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UKPDS risk engine related to CHD/CVD
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<blockquote data-quote="NorthernPam" data-source="post: 403598" data-attributes="member: 76218"><p>Hi Phoenix,</p><p>Thanks for the reply. Yes, I agree that in terms of identifying and treating things such as CVD/CHD the world has moved on and it’s much better now than it was when the original UKPDS took place. The point is that the risk assessment is based on that study. When later diabetes studies are compared there seems to be an opinion that UKPDS was flawed from the outset as it was based on participants keeping their bg below the arbitrary figure of 182 mg/dl (below 10 ish) set in the US which is the same target in the UK today. The 2010/2011 external validation that I referred to states that the risk has been overestimated. My understanding of this paper is that the criticism of ‘moderate to poor’ refers to the tool (software) that is used to make the assessment irrespective of outcomes in different geography. I hope I have explained that well enough.</p><p></p><p>I was 64 in May so at some stage in the next 30 years it is likely that something is going to see me off (!) and due to age alone I think my risk of all sorts of things increases. I was not unduly concerned when told that my risk of a heart attack in the next 10 years was around 19% and know that in NHS terms that will decrease anyway as I lose a further stone though I might be being too complacent here. Others are being quoted much higher figures. I am somewhat sceptical of any facts and figures they quote at me. What bothers me is that in addition to being given duff dietary advice some people are being scared witless by a risk assessment that could be 200+% out and that this appears to be based on a software tool that independent validation has deemed to need an overhaul as it produces moderate to poor results.</p><p></p><p>I am new to all this and although I have learned a lot in the last 4 months I know I have a great deal more to learn so if I am off-track with this please be patient with me.</p><p></p><p>To change the subject - I’ve seen your name on numerous forum posts and think you have been around a long time so please can I ask you a really dumb question? When you test 2 hours after meals should it be 2 hours after starting the meal or 2 hours after finishing it as the time could vary by 30 minutes or more? I did ask this question twice at my clinic review a couple of weeks ago and was met with blanks looks followed by ‘errr’ then ‘probably’ 2 hours after finishing. This is what I have been doing but am not sure it is right. Next week I have a home week and plan to do some specific meal and exercise testing and it seems daft if I don’t get the timings right so hope you can advise please.</p><p>Thanks, Pam</p></blockquote><p></p>
[QUOTE="NorthernPam, post: 403598, member: 76218"] Hi Phoenix, Thanks for the reply. Yes, I agree that in terms of identifying and treating things such as CVD/CHD the world has moved on and it’s much better now than it was when the original UKPDS took place. The point is that the risk assessment is based on that study. When later diabetes studies are compared there seems to be an opinion that UKPDS was flawed from the outset as it was based on participants keeping their bg below the arbitrary figure of 182 mg/dl (below 10 ish) set in the US which is the same target in the UK today. The 2010/2011 external validation that I referred to states that the risk has been overestimated. My understanding of this paper is that the criticism of ‘moderate to poor’ refers to the tool (software) that is used to make the assessment irrespective of outcomes in different geography. I hope I have explained that well enough. I was 64 in May so at some stage in the next 30 years it is likely that something is going to see me off (!) and due to age alone I think my risk of all sorts of things increases. I was not unduly concerned when told that my risk of a heart attack in the next 10 years was around 19% and know that in NHS terms that will decrease anyway as I lose a further stone though I might be being too complacent here. Others are being quoted much higher figures. I am somewhat sceptical of any facts and figures they quote at me. What bothers me is that in addition to being given duff dietary advice some people are being scared witless by a risk assessment that could be 200+% out and that this appears to be based on a software tool that independent validation has deemed to need an overhaul as it produces moderate to poor results. I am new to all this and although I have learned a lot in the last 4 months I know I have a great deal more to learn so if I am off-track with this please be patient with me. To change the subject - I’ve seen your name on numerous forum posts and think you have been around a long time so please can I ask you a really dumb question? When you test 2 hours after meals should it be 2 hours after starting the meal or 2 hours after finishing it as the time could vary by 30 minutes or more? I did ask this question twice at my clinic review a couple of weeks ago and was met with blanks looks followed by ‘errr’ then ‘probably’ 2 hours after finishing. This is what I have been doing but am not sure it is right. Next week I have a home week and plan to do some specific meal and exercise testing and it seems daft if I don’t get the timings right so hope you can advise please. Thanks, Pam [/QUOTE]
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