Spikes, carbs and hba1c..

[sparkyrich]

Hi, at the risk of showing my total ignorance (which I'm putting down to my age and conditions) I'd like to get my head round things a little more.

Now, many people follow a low carb/ high fat diet which seems to give good hba1c figures AND good blood levels 2 hours after meals etc,

I used to be one of this happy band till recently when events have scuppered my efforts somewhat. I've been naughty for the last 3 months. No testing and eating pretty much what I want. Got my review today and the DN says my numbers are fine.

So, to my question, if hba1c figures are all that matter, why the fluff do we bother about testing? Presumably there's been some research done into this as we T2's aren't expected to test ourselves and I find it hard to believe the government don't have our best interests at heart...


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[CollieBoy]

Hi, at the risk of showing my total ignorance (which I'm putting down to my age and conditions) I'd like to get my head round things a little more.

Now, many people follow a low carb/ high fat diet which seems to give good hba1c figures AND good blood levels 2 hours after meals etc,

I used to be one of this happy band till recently when events have scuppered my efforts somewhat. I've been naughty for the last 3 months. No testing and eating pretty much what I want. Got my review today and the DN says my numbers are fine.

And what is "fine"? this may be "By the time the BGs cause a complication, I won't be responsible!" always ask for values! :cry:

So, to my question, if hba1c figures are all that matter, why the fluff do we bother about testing? Presumably there's been some research done into this as we T2's aren't expected to test ourselves and I find it hard to believe the government don't have our best interests at heart...

If you beleive this you are more gullible than I thought (btw I don't trust politicians :twisted: )

 

[sparkyrich]

And what is "fine"? this may be "By the time the BGs cause a complication, I won't be responsible!" always ask for values! :cry:

Sorry, should be more precise, 5.8 not brilliant but not bad either. Just can't seem to find anything that says its ok to spike into double figures as long as the long term figure is ok. Unfortunately, with the exception of the good people on here, I can't find anything that says the opposite either.

Does anyone actually do any published research?


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[charon]

I agree.
I've been trying to find out the cause of diabetes related retinopathy, neuropathy and necropathy - which I guess are the important things.

I can find lots of research about diabetes and these complications but more difficult to find anything that says the high BG is the cause. I have a suspicion that often diabetes is taken to mean high BG rather than a control deficiency (which is possibly correctable) and so those that have diabetes but do not have high BG or large swings are discounted. I think it is only the BG that is the cause but can't confirm it.

I think the HbA1C is an average of the last 3 months and so if you are very high for a while but are usually low it will show as a good value. Whether or not the high values will do any lasting damage is the question. I suspect that the body will repair itself if enough time is given with lowish BG so the HbA1C is a reasonable tool but keeping things low would be better and I wouldn't want to wait 3 months to find out that something has changed - or maybe 5 months as it might need a full 3 months before the test to be detectable.

Other things are tiredness and lack of concentration - I had this but don't know whether it was due to BG spikes or continued high readings - I suspect the latter otherwise I would have had issues a lot earlier.

 

[noblehead]

So, to my question, if hba1c figures are all that matter, why the fluff do we bother about testing?

Irrespective of the type of diabetes it's important to test to monitor your bg control and see how your treatment/diet effect your bg readings, only then can you make adjustments to either one or both.

I don't have anything to hand but undoubtedly bg spikes will do some damage in the long-term so it's important to kep them to a minimum, likewise can be said for hypo's which I believe are damaging too. The Hba1c test is good at giving you an average over several weeks but doesn't give a true picture of the control, that is why bg testing is an important part of diabetes management as is diet and exercise.

Some type 2's on the forum no longer tests as much as they did as they have found their level to which they can control their condition, Sid Bonkers springs to mind who initially tested quite frequently when he was first diagnosed but rarely tests now and has a Hba1c in the low 5's, from time to time they'll test sporadically to see if things have changed but on the whole they don't see that it's necessary to test on a daily bases.

 

[LittleWolf]

Good point Charon. How can you define diabetes? I know of other people like me who would have FBG under 7 and 2 hour posts in the 6s-9s, we're considered normal but routinely spike into double figures. You could class People like us as prediabetic but what if you spike up to 20 eating 'normally'?

I don't think diabetes necessarily means your BG is high all day every day, rather your body can't handle sugar as it gets it like a normal person. Like the well controlled people. They are 4-8 all the time but still very much diabetic and are often symptomatic.

I still think keeping the spikes down is important. Coming down from them is what makes me feel ****** at least even if GP doesn't thing going up to 20 is problematic as long as you are back to under 10 sooner or later.

Screw what they say. I'd rather err on the side of caution. A good HbA1c can mask swings and spikes that I doubt are very good for you :/


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[charon]

If I had a better diet I would probably not have been diagnosed as diabetic.
When I'm working I tend to eat very badly - lots of chocolate and coca cola.
When I'm not working I'm a lot better - porridge, salads, roast dinners...

Tends to be 3 months on 2 months off for the last couple of years. I suspect it might have been the diabetes causing be to leave contracts as I became more and more tired.

Had I been tested after a "rest" period I suspect I would not have been diagnosed and I hope my next test will result in a non-diagnosis on it's own (like a lot here). Fortunately my last contract included vast amounts of chocolate (more than you are thinking) to try to increase my BG to combat fatigue (doh!) and I was quite ill (possibly unconnected) straight after leaving causing me to get checked.

To check for diabetes I think you need an impaired glucose tolerance test - to see how your body reacts to glucose rather than a check on how you are coping with your diet. If the average BG level is the only important thing then it doesn't matter - but if spikes are damaging then it's important to know that the odd bottle of sugary drink is bad - guess a lot of companies would be against giving out that sort of information.