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<blockquote data-quote="sud5nala" data-source="post: 1216042" data-attributes="member: 307629"><p><a href="http://www.diabetesforecast.org/2014/mar/the-brittle-diabetes-debate.html" target="_blank">Here</a>'s an article which suggests that one cause of wide glucose variability in Type 1 patients is gastroparesis. Gastroparesis, a result of diabetic neuropathy, is one of the complications of the disease. "People with [gastroparesis] may have problems synchronizing insulin dosing with the glucose absorption from the food they eat, resulting in blood glucose fluctuations."</p><p> </p><p>There are many physiological things that could be going wrong, and they could be caused either by the disease or by aging.</p><p> </p><p>The A1c test is not always accurate. There are factors which throw it off, and old age is one of them. There are published lists of interferences to the A1c. Unfortunately, the medical literature has nothing to offer as to the respective sizes of the effect of these interferences. But as to the difference of 52 and 48: I would be glad to attribute 1 or 2 points of it to aging.</p><p> </p><p>Digestion is a complicated process with many biochemical steps. This is not just true in general, but with respect to diabetes. Have you heard of the "loss of the incretin effect"? When food slides into the small intestine, this is supposed to stimulate some cells in the intestinal wall to send chemical messengers to the pancreas. This is one of the mechanisms for signalling the pancreas to release digestive enzymes. Anyway, the loss of this effect is one of the complications of diabetes and it is the basis of two new categories of diabetes medications since 2005.</p></blockquote><p></p>
[QUOTE="sud5nala, post: 1216042, member: 307629"] [URL='http://www.diabetesforecast.org/2014/mar/the-brittle-diabetes-debate.html']Here[/URL]'s an article which suggests that one cause of wide glucose variability in Type 1 patients is gastroparesis. Gastroparesis, a result of diabetic neuropathy, is one of the complications of the disease. "People with [gastroparesis] may have problems synchronizing insulin dosing with the glucose absorption from the food they eat, resulting in blood glucose fluctuations." There are many physiological things that could be going wrong, and they could be caused either by the disease or by aging. The A1c test is not always accurate. There are factors which throw it off, and old age is one of them. There are published lists of interferences to the A1c. Unfortunately, the medical literature has nothing to offer as to the respective sizes of the effect of these interferences. But as to the difference of 52 and 48: I would be glad to attribute 1 or 2 points of it to aging. Digestion is a complicated process with many biochemical steps. This is not just true in general, but with respect to diabetes. Have you heard of the "loss of the incretin effect"? When food slides into the small intestine, this is supposed to stimulate some cells in the intestinal wall to send chemical messengers to the pancreas. This is one of the mechanisms for signalling the pancreas to release digestive enzymes. Anyway, the loss of this effect is one of the complications of diabetes and it is the basis of two new categories of diabetes medications since 2005. [/QUOTE]
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