Type 1's - I need your thoughts!

PseudoBob77 · Mar 24, 2016

tim2000s said:
@catapillar I think this graph is a good visual representation:

Relative risk is the risk compared to a normal person getting the listed complications, so at hba1c of 6 you have (apparently) the same level of risk of all complications as a non-diabetic.

Now what I'd really like to see is something visual that shows glycaemic variability versus relative risk of complications.

From what i've read up, it's not so much the variability with hypers, it's the post prandial duration of it remaining high for prolonged periods after eating, that's where the damage occurs. This coupled with bad chloresterol and high blood pressure increases micro and macro vascular complications.

tim2000s · Mar 24, 2016

catapillar said:
Is there enough to data on that yet? I would of thought it's only fairly recently that greater numbers have been able to accurately record the variability (anything before cgm/libre would be just a best guess, rather than the actual variation, wouldn't it?) so we can't see the long term risk impact yet. I'm sure there have been good, reasoned guesses (I mean sensible science based theories, I don't mean to dismiss it with "guess"!) but not on the same solidity of data that DCCT draws from.

I suspect that it's more likely to be

PseudoBob77 said:
From what i've read up, it's not so much the variability with hypers, it's the post prandial duration of it remaining high for prolonged periods after eating, that's where the damage occurs. This coupled with bad chloresterol and high blood pressure increases micro and macro vascular complications.

There's certainly plenty to read. What seems to be the biggest issue in relation to variability is that when someone is longer term hyperglycaemic there are a number of protective mechanisms that kick in. When they are spiking for a short term, these don't seem to kick in and the oxidative stress caused by the spike continues when glucose levels return to a "normal" level.

I have to admit that there's a ton more reading to be done, but the older papers don't seem to like the idea that blood glucose variability has a big part to play, but Hba1C variability does, and more recent work disagrees. There is still a ton of work to be done in this area.

PseudoBob77 · Mar 24, 2016

tim2000s said:
I suspect that it's more likely to be

There's certainly plenty to read. What seems to be the biggest issue in relation to variability is that when someone is longer term hyperglycaemic there are a number of protective mechanisms that kick in. When they are spiking for a short term, these don't seem to kick in and the oxidative stress caused by the spike continues when glucose levels return to a "normal" level.

I have to admit that there's a ton more reading to be done, but the older papers don't seem to like the idea that blood glucose variability has a big part to play, but Hba1C variability does, and more recent work disagrees. There is still a ton of work to be done in this area.

Yes oxidative stress is a major factor, so an antioxidant rich diet would also help. It tends to be a mix of genetic/social factors that determine complication free lives.

Even in the general population adapting diet is important. If you read into vascular health and endothelial dysfunction, there's certain foods to counter this more effectively. High blood sugars harden and fur up the arteries, which is why a large portion of diabetics kick the bucket from cardiovascular disease.

Senga · Mar 26, 2016

steveo4 said:
Get the freestyle libre sensor available free on the NHS.

Probably work out less than it is costing at the moment for strips, as I am constantly testing to gain control

Regards

Type 1's - I need your thoughts!

PseudoBob77

Well-Known Member

tim2000s

Expert

PseudoBob77

Well-Known Member

Senga

Well-Known Member

Type 1's - I need your thoughts!

PseudoBob77

Well-Known Member

tim2000s

Expert

PseudoBob77

Well-Known Member

Senga

Well-Known Member

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