Diabetes Type 2 Day in Reading

[happydog]

This was a really informative day for Type 2s with lots of opportunities to ask questions with the "experts" and to network with other type 2s. I understand that they will be doing 80 of these days around the country. If you get the chance to go do so it is well worth it. I was surprised to learn that an HbA1c of 48 is considered good control. I thought that it had to be lower than that. Diabetes.co.uk will be putting information on their website and attendance is free. There was a nice lunch too! 🙂

 

[yorksman]

I was surprised to learn that an HbA1c of 48 is considered good control. I thought that it had to be lower than that.

You are right, it does. 48 is regarded by the NHS as a target for type 2 diabetics whereas 40 is the target for non diabetics. Roy Taylor warns in Medscape however:

"A clear distinction must be made between weight loss that improves glucose control but leaves blood glucose levels abnormal and weight loss of sufficient degree to normalize pancreatic function. The Belfast diet study provides an example of moderate weight loss leading to reasonably controlled, yet persistent diabetes. This study showed that a mean weight loss of 11 kg decreased fasting blood glucose levels from 10.4 to 7.0 mmol/L but that this abnormal level presaged the all-too-familiar deterioration of control."

Hence the NHS circular argument. Diabetes is progressive. This is inevitable. You have good control but things will get worse eventually. There is nothing that can be done about this. See for yourself. You achieved good control but eventually things got worse.

Roy Taylor on the other hand has demonstrated that:

"The extent of weight loss required to reverse type 2 diabetes is much greater than conventionally advised."

If you can, get it below 40 and aim to keep it below 40, preferably well below 40.

Setting a target of 48 has more to do with setting easily achievable targets than setting useful targets. You're still damaging your body with 48, just not as fast.

 

[LeeLee]

Hmmm. Let's see how long I can maintain my 33. It would be fantastic to prove 'em wrong! 🙂

 

[yorksman]

Hmmm. Let's see how long I can maintain my 33. It would be fantastic to prove 'em wrong! 🙂

If you are achieving 33 on diet and exercise alone, that is an achievment of some note and, if it is the result of a substantial loss in weight, according to Taylor, you may have rebooted some of your previously clogged up islets. The NHS view has been that the islets die but Taylor thinks that initially at least, they are merely 'metabolically inhibited'.

In any event, as long as it is that low, you are keeping all sorts of complications at bay so, long may your blood sugars be low.

 

[Davids]

I went to that session in Reading today. I thought it was very worthwhile. I chatted to the doctor who spoke quite a bit - he really surprised me with his very strong opinion that type 2s should not test their blood glucose levels. He thought it could do more harm than good and said there was no evidence that testing led to any improvement in control.

In my short time since diagnosis, I think testing has really helped me start to understand cause and effect.

He said the health service simply cannot afford it.

I am glad I am not in his health authority patch!

 

[Northerner]

I went to that session in Reading today. I thought it was very worthwhile. I chatted to the doctor who spoke quite a bit - he really surprised me with his very strong opinion that type 2s should not test their blood glucose levels. He thought it could do more harm than good and said there was no evidence that testing led to any improvement in control.

In my short time since diagnosis, I think testing has really helped me start to understand cause and effect.

He said the health service simply cannot afford it.

I am glad I am not in his health authority patch!

I would have liked to have met him! I really hate it when people are so dogmatic, although of course he revealed his true colours when he said the NHS couldn't afford it. He's wrong - not only in saying testing has no value, which is completely repudiated by the experiences of the vast majority of people whose stories I have read here, but in saying the NHS can't afford it. The NHS spends 80% of its diabetes budget on the treatment of complications, not test strips - educate people and support them with testing and it is likely that those costs would be significantly reduced, to say nothing of the terrible loss of quality of life that would be avoided.

As yorksman says about the HbA1c target, the profession is just trying to set easier to achieve targets, a bit like saying we need 5-a-day when actually the real advice would be much more. Similarly, by advising that people do not need to test, they are trying to make management of diabetes easier but ignoring the possible long-term consequences. If they can convince people that there is no hope (i.e. it is progressive and inevitable) then people become resigned and fatalistic and don't make waves - and are cheaper on short-term budgets.

 

[yorksman]

a bit like saying we need 5-a-day when actually the real advice would be much more.

On a palaeolithic diet, would that include mammoth, sabre toothed cats, hyaenas, woolly rhinocerous, bison and aurochs with maybe the odd arctic hare as a quick snack?

 

[happydog]

Sorry to say that I was not surprised by his attitude to Type 2s testing. I think that he is mistaken. I also overheard him saying to a colleague "at least the zealots are not out in force today". If trying to get the best quality of life for yourself healthwise and avoiding complications is being a zealot, count me in. He is also very pro statins and says really everyone who diabetes should be on them. Someone told me that doctors make money out of prescribing them. I don't know if that is true, has anyone else heard this? I came to the conclusion that there is still a lot for everyone to learn about diabetes and that the medical profession are still uncertain about some areas. Overall it was a good day.

 

[happydog]

Interesting post Yorksman. I'll take a look at medscape. Well done LeeLee brilliant figures. Hope they continue 🙂. I am on 36 at the moment, but always hopeful of an improvement

 

[LeeLee]

If you are achieving 33 on diet and exercise alone, that is an achievment of some note and, if it is the result of a substantial loss in weight, according to Taylor, you may have rebooted some of your previously clogged up islets. The NHS view has been that the islets die but Taylor thinks that initially at least, they are merely 'metabolically inhibited'.

In any event, as long as it is that low, you are keeping all sorts of complications at bay so, long may your blood sugars be low.

Yes, it was major weight loss that did the trick for me. I'd better not lose the plot again diet-wise, and will have to stay relatively low carb forever. Ho hum.

 

[happydog]

I did not have a major weight loss to do as I was well within the target weight for my height. I am now just borderline on being underweight. Like you I am trying to keep my carbohydrate intake under control and take more exercise. Thank you for the encouragement 🙂

 

[LeeLee]

I did not have a major weight loss to do as I was well within the target weight for my height. I am now just borderline on being underweight. Like you I am trying to keep my carbohydrate intake under control and take more exercise. Thank you for the encouragement 🙂

Well done happydog, hard work does pay off. It definitely helps to have a pancreas with a forgiving nature, but unfortunately that's not something granted to every T2 by the D-fairy.