Monday, September 28, 2009

Does anyone know the truth?

I came across a doctor's website while looking for an A1C to average blood glucose conversion chart a few days ago. This doc was saying that the North American guidelines for blood glucose control were not tight enough. His point of view was that if diabetics didn't have perfect blood glucose control that they were basically setting themselves up for long term complications. The less control, the sooner these problems would arise. The website is http://www.rajeun.net/HbA1c_glucose.html.

Then today, I was watching the Dr. Oz show (not really sure how valid his medical opinion is given it's a TV show?) and he measured the A1C of a severly overweight non-diabetic woman who needed to loose some weight and get healthier. Her A1C was 6.2 (average blood glucose of 8.0). For a Type 1 Diabetic, this would be a very good value. Adele has never been that low. Her best ever value was 6.5 (with too many lows really) and her last value was 7.7 (with alot less lows). Dr. Oz said that anything above 6.0 was a concern. So, what does that mean?

This makes me quite depressed. The pediatric endocrinologists at IWK in Halifax are telling us that it's OK to even have an A1C in the 9's (average blood glucose above 13.6) for a child Adele's age. Now, who's right? Are North American doctors giving diabetics a false sense of security by keeping A1C guidelines so high? Given that the perfect control (same as a healthy non-diabetic) is "virtually" impossible while playing the very, very complexe Type 1 game, are these guidelines so high simply to avoid severe and very dangerous lows? Are these guidelines so high to avoid Type 1 game burnout trying to bring blood glucose down to normal values? Looking at the numbers too much can really get to you after a while, since there is always room for improvement as well as so many outside factors that come into play.

So, are we kidding ourselves thinking that Adele will not have long-term complications simply because our control is very good (even excellent) according to the North American guidelines or are we just delaying the inevitable? Are we being lied to? Maybe this is just what I need to push me towards ensuring that I do everything in my power to give her the best possible blood glucose control (even if it's not perfect)? It's all that I can do right? Or maybe it's additional fuel for my Type 1 awareness drive and JDRF fundraising so that a cure for this terrible disease is found before it's too late? Hold on tight, this Type 1 ride isn't over yet...

1 comment:

Brian said...

Mike,

I'm told the same from my endo here in london, ontario. It is when he is older that he needs to get his average down between 4-6.

Having said that before Nathan could start on the pump they wanted to see 2 consecutive A1C under 8.0. Why, I'm not sure.

Brian