test strip results and HbA1c results

[david252]

Actually, you know what, forget my last post. I think I've stumbled onto a site for mentally derranged evangelists.

What reason's are there that a T2 shouldn't have an HbA1c of less than 7%...??/? Now let me think:

1. They're overweight (despite their best efforts - yes they have a life) and have significant insulin resistance.
2. They are unresponsive to oral therapy as most treatments after metformin cause weight gain and make their insulin resistance worse
3. They are elderly and don't understand or want to change their lifestyle
4. They are normal people who have lives (did I mention that already?) and quality of life is more important to them than quantity and don't want to change their lifestyles
5. All oral treatments have failed and they end up on insulin which makes them put on more weight, which makes their insulin resistance worse , which leads to higher levels of insulin which makes them put on more weight etc etc
6. They want to live in denial and won't engage in the treatment of their diabetes
7. they don't (or won't) accept the risks of poorly controlled diabetes.
8. They have low IQ's and can't understand the management requirements for diabetes
9. They come from poor socio-economic backgrounds and can't afford or don't have the experience of cooking healthy low fat/low carb meals

Welcome to THE REAL WORLD. This is an average diabetic population, you should all get yourselves out there and look at them some time.

Oh and did I mention - they have a life (outside of diabetes)?

 

[xyzzy]

Another generalization assuming that someone who wants to be healthy and takes just 3 months out of their life to get it back under control has "no life" and is a mentally deranged evangelist. Did you say that to smokers who spent a similar amount of time giving up to make themselves healthier? Bet you didn't.

Your stereotyping of people is absolutely outrageous and your argument makes no sense. On the one hand you stereotype T2 diabetics into your list of groups and then when you find some who do control their condition namely "us" you insult us by calling us deranged evangelists because we don't meet your stereotype!. All the majority of us do is effectively follow more up to date health guidelines than the NHS. Are all the diabetics in Sweden, America, Germany and other countries who follow those countries 21st century guidelines similarly mentally deranged evangelists?

I have a very good active and fulfilling life David and one I intend to continue with into my dotage.

 

[Pneu]

Snip

That post is near offensive.. many of us are very successful in our professional and/or personal lives.. Your post really just underlines what is wrong with the way in which type II diabetes gets treated in this country.. you can not fail to generalise or stereotype.. you present type IIs as 'fat and stupid people' it is genuinely disgusting.

Many of the people on this forum actively work within either the community supporting type II or within their local PCTs or with charity organisations trying to convince people like you that actually if we were to move the NHS advice into the 21st century then we could see a massive improvement in treatment for type II. Clearly the current strategy isn't working with the national diabetic audits returning the same results year on year... other countries (hell even the Americans) have realised that the old approach doesn't work.. Perhaps if you spent more time updating your knowledge and less time relying on preconceptions then you might actually learn something.

 

[Fraddycat]

I wouldn't agree that I am mentally deranged, but I agree that I am an evangelist. Finding this site in July and switching to a low carb high fat diet, with testing to see what affects my blood sugar has changed my life ... completely ... for the better. So like many people I have come to know on this forum, I TELL EVERYONE!! Especially my T2 friends and colleagues because I know it works and I feel 2000 times better than I did in July.

I blindly followed the 'carbs with every meal - balanced diet' advice from my Dr and DSN and got progressively worse. After 2 years of following NHS guidelines and climbing, as my friends here describe it so well, the meds escalator, I had got to the point that I knew something was wrong with my diet but I couldn't work out what, thank 'insert deity here' that I found this forum!!

 

[catherinecherub]

Actually, you know what, forget my last post. I think I've stumbled onto a site for mentally derranged evangelists.

What reason's are there that a T2 shouldn't have an HbA1c of less than 7%...??/? Now let me think:

1. They're overweight (despite their best efforts - yes they have a life) and have significant insulin resistance.
2. They are unresponsive to oral therapy as most treatments after metformin cause weight gain and make their insulin resistance worse
3. They are elderly and don't understand or want to change their lifestyle
4. They are normal people who have lives (did I mention that already?) and quality of life is more important to them than quantity and don't want to change their lifestyles
5. All oral treatments have failed and they end up on insulin which makes them put on more weight, which makes their insulin resistance worse , which leads to higher levels of insulin which makes them put on more weight etc etc
6. They want to live in denial and won't engage in the treatment of their diabetes
7. they don't (or won't) accept the risks of poorly controlled diabetes.
8. They have low IQ's and can't understand the management requirements for diabetes
9. They come from poor socio-economic backgrounds and can't afford or don't have the experience of cooking healthy low fat/low carb meals

Welcome to THE REAL WORLD. This is an average diabetic population, you should all get yourselves out there and look at them some time.

Oh and did I mention - they have a life (outside of diabetes)?

Isn't it curious that you see Type2 in a totally different light than this forum? Have you never met a person who is proactive in their management or have you dismissed their efforts as as many unenlightened G.P's do? If GPs are stereotyping Type2 then it is no wonder that we get a bad press and do not get listened to as is often the case for members here when they see their G.P. I am really relived that you were not my G.P. as your entrenched views do not offer hope to anyone who has had the misfortune to be on your patient list. It also explains why test strips are not forthcoming for many Type2s.

"The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge"........... Steven Hawking.

 

[Fraddycat]

Well saud Catherine!

 

[borofergie]

Actually, you know what, forget my last post. I think I've stumbled onto a site for mentally derranged evangelists.

I think the phrase you were looking for was "well controlled diabetics". I realise that this is probably an alien concept...

What reason's are there that a T2 shouldn't have an HbA1c of less than 7%...??/? Now let me think:
<insert a frankly offenisve list of excuses for why your standard advice doesn't work>

Welcome to THE REAL WORLD. This is an average diabetic population, you should all get yourselves out there and look at them some time.

Yup. We see it all the time. The REAL WORLD of diabetics whose GP's advise them against BG testing (even when it's on their own buck), tell them to get 50% of their energy from carbohydrates and then give them the "don't worry, a HbA1c of 7% is really, really, good".

You call it "THE REAL WORLD", I call it "AN INSTIUTIONALISED CULTURE OF FAILURE".

Oh and did I mention - they have a life (outside of diabetes)?

Yeah, cos not eating bread, pasta, rice, sugar and potatoes takes an incredible amount of time and effort. The good news is, that any time that you save by doing it now, you'll get back in double towards the end of your life, which you can enjoy, instead of being a blind amputee with renal failure.

Stephen
(HbA1c=4.9%, Marketing Professional, School Chairman of Governers, Charity Chairman, Runner)
(Just Sayin')

 

[catherinecherub]

Actually, you know what, forget my last post. I think I've stumbled onto a site for mentally derranged evangelists.

What reason's are there that a T2 shouldn't have an HbA1c of less than 7%...??/? Now let me think:

1. They're overweight (despite their best efforts - yes they have a life) and have significant insulin resistance.
2. They are unresponsive to oral therapy as most treatments after metformin cause weight gain and make their insulin resistance worse
3. They are elderly and don't understand or want to change their lifestyle
4. They are normal people who have lives (did I mention that already?) and quality of life is more important to them than quantity and don't want to change their lifestyles
5. All oral treatments have failed and they end up on insulin which makes them put on more weight, which makes their insulin resistance worse , which leads to higher levels of insulin which makes them put on more weight etc etc
6. They want to live in denial and won't engage in the treatment of their diabetes
7. they don't (or won't) accept the risks of poorly controlled diabetes.
8. They have low IQ's and can't understand the management requirements for diabetes
9. They come from poor socio-economic backgrounds and can't afford or don't have the experience of cooking healthy low fat/low carb meals

Welcome to THE REAL WORLD. This is an average diabetic population, you should all get yourselves out there and look at them some time.

Oh and did I mention - they have a life (outside of diabetes)?

I was going to edit my original post but decided on another one.

I would ask you if your unflattering and stereotypical generalisation of Type2s could be applied in any way to Type1s or are they a class apart when it comes to management given that you are one of them?

It would be interesting to see how you describe Type1s who cannot achieve their targets so that we can compare. It would also be interesting to see how you describe Type1s who successfully manage their diabetes with levels below the general target.

Lets try and make it a level playing field or see if you really are a Type1 snob who believes that Type2s brought it on themselves as they had a choice in the matter unlike Type1s.

 

[xyzzy]

(HbA1c=4.9%, Marketing Professional, School Chairman of Governers, Charity Chairman, Runner)

That's seriously worrying Stephen. Having a T2 diabetic with an HBA1c of 4.9 as Chairman of Governors and a Chairman of a Charity is clearly a very dangerous thing. Didn't you just complete the Great North Run? You need locking up immediately. :lol:

The stereotyping of diabetics as the dear ex doctor did shows all that is wrong with diabetic advice in this country in my opinion. Rather than examine the treatment and message that is being handed out they would rather blame their own patients rather than for one moment consider that maybe its the treatment and their own attitudes that is at fault.

Despite various posters offering evidence to the contrary I note that at no time did the doctor ever say phrases such as "that's interesting I'll take a look at that" or "how did you get your diabetes under control I'm interested to find out?". Rather the immediate response was the stereotypical condescending view of assuming all diabetics are fat lazy idiots who couldn't possibly know anything.

It is someones own choice if they wish to deny their condition and end up taking the associated consequences. My own GP says around 3% of diabetics learn to control diabetes to the extent that I do. I pointed out the obvious flaw in continuing down that line of thinking which is how many more percent WOULD control their diabetes if they actually were given advice that works! As you so rightly point out giving up or in many of our cases simply cutting down on rice, pasta, bread, potatoes and flour based products so that our blood levels normalize isn't rocket science is it?

 

[Grazer]

Returned to the thread this morning and first read:-

Look, please everybody, let's play nicely. I've apologised for acting high and mighty and yes I deserve the comebacks and yes I've generalised. I haven't picked on anyone and their individual management/levels of control etc. I accept that some people want to intensively look at controlling their diabetes.

At that stage I started to think "maybe he's a nice guy and we've been a bit hard here."
Then read the next bit :-

Actually, you know what, forget my last post. I think I've stumbled onto a site for mentally derranged evangelists.

and realised my first hunch was correct.
You really do think your knowledge as a GP trumps us all. So lets see;
You think that we don't need to test, as all we need do is follow a low GI diet. Nonsense.
Firstly, no matter HOW low the GI, there is maximum amount of carbs that a T2 on diet alone (or metformin) can eat and maintain good control. That amount varies from person to person. How do we find out how much WE can eat? By testing.
Next, what works as low GI for some doesn't for others. Some seem to find bananas OK; I can't touch them. But I can eat bread in reasonable quantities. How do we find out what works for US? By Testing!
I can eat shed loads of carbs in ther morning with hardly a rise providing I'm active. But in the evenings I can't tolereate many at all. Most people seem to be the other way around. So I weight my carb intake accordingly. How did I find out? By testing!
But you'd just send your patients away saying don't test, with generic advice to eat low GI. Hardly suprising then one of your statements:-

They are unresponsive to oral therapy as most treatments after metformin cause weight gain and make their insulin resistance worse

They would be, eating the wrong things. Although if they ate the RIGHT things, they may not need to go on to "treatments after metformin."

As for HbA1cs of 7.2% being fine; that's at best patronising and at worse dangerously misleading. I suggst you read Professor J S Christiansen's talk at the copenhagen summit on Diabetes. He pointed out that a NON diabetic with HbA1c of 5.5% comnpared to a more normal 4.6% had a 21% increased risk of cardiovascular disease. But we're supposed to believe that a level of 7.2% is OK? Nonsense. Even the authors of that poor study you referred to accepted that their findings didn't apply to the non insulin dependant population in the study. Simple commonsense tells you that a non-diabetics body wouldn't regulate to a level of 4.6% (on average) if 7% was "fine" It's awful how the NHS latched onto that one misleading study (when every other sensible one ever conducted showed the opposite findings) to try and justify higher targets - wouldn't be because that way, more diabetics would be hitting targets would it?

As for having a life, it's BECAUSE my diet, planned with the help of testing, led to:-
Blood pressure down from 155/85 to 117/75
Cholesterol down from 5.5 to 3.8 (no change in statins)
BMI down from 26 to 22
Waist size down from 38ins to 34ins
HbA1c down from 8.2% to 5.7%
That I'm able to play golf twice a week, go on snorkeling holidays abroad twice a year, tour europe on my motor bike every year, and carry out all the other active things I do in my life. And by the way:

They are elderly and don't understand or want to change their lifestyle

I'm retired and don't seem to find it an issue.
You need to re-think your pre-conceptions.

 

[wiflib]

I'm posting here because I want to follow this thread and I want to keep it active. I won't write what I had originally planned as that would probably end in a permanent ban. I do hope David is still reading this thread and is not a troll.

*Breathing calmly*

David, please read carefully around the forum, stories of people completely neglected by their HCP's who come to us in a terrible state because they have followed the standard NICE guidelines for years and are getting sicker and sicker. Some, including me, turn their lives around, sometimes within DAYS by understanding the truth. None of it possible without testing, testing, testing and understanding that all carbohydrates ingested turn to sugar. As someone once said here, would you advise a coeliac to eat wheat, an alcoholic to drink alcohol, those allergic to nuts to eat them?

Something else that I and quite a few people here suffer from is an addiction to carbs. I am unable to eat just one potato, one slice of bread, a square of chocolate. It's well documented here why.

wiflib.

HCP, mother, grandmother, friend, lover, trying to keep my head above water because the government decided to make me work harder, for longer and pay me even less and yes, I am directly responsible for the lives for the clients in my care.

Diagnosed over four years ago with an HbA1c of 5.7. Now 8 stones lighter, never hungry, lipids LOWER than the NICE guidelines with an HbA1c of 4.8 AND MEDICATION FREE.

 

[Grazer]

Good post wiflib, but did you mean this figure?

Diagnosed over four years ago with an HbA1c of 5.7.

 

[ladybird64]

Good people of the forum..I saw the Dr's response last night and an ironic smile crept across my tired old boat race. I, like Sheepie, wanted to give the doc a break and ask him to have a look around the forum before he judged. I said it twice.

I didn't respond last night because I would not waste my time, you know, cos I have a life and all that, in answering a post which only serves to reinforce what so many of have experienced.

I would also respectfully suggest (as I always do :angel: ) that we spend no more of our time addressing Dr David and his issues (and he certainly does have some!) and instead turn the post right back to where it started, with the poster and his needs. I am positive that hippi will get the help that he needs here, positive help and not just a pat on the shoulder and being told not to worry. :roll:

I would also suggest, cos I am on a roll this morning, that we don't bother getting wound up by the likes of Dr David and those who share his viewpoint as it is a waste of our time. You know the old saying. "There are none so blind as those that cannot see" and in this case it is evident..the evidence is there, right in front of his eyes but instead in engaging in discussion, he chooses to avoid it and instead resort to stereotypical name calling.

There have been quite a few of us who have achieved some success with our HCP's recently, those HCP's who are willing to look that bit further into the subject and to at least listen to a different point of view. Can we concentrate on them instead?

Leave Dr David's post where it is, a testament to the outdated attitudes and complete refusal to even LOOK at another point of view-especially when the evidence is there for all to see. The tide is turning..don't let negativity hold it back.

Shall we move on now? :wink:

 

[RoyG]

Wow, another train wreck here I see. If I'm an "deranged evangelist" bring it on. Because I don't personally care what I am called. I see my GP and nurse and I guess they see me as an maverick who no matter what they say will not toe their party NHS line. But no matter what, they cannot escape the fact and say to my face I have "excellent control" when my nurse says I wish all my DB patients where like you, my answer is simple. They could be if perhaps you stopped being so blinkered in your approach to their care looked closer at Diet and educated rather than preach. I now have my GP interested in my (our) methods and my attitude to the cholesterol debate, to the point he actually reads and looks at some of the information I give him. I would say not all GP's are so single minded as others. Listening to your patients can be very enlightening, because while most are extremely busy they rarely find the time to explore avenues which deviate from NICE. A nice touch to my visit to my GP the other day was to ask me. How do I feel in my self, have I noticed any erroneous symptoms to my life style change fiscally or mentally? Is he listening to me I think so, will his outlook change maybe, do I care if it doesn't and will it matter to me NO. So excuse me while I go back and put the silver foil back on my head and stab my fingers for fun :crazy: In answer to OP ask for another test, get a print out of all your readings always, test at different times for at least week, reduce carbs to around 30g for that week, then go back to what your normal diet was and do the same regarding test, and keep notes for both. post your results on here, some people on here are very knowledgeable and will be able to point you in right direction.

 

[wiflib]

Yep Grazer, crazy isn't it that I could have a figure like that, but my GTT was diagnostic and my meter used to confirm that when I tested in the early days. I also remember crippling hypos that used to leave me in a real state until I ate something or my liver dumped.

I'm one of the lucky ones, I was diagnosed purely by chance before all my beta cells were destroyed and the GTT confirmed the diagnosis. I suppose I may be a LADA or MODY but I will not test that theory, not as long as my BS, even at one hour after eating, NEVER get into the 6's and my fasting levels are always in the 4's. Unless I eat what we know is standard NHS advice.

wiflib

 

[Dillinger]

Well, I think Grazer is mentally deranged, but that's another story...

Dr David you have entered a key and controversial area for my Type 2 friends here; the vitriol you are receiving is based on the line you are holding and not you as a person; I'm sure you are a great person, so keep that in mind; it's not personal

However, as to what you are saying; it just does not cut it with those diabetics with exceptional control; that control comes from counting carbs and testing; just like us Type 1's.

The list of reasons you give for why an HBA1c is good are not reasons for why it is good at all; they are descriptions of how unfortunate people get those terrible figures.

Best

Dillinger

 

[Defren]

I went to bed a mixture of fuming and despair. If a so called ex GP won't look at our results, changing the entire system is going to be such an up hill battle. I also like CatherineC feel rather relieved Dr D(eath) D(avid) is not my GP. My GP fully supports all I do to keep tight control. He did prescribe unlimited strips until my latest HbA1c and even now I still get 50 a month. He supported me doing the Newcastle Diet, ok, with rolled eyes, but he knows how pro active I am, so agreed. It worked for me, he was impressed. I know and I really do appreciate my GP is one of a small group of progressive GP's but why oh why oh why won't other HCP involved in Diabetes care listen to us. Look at our results. Many of us keep logs of everything. I have extensive logs of everything from food diary to amount of exercise I do and everything in between. It's no good if they are not totally accurate, how would that help me, so why can't other GP's look and take note of other peoples logs?

I dread to think what my health would be like now had I not found this forum and all the amazing help and advice and had a super supportive health team and family behind me.

 

[BioHaZarD]

Dear David252

I have jus read through this and cannot believe your view.

When I was diagnosed in may I was HbA1c of 11.1%, cholesterol of 4.5 and whisked off to the DN, and put on 1 Metformin and told to increase to 2 in a week, eat plenty of starchy carbs with each meal. I purchased a meter and tested several time before and after meals.

I then found this forum and read it. So decided to follow the advice of people with diabetes who have gone through the sides in real life. I started. Very low carb high fat diet. I did try the NHS way few a few days and m levels were never under 8. So no more.

3 months later I see my doctor and showed him my results between 4 8 and 5.5 everyday with meals. He was impressed and ordered another hbA1c. They came back as HbA1c 5.5%, cholesterol 3.5, my blood pressure has always been great. I booked a DN appointment to update her and she could not believe it, eh called my her star pupil and said she has never seen one of her patients that as come down under 6%. If that's the case why does she not change her advice, she cannot be a very good DN if she as ever helped her patients get good control. Her man advice used to be for me " I can give you more pills o eat more carbs". She accepts this works for me and to continue.

If the NHS, GP's and DN's cannot see the facts in front of them when a patient like me and others here then there is little hope for others.

It saddens me......

 

[Grazer]

Completely agree Jo. I have a friend who arranged a test purely because I had been diagnosed. His fasting BG was 16 and his HbA1c was 11.5%
His doctor wanted to put him straight on meds, but he refused and came to see me Instead. I had my doubts because of his very high levels, but spent a lot of time advising him in the normal way we're all familiar with. Just over 3 months later he clocked an HbA1c of 5.8%, diet only, not even metformin. His doc was astonished, called it "remarkable", praised him, but NOT ONCE did he ask "how did you do that?"

 

[BioHaZarD]

Completely agree Jo. I have a friend who arranged a test purely because I had been diagnosed. His fasting BG was 16 and his HbA1c was 11.5%
His doctor wanted to put him straight on meds, but he refused and came to see me Instead. I had my doubts because of his very high levels, but spent a lot of time advising him in the normal way we're all familiar with. Just over 3 months later he clocked an HbA1c of 5.8%, diet only, not even metformin. His doc was astonished, called it "remarkable", praised him, but NOT ONCE did he ask "how did you do that?"

Who's Jo? :lol: