Today's silly question

[JMyrtle]

I went for my eye test on Thursday and what a "little Job's comforter" he was!
I explained that although it was my first official diabetic eye test I had one done at the hospital last September when they were trying to find out why I had had a blocked vein in my eye ( they never did find out by the way) and that I had no signs of diabetic changes in my eyes then.
The eye tester told me that at my age I must have as all diabetics do, it would get worse and I could even loose my sight eventually.
However after the test he told me my eyes were clear, i would get a confirmation letter in about four weeks and would be recalled in a year.
My question is at what level does raised blood glucose start to impact on sight and other functions and how long do such changes take to occur?
At sixty six years of age with an HbA1c of 51 and no other symptoms do I actually have that much to worry about or will something else get me first?
I know 51 is higher than normal but not by much and the new guidelines recommend no medication, diet only control on readings under 60.

 

[trophywench]

Well I've been T1 for 46 years in August and I kind of live in trepidation that one day I'll wake up with every diabetic complication known to medical science - but until that day I'll carry on doing what I've always done !

I was also told about, I dunno - 5 or so years ago by a photographer that it was perfectly normal to have signs in the eyes after 10 years - I burst out laughing and said 'What about 40 then?'. She was a tad bemused that I didn't have any noticeable ones so she was in the same boat as me and you.

We've been chewing over the possible role of C-peptide and whether it accounts for the protection of such as me and you amongst many others.

 

[Slippylizard]

Hi Jackie. Great question and fair to ask. I can't answer that one however you do say that any readings under 60 are not recommended medication and diet only. I've never come across that before where does it come from please? I'm really not doubting you I've just not come across it. Thanks. 🙂

 

[Ralph-YK]

HbA1c levels are:
30 (?) - 41 are classed as "normal"
42 - 47 is called pre diabetic
Going 48 or above gets you a diagnosis of diabetic (even if you go lower than this you are still classed as diabetic, just not with diabetic/high levels. As in well controlled).
People on here have been diagnosed with levels between the 50s and around 100.
As for the rest of your question, I don't know.

The eye tester told me that at my age I must have as all diabetics do

Must have? I have doubts.

it would get worse and I could even loose my sight eventually.

Managing your diabetes will reduce the risk of this. There are people on here who have been diabetic for years, even decades, and I believe they've not lost any sight yet.

 

[Amigo]

NICE seem to suggest keeping the level around 48 prevents diabetic complications.

I’ve not seen the guidelines on remaining under 60 to avoid medication however.

 

[Mark Parrott]

Well, my brother has been badly controlling his diabetes for 20 years & still has no complications.

 

[everydayupsanddowns]

There are large comprehensive trials that show an association between lower HbA1c and ‘reduced risk’ of complications, including (I think especially?) those to do with eyes. The risk graph is like a reverse L shape, with a steep rise at higher numbers, but curving and levelling to a gentle flattish slope lower than 7.5% with less risk reduction down through the 6s.

But there are no guarantees, and 2 people with the same A1c can have very different outcomes, partly because A1c is a fairly crude measure and two completely different glucose profiles can give the same result, but mostly perhaps, because this is biology, not maths.

I have known young people with T1 and less than ideal BGs who have begun to develop quite serious retinopathy within 5 years.

I’ve also been on the receiving end of ‘after 20 years you will almost certainly have some’ but I don’t. And Jenny TW has twice that mileage and is still clear.

So yes, bear it in mind as a risk. But don’t fret about every single 10+ you see on a meter. I know I get several of those a week and so far, my eyes remain clear.

 

[JMyrtle]

Ok one of the people I sit on a committee with is a local GP ( not mine) and he told me that the local h/a are concerned about the high level of over 65s being diagnosed with type 2 and being put on medication because of the costs involved when there is every chance that something other than diabetes will get them first.
They have therefore issued unofficial guidelines that type 2s over 60 with a HbA1c of less than 60 be put on diet control only first.
At my foot check the nurse said the guidelines are for type 2s not to test but as you are I can tell you that if none of your readings go over 10 you will not be put into medication.
My readings are 7-8 before breakfast, 5-6 before evening meal and back to 7-8 two hours later, I don't bother to test after breakfast because I always have tea,one slice of wholemeal Hovis with butter, one egg and one slice of bacon and know my reading will always be be about 6.5 two hours later, we don't eat lunch.
Also if anyone reads the Daily Mirror, there was a letter to Dr Miriam Stoppard asking if type 2 was reversals and she said that " following the results of a study Diabetes UK recommends two options, loose weight and cut down on all kinds of sugar and refined carbohydrates"
" 86% of those who loose 33lb or more regardless of height or gender find themselves in remission"
At last someone people take notice of is listening to us.

 

[mikeyB]

The development of diabetic eye complications are more associated with number of years diagnosed than the level of HbA1c, though this difference disappears with very badly controlled diabetes. It’s also different in metabolic syndrome, rather than simple T2, and T1.

Given this complicated picture, it’s completely unpredictable as to when or if will occur, except, as I said, in wildly uncontrolled diabetes.

 

[JMyrtle]

Thanks Mike

 

[Drummer]

When diagnosed I had background retinopathy, I went low carb and now I have gone back to having normal everything including eyes.