we will all die, and the vast majority, diabetic or not, will do so with our feet on. In the meantime lets try living in a real world.

 

[graham64]

just because some amateur called Bernstein

Hi Ken I see you called Dr Bernstein an amateur can you tell me how you came to this conclusion. Does his Status of being a doctor specialising in diabetes count for nothing, if you check out google scholar you will find a lot of his work.

http://scholar.google.co.uk/scholar?hl= ... =&as_vis=0

Included is a study in which our own Dr Katharine contributed, I sure you'll agree with me in saying that Dr Katharine is a well respected and knowledgeable GP. So I don't think she would work with amateurs, I feel sure if you PM her with your concerns about Dr Bernsteins qualifications she will put you straight.

http://www.nutritionandmetabolism.com/content/5/1/9

Graham

 

[ally5555]

Must admit graham most of his information is very anecdotal - I dont see very much published work from him and the rumours about his control continue!

 

[cugila]

As it is my personal opinion I do not have to defend my opinion.

There are many who I consider amateurs for one reason or another. That is my choice and I do not have to answer to you.

 

[ally5555]

hi ken

Im on your side - that other forum is horrid.

allyxx