QRISK3 algorithm

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"In type 2 diabetes, the pathogenesis of atherosclerosis-related disease is multifactorial (Betteridge, 2011). Glycaemic control has been consistently shown to prevent microvascular complications. However, large, randomised trials have failed to demonstrate the same consistent beneficial effects of intensive glycaemic control on improving cardiovascular outcomes. Thus, optimal glucose control in isolation is not sufficient to reduce cardiovascular risk" https://www.pcdsociety.org/download/resource/2070

Edited to try and correct link.

Haven’t looked at this in detail but could that be because glycemic control has typically been achieved by medications and that does little to address hyperinsulemia which causes its own damage. Whereas in more recent times glycemic control might be by means of low carb etc which does address the underlying issue of insulin resistance. Also with the fairly recent and rapid increase in flash and continuous monitors a steady and greater % of time in range would result in better outcomes than a reasonable Hb1ac but comprising of highs and lows perhaps.

 

[HSSS]

As well as a lack of any diabetic scoring (unlike cholesterol and bp measures) the postcode part really gripes me. That’s not even about me personally. In my postcode there are some wide ranges of socio economic circumstances and even within them we are talking trends and populations not individuals. Yet they will prescribe medication on the basis of my house number