thanks, i had a look at type 1 hba1c results thread and now i feel like theres a lot more to go. I see people with 6%+ say they want to lower it more so thats my goal too now !
This really resonates with me, @TheBigNewt . In my first couple of years with diabetes my paediatrician kept on and on and on about my HbA1c needing to be lower - so much so that I started secretly injecting more insulin so as to keep him happy.Lows are bad news, I should know. My motto in the old days was: "the best way to know you're not high is to be low". Bad motto!
There was a big randomized study of Type 2 diabetics (different than us, I know that) and one group was going for tight control the other stayed on their usual regimen and their A1C's were like 7.7 and the other group's goal was <6.0. They obviously were on more drugs (some oral of course) and they stopped the study early because the tight control group had more deaths. I realize that Type 2's are different but still they couldn't show tight control helped (in fact it came out worse).This really resonates with me, @TheBigNewt . In my first couple of years with diabetes my paediatrician kept on and on and on about my HbA1c needing to be lower - so much so that I started secretly injecting more insulin so as to keep him happy.
This is when I was 11 and 12. It still shocks me today that I did that. But even today (I'm 42) I have big big issues about not ever wanting to be over 7mmol/l every single time I test my blood sugar.
There was a big randomized study of Type 2 diabetics (different than us, I know that) and one group was going for tight control the other stayed on their usual regimen and their A1C's were like 7.7 and the other group's goal was <6.0. They obviously were on more drugs (some oral of course) and they stopped the study early because the tight control group had more deaths. I realize that Type 2's are different but still they couldn't show tight control helped (in fact it came out worse).
The fact that Type 2 diabetics have varying levels of pancreatic function, that some respond better than others to different approaches, the fact that some are on one type of meds for diabetes and others are on entirely different ones, some use insulin, some don't some rely purely on diet of varying kinds), some eat no carbs, others eat some, some are on meds and diets, some are on a pile of different meds for different conditions (pre-exisiting and/or as a consequence of diabetes)..the fact that soem say they stick to a diet strictly but don't, the fact that "usual regimens" means nothing without detail, age, sex, genes, steroids etc etc etc...completely negates the validity of any findings in such vague studies. Speaking personally, having been on meds and off meds, having adhered to a strict low carb diet and a more relaxed diet - it is entirely bonkers to say that there is evidence that tight control did not help! Just saying.
FYI this ACCORD study 2011, was the lead article in the NEJM, and involved 10,000 Type 2 diabetics using multiple academic medical centers, so it is hardly a "vague" study. It was a tightly controlled, randomized, huge study designed to answer their primary question. And they stopped it early due to excess (cardiovascular) mortality in the tight control group. Oral agents are different from insulin..the fact that soem say they stick to a diet strictly but don't, the fact that "usual regimens" means nothing without detail, age, sex, genes, steroids etc etc etc...completely negates the validity of any findings in such vague studies. .
FYI this ACCORD study 2011, was the lead article in the NEJM, and involved 10,000 Type 2 diabetics using multiple academic medical centers, so it is hardly a "vague" study. It was a tightly controlled, randomized, huge study designed to answer their primary question. And they stopped it early due to excess (cardiovascular) mortality in the tight control group. Oral agents are different from insulin.
The study was stopped after 3.7 years, so it's not like it didn't go on for awhile. The point is the premise going in was that the outcome would be better in the intensively treated group (avg A1C=6.6) vs the "standard" group (A1C=7.7). The A1C was 8.3 in both groups at the start. These people all had diabetes for at least 10 years and weighed about 93kg, so they were a higher risk group for sure. Fewer heart attacks but more cardiovascular deaths in the intensive group, who took more diabetes drugs on the average. Not what they expected at all. Their LDL cholesterol was around 90 in both groups and didn't change, so I'm sure most were on statins.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?