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Quite like this one and thought it might deserve its own thread. I will delete if someone tells me what I am aiming to explain is horribly wrong. It's my way of trying to show borofergie (and anyone else) that real testing with a meter each day can be more important than an HbA1c result
In the existing thread starting from here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=1&t=26841&start=39 you will find some additional stuff including some simple maths to show how the story below works in real life... ish
What follows is not supposed to be biologically accurate btw but in some ways I wish it was
===================================================================================
Ok borofergie it worries me that someone as obviously up on this as you doesn't get the HbA1c thing. So here's a story for your delectation (and anyone else) who wants to see why HbA1c is not all that good as a safety predictor. This way uses no maths at all.
You need to enter imagination land to do this and in my imagination it gets pretty gruesome so you have been warned!
Think of your blood, now zoom in to where you can see individual blood cells swimming about. If you're like me you end up with a mental image of lots of little red blobs moving around.
Now lets impose a personality on each blob. Make each blob a little spiky devil monster with big teeth and evil glowing eyes.
Now each monster can be in two states. Asleep or awake.
When they are asleep all is well, when they wake up then depending on how woken up they are they will progressively become angrier and angrier and psychotically and berserkly go around your body attacking the blood cells in the backs of your eyes cos they want to blind you or attack your feet to try and make them drop off or attack things called your beta cells which make their arch nemesis the insulin fairies.
First important thing to notice.
The insulin fairies are just that little fairies but they carry big hammers that they use to whack the evil awake blood cells with to put them back to sleep.
Second important thing to notice.
The blood cell devils are woken up by glucose which is coming from what you eat. The glucose ISN'T in liquid form so it can't be absorbed by all the devils just bathing in it. Its found in little sugar cubes so each blood devil has to be able to grab one to wake itself up. If it can grab two, or three or more GREAT it becomes more awake and more evil but it has to be able to grab at least one to wake up.
Third important thing to notice.
If I restrict what I eat I can control how many blood cell devils will wake up because if I'm good there won't be enough sugar cubes for all the cell monsters so only SOME will be able to wake up.
Fourth thing you notice.
Like most other living things the evil demonic blood cells have a life span. Each one lives for exactly 90 days and whenever any individual one shifts its mortal coil because of old age its instantly replaced by a new ASLEEP one so the total number of monsters stays the same each day and importantly if nothing is done to wake them up the proportion of AWAKE devils will fall each day because the new ones are always born ASLEEP.
Fifth thing you notice
Once they've been woken up the little b*****s stay awake. They can never be put make to sleep UNLESS an insulin fairy hits them with a hammer or they die when their 90 days is up.
So starting to bring it all together.
Imagine two weird people. They both only eat at one time each day. One just eats cheese which contains only a tiny number of sugar cubes, the other eats curry sauce and chips which contains loads.
Both have the same number of insulin fairies.
In both people just before they eat they number of awake blood devils is roughly the same.
In the person who eats cheese in the hour just after they eat the number of blood cell monsters awake and doing damage keeps roughly the same. The number does not spike.
In the other person its different in the hour afterwards LOTS of monsters are woken up career around his body ripping this and that eyeball blood vessel to shreds, hacking away at his feet and especially like tracking down and horribly mutilating, torturing and then finally gorging on the beta cells that make the insulin fairies as they are their favourite thing to eat.
Everyday during that hour the insulin fairies mount a valiant defence and hammer as many of the little blighter's they can find but ON AVERAGE each day just a few and ONLY A FEW blood devils escape and keep awake. They manage to stay awake until they day when their time is up and they die.
So because blood devils that reach 90 days and die are always replaced by ones that are ASLEEP and because the person eats the same curry sauce and chips each day THE AVERAGE number of AWAKE blood devils is the same on each of the 90 days. There are a FEW more AWAKE in our curry guzzling friend but not very many more than his cheese eating partner.
BUT THERE IS A DIFFERENCE ISN'T THERE. Our cheese eating friend never gets attacked for the one hour each day and his eyeball blood vessels and feet and beta cells remain intact.
Now both people go to their doctors who take the sample of blood monsters that gets sent to the lab. The lab results come back.
The GP says to the Cheese eater. Well done Mr Cheese you have over the last 90 days on AVERAGE very little blood monster activity your score is 5.4%, keep it up you fine fellow.
The GP says to the Curry sauce eater and chips eater. Well done Mr Sauce you have over the last 90 days on AVERAGE very little blood monster activity your score is 5.5%, keep it up you fine fellow.
Here endith the imagination of xyzzy.
Hope that clears it up for you
In the existing thread starting from here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=1&t=26841&start=39 you will find some additional stuff including some simple maths to show how the story below works in real life... ish
What follows is not supposed to be biologically accurate btw but in some ways I wish it was
===================================================================================
Ok borofergie it worries me that someone as obviously up on this as you doesn't get the HbA1c thing. So here's a story for your delectation (and anyone else) who wants to see why HbA1c is not all that good as a safety predictor. This way uses no maths at all.
You need to enter imagination land to do this and in my imagination it gets pretty gruesome so you have been warned!
Think of your blood, now zoom in to where you can see individual blood cells swimming about. If you're like me you end up with a mental image of lots of little red blobs moving around.
Now lets impose a personality on each blob. Make each blob a little spiky devil monster with big teeth and evil glowing eyes.
Now each monster can be in two states. Asleep or awake.
When they are asleep all is well, when they wake up then depending on how woken up they are they will progressively become angrier and angrier and psychotically and berserkly go around your body attacking the blood cells in the backs of your eyes cos they want to blind you or attack your feet to try and make them drop off or attack things called your beta cells which make their arch nemesis the insulin fairies.
First important thing to notice.
The insulin fairies are just that little fairies but they carry big hammers that they use to whack the evil awake blood cells with to put them back to sleep.
Second important thing to notice.
The blood cell devils are woken up by glucose which is coming from what you eat. The glucose ISN'T in liquid form so it can't be absorbed by all the devils just bathing in it. Its found in little sugar cubes so each blood devil has to be able to grab one to wake itself up. If it can grab two, or three or more GREAT it becomes more awake and more evil but it has to be able to grab at least one to wake up.
Third important thing to notice.
If I restrict what I eat I can control how many blood cell devils will wake up because if I'm good there won't be enough sugar cubes for all the cell monsters so only SOME will be able to wake up.
Fourth thing you notice.
Like most other living things the evil demonic blood cells have a life span. Each one lives for exactly 90 days and whenever any individual one shifts its mortal coil because of old age its instantly replaced by a new ASLEEP one so the total number of monsters stays the same each day and importantly if nothing is done to wake them up the proportion of AWAKE devils will fall each day because the new ones are always born ASLEEP.
Fifth thing you notice
Once they've been woken up the little b*****s stay awake. They can never be put make to sleep UNLESS an insulin fairy hits them with a hammer or they die when their 90 days is up.
So starting to bring it all together.
Imagine two weird people. They both only eat at one time each day. One just eats cheese which contains only a tiny number of sugar cubes, the other eats curry sauce and chips which contains loads.
Both have the same number of insulin fairies.
In both people just before they eat they number of awake blood devils is roughly the same.
In the person who eats cheese in the hour just after they eat the number of blood cell monsters awake and doing damage keeps roughly the same. The number does not spike.
In the other person its different in the hour afterwards LOTS of monsters are woken up career around his body ripping this and that eyeball blood vessel to shreds, hacking away at his feet and especially like tracking down and horribly mutilating, torturing and then finally gorging on the beta cells that make the insulin fairies as they are their favourite thing to eat.
Everyday during that hour the insulin fairies mount a valiant defence and hammer as many of the little blighter's they can find but ON AVERAGE each day just a few and ONLY A FEW blood devils escape and keep awake. They manage to stay awake until they day when their time is up and they die.
So because blood devils that reach 90 days and die are always replaced by ones that are ASLEEP and because the person eats the same curry sauce and chips each day THE AVERAGE number of AWAKE blood devils is the same on each of the 90 days. There are a FEW more AWAKE in our curry guzzling friend but not very many more than his cheese eating partner.
BUT THERE IS A DIFFERENCE ISN'T THERE. Our cheese eating friend never gets attacked for the one hour each day and his eyeball blood vessels and feet and beta cells remain intact.
Now both people go to their doctors who take the sample of blood monsters that gets sent to the lab. The lab results come back.
The GP says to the Cheese eater. Well done Mr Cheese you have over the last 90 days on AVERAGE very little blood monster activity your score is 5.4%, keep it up you fine fellow.
The GP says to the Curry sauce eater and chips eater. Well done Mr Sauce you have over the last 90 days on AVERAGE very little blood monster activity your score is 5.5%, keep it up you fine fellow.
Here endith the imagination of xyzzy.
Hope that clears it up for you
