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HBA1C and Risk Assessment

B

Bluenosesol

Well-Known Member
Messages
446
Location
Solihull, West Midlands
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Dark mornings, intolerance any one with a superiority complex...
Folks,

The UKPDS Study* published in 2000, managed to quantify many of the benefits of reducing a high HbA1c level by just 1%.

A 16% decrease in risk of heart failure
A 14% decrease in risk of fatal or nonfatal myocardial infarction (heart attack)
A 12% decrease in risk of fatal or nonfatal stroke
A 21% decrease in risk of diabetes-related death
A 14% decrease in risk of death from all causes
A 43% decrease in risk of amputation
A 37% decrease in risk of small blood vessel disease (eg, retinal blood vessel disease causing vision loss).
Now what I am trying to understand is this...
If one managed to reduce HBA1C by 5% do I simply multiply by 5 to ascertain my risk.
Eg 12% decrease in all strokes risk per 1% of HBA1C reduction = 60% reduced risk at a 5% reduction?..
If that is so, what happens when the risk reduction becomes greater than 100%?
Eg 37% decrease in risk of small vessel disease per 1% = 171% risk reduction at 5%...

Grateful for learned intervention.... :? :D

Steve
 
I'm pretty sure there's something somewher about diminishing returns below 5%. It may be on David Mendosa's website.
Hana
 
What level of Hba1c did they conduct the test on for them to class a high HbA1c level in the first place ?

Also what are the percentage risks of us getting that stuff in the first place and what is the percentace of none diebetes people getting it too ?

I hate people that do these survey things and don't give you the full story.

Next they will be telling me smoking is bad for me too.. :roll:
 
There is no level in which the risk is reduced to nil :(
There are also other factors for example blood pressure.
This medscape article gives some slides (including data from the UKPDS) that may be useful, though the text is sobering.
http://cme.medscape.com/viewarticle/449657

On the other hand, as individuals, we may fare very differently to the stats.
On another forum a person with longterm type 1 shared his Hb A1cs .
1945- 1988, no tests but suspects his levels were high (only 1 injection a day)
From 1980 -1988, they varied between 8% and 11,
From 1988 they fell to the 6s until 2000
From 2000 onwards they werein the 5's
As he says' I feel so lucky to be alive and healthy, without complications.'
 
Its frustrating, I am sick of hearing that with good control I am nevertheless a deadman walking yet hear loads of anecdotes of people who have lived for many years with very poor control and no complications....

My GP advised me not to plan for a lengthy retirement....

So where do I take my stance?

:(

Steve.
 
Bluenosesol said:
Its frustrating, I am sick of hearing that with good control I am nevertheless a deadman walking yet hear loads of anecdotes of people who have lived for many years with very poor control and no complications....

My GP advised me not to plan for a lengthy retirement....

So where do I take my stance?

:(

Steve.
Click to expand...

Hi Steve,
Keeping your BG under control must reduce the odds of getting complications stick with it. Check out manokent 40 years Low Carbing no complications and still enjoying a few rounds of golf every week at the age of 85 :shock:

Cheers
Graham
 
To be honest Graham,

on balance I am quite optimisitic...I am just aware that some of the professional fraternity use a psychological process whereby they paint as black a picture as they can to provide maximum incentive to the diabetic. (Do this or you die :twisted: - It worked in my case!!).
Then there are the incessant statistics and reports on likelihood of outcomes, complications, etc which appear to be easily undermined by simple anecdotal evidence and social observation.

I am aware that 80% of T2 diabetics live with their condition without managing it and there are many reasons for that including indifference and poor advice and support.
It is this situation which underpins the attitudes of GP's as they assume that newly diagnosed patients will fall into that category and hence tar us all with the same brush.
When I had my first 3 month review, the Diabetes Nurse reacted as though I was the only patient she had ever seen to reduce their HBA1C, which convinced me that our surgery's average diabetic patient is a non conformist to the great frustration of the practice nurses and GP's.

My goal is to get to 5.0 % and stay there! :D

Thanks for the support and here's to surpassing the achievements of the Manokent!.

Regards Steve.
 
I am just aware that some of the professional fraternity use a psychological process whereby they paint as black a picture as they can to provide maximum incentive to the diabetic. (Do this or you die - It worked in my case!!).
Click to expand...

Steve.

I did all that they said and nearly DID die.......strange that ?
Then I got a life by cutting out the carbs. :D
 
It's all a medical plot
Don't tell the patients what DOES WORK. then blame them when they can't keep control by your method. then, when they get sick, call them non-compliant. Those that do follow your advice naturally enough DO deteriorate, so make it a "given" that EVERYONE WILL.
It absolves the medics of responsibility for their patients' complications.
 
Bluenosesol said:
Folks,

The UKPDS Study* published in 2000, managed to quantify many of the benefits of reducing a high HbA1c level by just 1%.

A 16% decrease in risk of heart failure
A 14% decrease in risk of fatal or nonfatal myocardial infarction (heart attack)
A 12% decrease in risk of fatal or nonfatal stroke
A 21% decrease in risk of diabetes-related death
A 14% decrease in risk of death from all causes
A 43% decrease in risk of amputation
A 37% decrease in risk of small blood vessel disease (eg, retinal blood vessel disease causing vision loss).
Now what I am trying to understand is this...
If one managed to reduce HBA1C by 5% do I simply multiply by 5 to ascertain my risk.
Eg 12% decrease in all strokes risk per 1% of HBA1C reduction = 60% reduced risk at a 5% reduction?..
If that is so, what happens when the risk reduction becomes greater than 100%?
Eg 37% decrease in risk of small vessel disease per 1% = 171% risk reduction at 5%...

Grateful for learned intervention.... :? :D

Steve
Click to expand...
I would suggest if the starting (reference) high HBA is e.g. 10%, then a reduction to 9% gives the stated benefits. Likewise, a reduction from 8% to 7%. A reduction to 5% from any higher value would reduce your risks to a non-diabetic level, provided you do not have significant existing damage from being too high.

They would not be talking about a true 1% reduction, i.e. from 10% to 9.9%. That could not be measurable, let alone significant.
 
Statistics.......if you have the weekend free and a degree in Biostatistics, feel free to check this link out. It explains how it is all worked out ............I think ? :?

http://www.answers.com/topic/statistics

You have to scroll down to the section entitled:
Encyclopedia of Public Health: Statistics for Public Health
 
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