Average A1c 9%

[Jonk]

In a separate thread, people are marveling at the fact that
the average A1c in America is 9%. The logical conclusion most
are coming to is that it must be bad medical advice.

In defense of the doctors, I think people have to look at
denial and non-compliance.

I go to Kaiser in LA (Sunset, if you know the area) which
services a large central city population. My nurse-DCE has
told me that most of her patients won't even test once a day.
She rarely recommends MDI because most of her patients won't
do it. She figures she's lucky if they will take one or two
shots a day.

My sister just took the class in intro to diabetes. They of
course taught the food pyramid. After the class she asked the
instructor why she didn't differentiate between fast and slow
carbos - like whole wheat bread over white bread. The response
was that they try to limit their recommendations to what
people actually might do.

So all the advice offered is aimed at the lowest common
denominator.

A friend of my daughter's lives in South Central LA. His
mother is severely obese and diabetic. She takes Glucophage
and tests once a day in the morning when she remembers. She
runs in the 150s and figures that means she's doing good. Coke
remains her drink of choice since Diet Coke tastes awful to
her. And she's an excellent cook who does a lot of baking. Her
brother just had a leg removed. That event has had no impact
in her diabetic regimen, nor his.

These are not stupid people, just very poor. She works (rather
worked, when she could still walk) as a pharmacy tech. She
knows about diabetes and all the drugs involved. She's just in
severe denial. So are her children who are both obese and one
of whom is a diagnosed diabetic.

Everybody in this news group is part of an elite: they can
read, write and get on the internet - and find news groups. By
definition, the performance level in this group is going to
far exceed the national average.

Additionally, the encouragement and sense of community in
this group pushes people to a higher level of performance
than they would achieve with the same level of knowledge but
without the group.

So I'm not surprised that the average A1c is as high as 9%;
I'm surprised it's that low.

Jon

[Julie Bove]

"JonK" <jon@the-kaplansNOSPAM.com> wrote in message
news:405E0D23.5D9F5C02@the-kaplansNOSPAM.com...
> In a separate thread, people are marveling at the fact that
> the average A1c in America is 9%. The logical conclusion
> most are coming to is that it must be bad medical advice.
>
> In defense of the doctors, I think people have to look at
> denial and non-compliance.
>
> I go to Kaiser in LA (Sunset, if you know the area) which
> services a large central city population. My nurse-DCE has
> told me that most of her patients won't even test once a
> day. She rarely recommends MDI because most of her patients
> won't do it. She figures she's lucky if they will take one
> or two shots a day.
>
> My sister just took the class in intro to diabetes. They of
> course taught the food pyramid. After the class she asked
> the instructor why she didn't differentiate between fast and
> slow carbos - like whole wheat bread over white bread. The
> response was that they try to limit their recommendations to
> what people actually might do.
>
> So all the advice offered is aimed at the lowest common
> denominator.
>
> A friend of my daughter's lives in South Central LA. His
> mother is severely obese and diabetic. She takes Glucophage
> and tests once a day in the morning when she remembers. She
> runs in the 150s and figures that means she's doing good.
> Coke remains her drink of choice since Diet Coke tastes
> awful to her. And she's an excellent cook who does a lot of
> baking. Her brother just had a leg removed. That event has
> had no impact in her diabetic regimen, nor his.
>
> These are not stupid people, just very poor. She works
> (rather worked, when she could still walk) as a pharmacy
> tech. She knows about diabetes and all the drugs involved.
> She's just in severe denial. So are her children who are
> both obese and one of whom is a diagnosed diabetic.
>
> Everybody in this news group is part of an elite: they can
> read, write and get on the internet - and find news groups.
> By definition, the performance level in this group is going
> to far exceed the national average.
>
> Additionally, the encouragement and sense of community in
> this group pushes people to a higher level of performance
> than they would achieve with the same level of knowledge but
> without the group.
>
> So I'm not surprised that the average A1c is as high as 9%;
> I'm surprised it's that low.

I don't know if the number is really 9% or not, but it
wouldn't surprise me if it were. I know plenty of
diabetics who are in denial and even more who are totally
uninformed about their disease. It seems that the most
common thought people have is that they just take a pill
or two and be done with
it. And most Drs. just assume that the majority of their
patients will think this way, so they don't expect
any more. These people probably have no clue what
their A1c is.

I know people with type 1 or type 2 who use insulin who have
terrible trouble with hypos. For them, tight control is next
to impossible to achieve. So they aim for higher numbers than
the rest of us.

I think those of us here on this NG are the minority. I've
been accused by one Dr. of exercising too much. When I told
her that exercise after both dinner and lunch was the only way
I could keep my BG down, she scoffed and said nobody needed to
exercise more than 3 times a week. This same Dr. also thought
I was being too extreme when I was unhappy with my numbers
that were running over 200 for several days due to an
infection that wasn't healing or being treated properly by any
of my Drs. At least I got my Endo. to listen to me and get
some additional meds.

Knowledge is a good thing, but rather meaningless if people
don't want to learn. And that seems to be how most
diabetics are.
--
Type 2 http://users.bestweb.net/~jbove/

[Mack©®]

On Sun, 21 Mar 2004 21:46:12 GMT, JonK
<jon@the-kaplansNOSPAM.com> wrote:

>In a separate thread, people are marveling at the fact that
>the average A1c in America is 9%. The logical conclusion most
>are coming to is that it must be bad medical advice.
>
>In defense of the doctors, I think people have to look at
>denial and non-compliance.

non-compliance has become the catch word for diabetes. There
are some who are in denial, some who are non-compliant and
just as many who have doctors who settle for less than optimal
numbers because they either don't want to put forth the effort
to motivate the individual or simply believe it is not got to
make any difference. You also have to keep in mind that the
majority of diabetics are NOT under the care of specialists.

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt
>
>I go to Kaiser in LA (Sunset, if you know the area) which
>services a large central city population. My nurse-DCE has
>told me that most of her patients won't even test once a day.
>She rarely recommends MDI because most of her patients won't
>do it. She figures she's lucky if they will take one or two
>shots a day.
>
>My sister just took the class in intro to diabetes. They of
>course taught the food pyramid. After the class she asked the
>instructor why she didn't differentiate between fast and slow
>carbos - like whole wheat bread over white bread. The
>response was that they try to limit their recommendations to
>what people actually might do.
>
>So all the advice offered is aimed at the lowest common
>denominator.
>
>A friend of my daughter's lives in South Central LA. His
>mother is severely obese and diabetic. She takes Glucophage
>and tests once a day in the morning when she remembers. She
>runs in the 150s and figures that means she's doing good.
>Coke remains her drink of choice since Diet Coke tastes awful
>to her. And she's an excellent cook who does a lot of baking.
>Her brother just had a leg removed. That event has had no
>impact in her diabetic regimen, nor his.
>
>These are not stupid people, just very poor. She works
>(rather worked, when she could still walk) as a pharmacy
>tech. She knows about diabetes and all the drugs involved.
>She's just in severe denial. So are her children who are both
>obese and one of whom is a diagnosed diabetic.
>
>Everybody in this news group is part of an elite: they can
>read, write and get on the internet - and find news groups.
>By definition, the performance level in this group is going
>to far exceed the national average.
>
>Additionally, the encouragement and sense of community in
>this group pushes people to a higher level of performance
>than they would achieve with the same level of knowledge but
>without the group.
>
>So I'm not surprised that the average A1c is as high as 9%;
>I'm surprised it's that low.
>
>Jon

[Wes Grolea]

JonK wrote:
> In a separate thread, people are marveling at the fact that
> the average A1c in America is 9%. The logical conclusion
> most are coming to is that it must be bad medical advice.
>
> In defense of the doctors, I think people have to look at
> denial and non-compliance.

I think both are true. Many folks won't follow good advice,
BUT some of the advice that is given is not good. When I was
diagnosed, my doctor had a nurse call me and say "Buy a
glucose meter and take Glucovance." Literally, that was all.

I got another doctor who I think is pretty good, but I'm a
veteran, so I went to the V.A. clinic to save money on
meds. The doctor there said, "Your A1c is 8.2& That's
excellent. There's no reason for you to test so often. Once
a week is plenty."

(By the way, I didn't need the Glucovance. Severe hypo the
first one, and never took another. Made the five percent club
within six months.)

--
Wes Groleau
------
"The reason most women would rather have beauty than
brains is they know that most men can see better than
they can think."
-- James Dobson

[Extreme-Cc]

"Mack©®" <asdnospamhere@example.com> wrote in message
news:pmds50hos5rmoj0p154rpa8lh4438erli7@4ax.com...

You also have
> to keep in mind that the majority of diabetics are NOT under
> the care of specialists.
>
> Mack©®

with 15+ million diabetics in the US alone I certainly have no
way to know if that's true. but yes people probably would do
better under the care of specialists.

[Extreme-Cc]

"Wes Groleau" <groleau+news@freeshell.org> wrote in message
news:2dOdnaEJSLPg0sPdRVn-vw@gbronline.com...
> JonK wrote:
> > In a separate thread, people are marveling at the fact
> > that the average A1c in America is 9%. The logical
> > conclusion most are coming to is that it must be bad
> > medical advice.
> >
> > In defense of the doctors, I think people have to look at
> > denial and non-compliance.
>
> I think both are true. Many folks won't follow good advice,
> BUT some of the advice that is given is not good. When I was
> diagnosed, my doctor had a nurse call me and say "Buy a
> glucose meter and take Glucovance." Literally, that was all.

when were you diagnosed?

>
> I got another doctor who I think is pretty good, but I'm a
> veteran, so I went to the V.A. clinic to save money on meds.
> The doctor there said, "Your A1c is 8.2& That's excellent.
> There's no reason for you to test so often. Once a week is
> plenty."
>
> (By the way, I didn't need the Glucovance. Severe hypo the
> first one, and never took another. Made the five percent
> club within six months.)

thats great about making the 5% club with in 6 months. i think
it took me 6 months to get a 5.1 on my a1c.
>
> --
> Wes Groleau
> ------
> "The reason most women would rather have beauty than
> brains is they know that most men can see better than
> they can think."
> -- James Dobson

[Frederic E]

"Mack©®" <asdnospamhere@example.com> wrote in message
news:pmds50hos5rmoj0p154rpa8lh4438erli7@4ax.com...
> have doctors who settle for less than optimal numbers
> because they either don't want to put forth the effort to
> motivate the individual or simply believe it is not got to
> make any difference. You also have to keep in mind that the
> majority of diabetics are NOT under the care of specialists.
>

Hi, Four years ago when researching diabetes, I came across an
Article by the British national health service. I stated that
it would cost about $6000 per diabetic patient per year to
have an specialist work with individual patients. The cost
would ruin the system in no time. The recommendation was
education in support groups. But how do you get people in
denial, or who don't care to go support groups?

Fred Henzi

[The Real N]

Mack©® wrote:
> On Sun, 21 Mar 2004 21:46:12 GMT, JonK
> <jon@the-kaplansNOSPAM.com> wrote:
>
>
>>In a separate thread, people are marveling at the fact that
>>the average A1c in America is 9%. The logical conclusion
>>most are coming to is that it must be bad medical advice.
>>
>>In defense of the doctors, I think people have to look at
>>denial and non-compliance.
>
>
> non-compliance has become the catch word for diabetes. There
> are some who are in denial, some who are non-compliant and
> just as many who have doctors who settle for less than
> optimal numbers because they either don't want to put forth
> the effort to motivate the individual or simply believe it
> is not got to make any difference. You also have to keep in
> mind that the majority of diabetics are NOT under the care
> of specialists.

Majority of diabetics? Majority of diabetics who are regulars
on this NG, maybe, but without all the people here confirming
your statement, I really doubt
it. But, then again, unlike you, I have new things to learn.

>
> Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
> http://www.insulin-pumpers.org
>
> In tribute to the United States of America and the State of
> Israel, two bastions of strength in a world filled with
> strife and terrorism.
>
> "To announce that there must be no criticism of the
> President, or that we are to stand by the President
> right or wrong, is not only unpatriotic and servile,
> but is morally treasonable to the American public."
>
> ...Theodore Roosevelt
>
>>I go to Kaiser in LA (Sunset, if you know the area) which
>>services a large central city population. My nurse-DCE has
>>told me that most of her patients won't even test once a
>>day. She rarely recommends MDI because most of her patients
>>won't do it. She figures she's lucky if they will take one
>>or two shots a day.
>>
>>My sister just took the class in intro to diabetes. They of
>>course taught the food pyramid. After the class she asked
>>the instructor why she didn't differentiate between fast and
>>slow carbos - like whole wheat bread over white bread. The
>>response was that they try to limit their recommendations to
>>what people actually might do.
>>
>>So all the advice offered is aimed at the lowest common
>>denominator.
>>
>>A friend of my daughter's lives in South Central LA. His
>>mother is severely obese and diabetic. She takes Glucophage
>>and tests once a day in the morning when she remembers. She
>>runs in the 150s and figures that means she's doing good.
>>Coke remains her drink of choice since Diet Coke tastes
>>awful to her. And she's an excellent cook who does a lot of
>>baking. Her brother just had a leg removed. That event has
>>had no impact in her diabetic regimen, nor his.
>>
>>These are not stupid people, just very poor. She works
>>(rather worked, when she could still walk) as a pharmacy
>>tech. She knows about diabetes and all the drugs involved.
>>She's just in severe denial. So are her children who are
>>both obese and one of whom is a diagnosed diabetic.
>>
>>Everybody in this news group is part of an elite: they can
>>read, write and get on the internet - and find news groups.
>>By definition, the performance level in this group is going
>>to far exceed the national average.
>>
>>Additionally, the encouragement and sense of community in
>>this group pushes people to a higher level of performance
>>than they would achieve with the same level of knowledge but
>>without the group.
>>
>>So I'm not surprised that the average A1c is as high as 9%;
>>I'm surprised it's that low.
>>
>>Jon

[The Real N]

Extreme-CC's wrote:
> "Mack©®" <asdnospamhere@example.com> wrote in message
> news:pmds50hos5rmoj0p154rpa8lh4438erli7@4ax.com...
>
> You also have
>
>>to keep in mind that the majority of diabetics are NOT under
>>the care of specialists.
>>
>>Mack©®
>
>
> with 15+ million diabetics in the US alone I certainly have
> no way to know if that's true.

You are absolutely correct. Like I've said, talk is cheap.

> but yes people probably would do better under the care of
> specialists.

[Gman99]

> I go to Kaiser in LA (Sunset, if you know the area) which
> services a large central city population. My nurse-DCE has
> told me that most of her patients won't even test once a
> day. She rarely recommends MDI because most of her patients
> won't do it. She figures she's lucky if they will take one
> or two shots a day.

Studies have shown that the level of self testing has no
affect on one's treatment. In the study (I'll see if I can
find it) subjects were grouped by level of testing...there was
no significant difference in A1c's between the two groups.
Testing is not a means to an end !

> My sister just took the class in intro to diabetes. They of
> course taught the food pyramid. After the class she asked
> the instructor why she didn't differentiate between fast and
> slow carbos - like whole wheat bread over white bread. The
> response was that they try to limit their recommendations to
> what people actually might do.

Most people don't know what a carb is let alone the difference
between fast and slow. The concept of GI is way over their
heads. MOST diabetics do NOT take good care of themselves
which is why the numbers related to increased risks of
everything seems so ominus.

[markd]

It is important to remember in that styudy they wer doing a
survey to see what folks are actually doing about testing, not
trying to find the best approach to get the best a1c result.
If they all tested 20 times a day and didn't make diet etc.
changes accordingly, it would mean nothing about a1c breakout
info. For we t2 folk, a better study would be to see how
testing is used to adjust behaviors concerning exercise and
diet based on the pp levels and then relate that to a1c
results. Based on the self reported results here, keeping all
manner of possible limitations in mind, a1c and use of testing
would be significant.
>> > Any idea what "level of testing" meant/means?
>> >
>> How often the subject self-tested (how many times a day /
>> how many days a week...etc).
>>
>> Still looking....
>
>Nope...this is the one....
>
>http://www.findarticles.com/cf_dls/m0CUH/6_24/76610101/p1/ar-
>ticle.jhtml

[Jenny]

Mack,

I think that we have to distinguish between the noncompliance
that comes from denial--a real and prevalent problem, and the
noncompliance that results when patients try the diets and
meds their doctors prescribe only to find that they have no
effect on their control

All too often, the female patient who goes on a low fat low
cal diet and can't lose weight is often accused of being
"noncompliant" and told that she's lying about her diet, or
not counting calories correctly. I have had this happen.
When her blood sugar goes up on the 300 grams a day of
carbs the Nutritionist prescribes, it is very easy to
decide that diet is ineffective, degeneration the only
future, so what the hell.

The stats from articles writing about how great Avandia is for
control are interesting. The typical patient has a fasting
blood sugar near 200 mg/dl and with Avandia it drops 30 mg/dl.
This is hailed as a great response. But the patient is still
way too high and feels like crap all the time. Their
complications aren't getting better either.

Finally, a lot of newly diagnosed patients are hearing from
their doctors that type 2s will deteriorate no matter what
they do. A lot decide that if that's the case, why starve and
torment themselves with drugs that have nasty side effects. If
the diet and meds prescribed make you feel like crap and don't
do anything to control your blood sugar, yes, you will end up
noncompliant.

Give the patient a diet that works to control blood sugars and
meds including insulin that bring down the blood sugars
effectively, and you might see a whole different pattern with
compliance.

-- Jenny - Low Carbing for 4 years. At goal for weight.
Type 2 diabetes, hba1c 5.2. Cut the carbs to respond to my
email address!

Low carb facts and figures, my weight-loss photos, tips,
recipes, strategies for dealing with diabetes and more at
http://www.geocities.com/jenny_the_bean/

Looking for help controlling your blood sugar? Visit
http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm

"Mack©®" <asdnospamhere@example.com> wrote in message
news:pmds50hos5rmoj0p154rpa8lh4438erli7@4ax.com...
> On Sun, 21 Mar 2004 21:46:12 GMT, JonK
> <jon@the-kaplansNOSPAM.com> wrote:
>
> >In a separate thread, people are marveling at the fact that
> >the average A1c in America is 9%. The logical conclusion
> >most are coming to is that it must be bad medical advice.
> >
> >In defense of the doctors, I think people have to look at
> >denial and non-compliance.
>
> non-compliance has become the catch word for diabetes. There
> are some who are in denial, some who are non-compliant and
> just as many who have doctors who settle for less than
> optimal numbers because they either don't want to put forth
> the effort to motivate the individual or simply believe it
> is not got to make any difference. You also have to keep in
> mind that the majority of diabetics are NOT under the care
> of specialists.
>
> Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
> http://www.insulin-pumpers.org
>
> In tribute to the United States of America and the State of
> Israel, two bastions of strength in a world filled with
> strife and terrorism.
>
> "To announce that there must be no criticism of the
> President, or that we are to stand by the President
> right or wrong, is not only unpatriotic and servile,
> but is morally treasonable to the American public."
>
> ...Theodore Roosevelt
> >
> >I go to Kaiser in LA (Sunset, if you know the area) which
> >services a large central city population. My nurse-DCE has
> >told me that most of her patients won't even test once a
> >day. She rarely recommends MDI because most of her patients
> >won't do it. She figures she's lucky if they will take one
> >or two shots a day.
> >
> >My sister just took the class in intro to diabetes. They of
> >course taught the food pyramid. After the class she asked
> >the instructor why she didn't differentiate between fast
> >and slow carbos - like whole wheat bread over white bread.
> >The response was that they try to limit their
> >recommendations to what people actually might do.
> >
> >So all the advice offered is aimed at the lowest common
> >denominator.
> >
> >A friend of my daughter's lives in South Central LA. His
> >mother is severely obese and diabetic. She takes Glucophage
> >and tests once a day in the morning when she remembers. She
> >runs in the 150s and figures that means she's doing good.
> >Coke remains her drink of choice since Diet Coke tastes
> >awful to her. And she's an excellent cook who does a lot of
> >baking. Her brother just had a leg removed. That event has
> >had no impact in her diabetic regimen, nor his.
> >
> >These are not stupid people, just very poor. She works
> >(rather worked, when she could still walk) as a pharmacy
> >tech. She knows about diabetes and all the drugs involved.
> >She's just in severe denial. So are her children who are
> >both obese and one of whom is a diagnosed diabetic.
> >
> >Everybody in this news group is part of an elite: they can
> >read, write and get on the internet - and find news groups.
> >By definition, the performance level in this group is going
> >to far exceed the national average.
> >
> >Additionally, the encouragement and sense of community in
> >this group pushes people to a higher level of performance
> >than they would achieve with the same level of knowledge
> >but without the group.
> >
> >So I'm not surprised that the average A1c is as high as 9%;
> >I'm surprised it's that low.
> >
> >Jon

[Jonk]

gman99 wrote:

> Studies have shown that the level of self testing has no
> affect on one's treatment. In the study (I'll see if I can
> find it) subjects were grouped by level of testing...there
> was no significant difference in A1c's between the two
> groups. Testing is not a means to an end !
>
> Most people don't know what a carb is let alone the
> difference between fast and slow. The concept of GI is way
> over their heads. MOST diabetics do NOT take good care of
> themselves which is why the numbers related to increased
> risks of everything seems so ominus.

Exactly my point.

Additionally, I find that some doctors (my doctor, who in most
regards is just marvelous) are cautious and tread lightly when
it comes to scaring the patient.

When he took me off Glucophage he said that one of my blood
tests indicated kidney trouble and that continuing Glucophage
was dangerous. He didn't say that I had kidney damage as a
diabetic complication from poor control, and that I had done
permanent, irreversible damage to myself. That might have
woken me up a little more.

Jon

[The Real N]

gman99 wrote:
>>I go to Kaiser in LA (Sunset, if you know the area) which
>>services a large central city population. My nurse-DCE has
>>told me that most of her patients won't even test once a
>>day. She rarely recommends MDI because most of her patients
>>won't do it. She figures she's lucky if they will take one
>>or two shots a day.
>
>
> Studies have shown that the level of self testing has no
> affect on one's treatment. In the study (I'll see if I can
> find it)

Please do. Since this appears to be, in my mind, a strong
possibility, I sure would like to see some directly observable
data, so that I can turn it into a fact.

I suspect that a part of this comes from my doctor (specialty
nutrition) who says...... (omitted to avoid a range war).

> subjects were grouped by level of testing...there was no
> significant difference in A1c's between the two groups.
> Testing is not a means to an end !

Any idea what "level of testing" meant/means?

>
>
>>My sister just took the class in intro to diabetes. They of
>>course taught the food pyramid. After the class she asked
>>the instructor why she didn't differentiate between fast and
>>slow carbos - like whole wheat bread over white bread. The
>>response was that they try to limit their recommendations to
>>what people actually might do.
>
>
> Most people don't know what a carb is let alone the
> difference between fast and slow. The concept of GI is way
> over their heads. MOST diabetics do NOT take good care of
> themselves which is why the numbers related to increased
> risks of everything seems so ominus.

[Bj In Texa]

Frederic E Henzi wrote:
> The recommendation was education in support groups. But how
> do you get people in denial, or who don't care to go
> support groups?
>

How do you get them to go to a specialist? Many simply write
the long term effects of DM to aging, or will only see a
doctor if the symptoms become too severe.

Denial is a difficult mental condition to overcome
regardless of education and economic conditions. Many
people are comfortable in their lives and have a fear of
having to change.

BJ

[Gman99]

> Any idea what "level of testing" meant/means?
>
How often the subject self-tested (how many times a day / how
many days a week...etc).

Still looking....

[Alan]

On Mon, 22 Mar 2004 11:31:35 -0500, "Jenny"
<lottadatacarbs@hotmail.com> wrote: <snip>
>Finally, a lot of newly diagnosed patients are hearing from
>their doctors that type 2s will deteriorate no matter what
>they do. A lot decide that if that's the case, why starve and
>torment themselves with drugs that have nasty side effects.
>If the diet and meds prescribed make you feel like crap and
>don't do anything to control your blood sugar, yes, you will
>end up noncompliant.
>
>Give the patient a diet that works to control blood sugars
>and meds including insulin that bring down the blood sugars
>effectively, and you might see a whole different pattern with
>compliance.

I think you've hit the nail on the head. Then the high average
A1c in the diabetic community is compunded by those who are
compliant, but receive ineffective treatment because of advice
based on shaky IMO basic premises.

Does anyone know of any studies into compliance, particularly
after an initial period of compliance without effective
results? Was it an aspect looked at in the Nurses Study?

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

[Frank Roy]

The real Norm wrote:

> Majority of diabetics? Majority of diabetics who are
> regulars on this NG, maybe, but without all the people here
> confirming your statement, I really doubt
> it. But, then again, unlike you, I have new things to
> learn.
>
Old Al has given number for diabetics and for
endocrinologists. There is no way that the number of
endocrinologists could see all the diabetic patients.

" An endo is an Endocrinologist, the top medical specialist in
the field of diabetes. When you want the last word or the
definitive treatment, you ask an endo, read an endo's report
or go to the American Association of Clinical Endocrinologists
for the answer.

Sad situation:

There are 16.5 million diabetics in the U.S.

There are 3000 endos

That's 5500 diabetics per endo.

(In my case, we have 2 endo's covering 4 counties in
Michigan. If one estimates that 6.5% of the
four-county population is diabetic, that 5500 number
is just about right. . .and we only had one endo until
a few years ago)

I once asked a very busy** endo, "How many diabetics
does he treat each year?" He estimated that the diabetic
portion of his practice covers less than 1200 individual
diabetics."

I don't know where OldAl got his numbers for endocrinologist,
but his number for diabetics is in the ball park.

Physicians: http://www.bls.gov/oco/ocos074.htm Physicians and
surgeons held about 583,000 jobs in 2002; approximately 1 out
of 6 was self-employed. About half of salaried physicians and
surgeons were in office-based practice, and almost a quarter
were employed by hospitals. Others practiced in Federal,
State, and local government; educational services; and
outpatient care centers.

Bureau of Labor Statistics (BLS)
http://www.bls.gov/oes/2002/oes_stru.htm#29-0000 Estimates for
2002 ---------------- number Family and General Practitioners
- 115,020 Internists, General - ------------- 50,380
Obstetricians and Gynecologists --- 19,970 Surgeons
-------------------------- 51,580 Anesthesiologists
----------------- 24,780
Psychiatrists --------------------- 19,750 Pediatricians,
General ------------ 27,320

Specific figures for endocrinologists were not given by BLS,
but judging by the relative figures you see above 3000 is not
too wild and not all of them treat diabetics.

Frank

[Gman99]

nospam@bogusemail.com (gman99) wrote:
> >
> > Any idea what "level of testing" meant/means?
> >
> How often the subject self-tested (how many times a day /
> how many days a week...etc).
>
> Still looking....

Found it...I think...

http://www.findarticles.com/cf_dls/m0CUH/11_24/80381005/p1/ar-
ticle.jhtml

[Gman99]

nospam@bogusemail.com (gman99) wrote:
> >
> > Any idea what "level of testing" meant/means?
> >
> How often the subject self-tested (how many times a day /
> how many days a week...etc).
>
> Still looking....

Nope...this is the one....

http://www.findarticles.com/cf_dls/m0CUH/6_24/76610101/p1/art-
icle.jhtml

[Frank Roy]

Frank Roy wrote:

> There is no way that the number of endocrinologists could
> see all the diabetic patients.

In the American Medical Association publication, "Physician
Characteristics and Distribution in the US," 2004 edition,
figures for the total number of phyicians is 853,187 and the
number of endocrinologist is 4,461 for the year 2002.

Bear in mind that endocrinologist see people with thyroid,
reproduction, and other endocrine health problems besides
diabetes. I believe that current population estimates for the
US is about 290 million people. Many people with diabetes have
not been diagnosed. Those people would not be attempting to
see endocrinologist for diabetic reasons. Of the approximately
18 million people who may have diabetes maybe 2/3 have been
diagnosed or 12 million. That amounts to 2,690 patients per
endocrinologist if all of them only saw diabetic patients.
2,690 patients divided by 260 days (if these doctors worked 5
days per week and 52 weeks in the year) amounts to over 100
patients per day and about 12-13 patients per hour or 5
minutes a piece.

Frank

[Priscilla]

gman99 <nospam@bogusemail.com> quoth:
>nospam@bogusemail.com (gman99) wrote:
>> >
>> > Any idea what "level of testing" meant/means?
>> >
>> How often the subject self-tested (how many times a day /
>> how many days a week...etc).
>>
>> Still looking....

>Found it...I think...

>http://www.findarticles.com/cf_dls/m0CUH/11_24/80381005/p1/a-
>rticle.jhtml

"Overall, 471 patients (17%) stated that they tested their
blood glucose levels at home [greater than or equal to] 1
time per day, 899 patients (31%) tested their blood glucose
levels [greater than or equal to] 1 time per week, and 414
patients (14%) tested their blood glucose levels <1 time per
week, whereas 1,071 patients (38%) stated that they never
practiced SMBG."

So they placed subjects who tested just once a day into their
category of highest testing level. Basically they were
comparing gradations of inadequate testing.

Priscilla

[Alan]

On 22 Mar 2004 20:15:35 GMT, nospam@bogusemail.com
(gman99) wrote:

>nospam@bogusemail.com (gman99) wrote:
>> >
>> > Any idea what "level of testing" meant/means?
>> >
>> How often the subject self-tested (how many times a day /
>> how many days a week...etc).
>>
>> Still looking....
>
>Nope...this is the one....
>
>http://www.findarticles.com/cf_dls/m0CUH/6_24/76610101/p1/ar-
>ticle.jhtml

I read both articles with interest.

Those few of us who tested 8 to ten times daily in the initial
stages to gain a level of control over this disease will be
totally unsurprised at their conclusions.

IMO there is a minimal threshold point, particularly in the
early stages of learning what causes high BGs in your own
body, below which testing is ineffective for self-management.
There is also a structured testing regimen necessary to
provide usable data, and some analysis of the results and
action to modify diet and exercise is necessary to make the
testing effective.

It's like saying that prospective athletes who trained for up
to five minutes daily never reached competitive levels,
without noting that some of those who had a high-level
training program did. Conclusion: athletic training is
ineffective.

To quote this cite: "Testing at least twice per day was
uncommon and showed no relation to [HbA.sub.1c] value."

And your earlier cite: "Overall, 471 patients (17%) stated
that they tested their blood glucose levels at home [greater
than or equal to] 1 time per day" - that was the "frequently
testing" group!

And the: "CONCLUSIONS -- The data for all patients combined
indicate that self-monitoring of blood glucose is more common
as [HbA.sub.1c] increases, suggesting that patients with
poorer glycemic control have a greater tendency to
self-monitor. However, the increase in frequency of
self-monitoring with increasing [HbA.sub.1c] value is related
to the higher proportion of insulin-treated patients, who are
more likely to self-monitor, in higher [HbA.sub.1c]
categories. Within each diabetes therapy category there was
little relationship between the frequency of testing and
[HbA.sub.1c] value. Indeed, half of patients with [HbA.sub.1c]
[greater than]8%, the ADA value at which intensification of
glucose control is recommended [1], monitored less than once
per week."

So what these learned professors are saying is that testing up
to once per day, or even occasionally twice daily, had no
significant effect on A1c and only served to increase stress
(said elsewhere). And someone paid them lots of money to
discover that.

Now, can you provide some cites which specifically discuss the
lack of value of a regulated one- and two-hour post-prandial
testing regimen applied in the initial stages of SMBG?

Once again, I appeal to one of the researchers lurking on this
ng to consider this as a worthy research project.

Finally, read that last sentence of the conclusion again -
"[greater than]8%, the ADA value at which intensification
of glucose control is recommended [1]". The implication
that intensification is unnecessary below that threshold is
also a worry.

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

[The Real N]

gman99 wrote:
> nospam@bogusemail.com (gman99) wrote:
>
>>>Any idea what "level of testing" meant/means?
>>>
>>
>>How often the subject self-tested (how many times a day /
>>how many days a week...etc).
>>
>>Still looking....
>
>
> Found it...I think...
>
> http://www.findarticles.com/cf_dls/m0CUH/11_24/80381005/p1/-
> article.jhtml

How refreshing... to have support for something of
importance. Thanks.

However, I wonder how many here can take it at face value,
without nit-picking words and phrases.

Q of L, quality of life (diabetes-related stress, diabetes
health distress, diabetes-related worries, and Centers for
Epidemiologic Studies-Depression scale).

This is an important issue that, IMO, isn't mentioned here
enough, if at all. I have talked in terms of healthful
longevity, which implied physical well-being, but mental
well-being was in the back of my head, perhaps because of the
effects of my undiagnosed sleep apnea, which, as indicated
previously, scared me far more than the potential
complications of diabetes.

When I was walking around in a daze, like a zombie, I didn't
much care if I had four limbs or not. Of course, everyone who
comes here, is immediately warned about the complications of
diabetes, in order to motivate them to do whatever is
suggested here. My issue is not whether what is suggested is
right or wrong, but, rather, whether it was appropriate at the
time. And I see this as a significant consideration in the
link above.

And not being provided with any directly observable data, to
support the statements, makes it even more problematic
mental-health wise.

But, it didn't motivate me, and one of these days I'm going to
try and find time to go to the archives and get a feeling for
how many other newbies came here, heard the party-line, and
left, like me, but never returned. Of course, just because
they didn't return doesn't mean they didn't take the advice
here and live happily ever after. I just don't happen to think
that, based on my own experience and the link above.

I am no longer a 'strong' person, like I was before my
permanent cognitive deficits of 20 years ago. When I newbie
comes to visit, there are some mind-readers and fortune
tellers here, who think they have the ability to 'know'
someone with one or two posts.

JMO

[Alan]

On 22 Mar 2004 20:15:35 GMT, nospam@bogusemail.com
(gman99) wrote:

>nospam@bogusemail.com (gman99) wrote:
>> >
>> > Any idea what "level of testing" meant/means?
>> >
>> How often the subject self-tested (how many times a day /
>> how many days a week...etc).
>>
>> Still looking....
>
>Nope...this is the one....
>
>http://www.findarticles.com/cf_dls/m0CUH/6_24/76610101/p1/ar-
>ticle.jhtml

I read both articles with interest.

Those few of us who tested 8 to ten times daily in the initial
stages to gain a level of control over this disease will be
totally unsurprised at their conclusions.

IMO there is a minimal threshold point, particularly in the
early stages of learning what causes high BGs in your own
body, below which testing is ineffective for self-management.
There is also a structured testing regimen necessary to
provide usable data, and some analysis of the results and
action to modify diet and exercise is necessary to make the
testing effective.

It's like saying that prospective athletes who trained for up
to five minutes daily never reached competitive levels,
without noting that some of those who had a high-level
training program did. Conclusion: athletic training is
ineffective.

To quote this cite: "Testing at least twice per day was
uncommon and showed no relation to [HbA.sub.1c] value."

And your earlier cite: "Overall, 471 patients (17%) stated
that they tested their blood glucose levels at home [greater
than or equal to] 1 time per day" - that was the "frequently
testing" group!

And the: "CONCLUSIONS -- The data for all patients combined
indicate that self-monitoring of blood glucose is more common
as [HbA.sub.1c] increases, suggesting that patients with
poorer glycemic control have a greater tendency to
self-monitor. However, the increase in frequency of
self-monitoring with increasing [HbA.sub.1c] value is related
to the higher proportion of insulin-treated patients, who are
more likely to self-monitor, in higher [HbA.sub.1c]
categories. Within each diabetes therapy category there was
little relationship between the frequency of testing and
[HbA.sub.1c] value. Indeed, half of patients with [HbA.sub.1c]
[greater than]8%, the ADA value at which intensification of
glucose control is recommended [1], monitored less than once
per week."

So what these learned professors are saying is that testing up
to once per day, or even occasionally twice daily, had no
significant effect on A1c and only served to increase stress
(said elsewhere). And someone paid them lots of money to
discover that.

Now, can you provide some cites which specifically discuss the
lack of value of a regulated one- and two-hour post-prandial
testing regimen applied in the initial stages of SMBG?

Once again, I appeal to one of the researchers lurking on this
ng to consider this as a worthy research project.

Finally, read that last sentence of the conclusion again -
"[greater than]8%, the ADA value at which intensification
of glucose control is recommended [1]". The implication
that intensification is unnecessary below that threshold is
also a worry.

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

[Priscilla]

Priscilla H Ballou <phb@shell01.theworld.com> quoth:
>gman99 <nospam@bogusemail.com> quoth:
>>nospam@bogusemail.com (gman99) wrote:
>>> >
>>> > Any idea what "level of testing" meant/means?
>>> >
>>> How often the subject self-tested (how many times a day /
>>> how many days a week...etc).
>>>
>>> Still looking....
>>Found it...I think... http://www.findarticles.com/cf_dls/m0-
>>CUH/11_24/80381005/p1/article.jhtml

>"Overall, 471 patients (17%) stated that they tested their
>blood glucose levels at home [greater than or equal to] 1
>time per day, 899 patients (31%) tested their blood glucose
>levels [greater than or equal to] 1 time per week, and 414
>patients (14%) tested their blood glucose levels <1 time per
>week, whereas 1,071 patients (38%) stated that they never
>practiced SMBG."

>So they placed subjects who tested just once a day into their
>category of highest testing level. Basically they were
>comparing gradations of inadequate testing.

And just a couple of clicks away was this:

http://www.findarticles.com/cf_dls/m0CUH/6_26/102724388/p1/ar-
ticle.jhtml

"Intensified blood glucose monitoring improves glycemic
control in stable, insulin-treated veterans with type 2
diabetes: the Diabetes Outcomes in Veterans Study (DOVES)."

Priscilla

[Frank Roy]

markd@toad-net.com wrote:
> For we t2 folk, a better study would be to see how testing
> is used to adjust behaviors concerning exercise and diet
> based on the pp levels and then relate that to a1c results.
> Based on the self reported results here, keeping all manner
> of possible limitations in mind, a1c and use of testing
> would be significant.

Eating by the meter is the most effective means of making
adjustments in lifestyle when it comes to diet. I'm not to
sure about the exercise aspect. After reading about some
people that would exercise after eating (a half an hour to
several hours after eating) then testing, these people were
getting an idea about how to exercise and bring about better
blood glucose control.

I made a graph called a scatter diagram. The vertical
axis was bg in
mg/dl and the horizontal axis was the time of day. One thing
I noticed was the amount that my bedtime mg/dl varied. I
don't remember the number of days I had plotted on that 24
hour dimension (maybe 60 days). This diagram gave me an
incentive to try and reduce the variableness in these
bedtime readings. This was significant in bringing my
HbA1c down from
5.9% to 5.5%. I am not saying that this would work for
everybody, but it did for me. My point is that the meter
reading doesn't necessarily result in an immediate
adjustment for blood glucose control. After 3 years, I am
still on a learning curve for managing this disease.

Frank

[Alan]

On Mon, 22 Mar 2004 19:16:51 -0500, Frank Roy
<froy@erols.com> wrote:

>After 3 years, I am still on a learning curve for managing
>this disease.
>
>Frank

Anyone who says they aren't still learning is heading
for trouble.

Keep posting please, Frank. I don't always understand you
first (or even second) time around; but it's all filed away to
hopefully come together when I've learnt a bit more.

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

[Mack©®]

On Mon, 22 Mar 2004 07:07:04 GMT, "The real Norm" <"The real
Norm"@socal.rr.com> wrote:

>Mack©® wrote:
>> On Sun, 21 Mar 2004 21:46:12 GMT, JonK
>> <jon@the-kaplansNOSPAM.com> wrote:
>>
>>
>>>In a separate thread, people are marveling at the fact that
>>>the average A1c in America is 9%. The logical conclusion
>>>most are coming to is that it must be bad medical advice.
>>>
>>>In defense of the doctors, I think people have to look at
>>>denial and non-compliance.
>>
>>
>> non-compliance has become the catch word for diabetes.
>> There are some who are in denial, some who are
>> non-compliant and just as many who have doctors who settle
>> for less than optimal numbers because they either don't
>> want to put forth the effort to motivate the individual or
>> simply believe it is not got to make any difference. You
>> also have to keep in mind that the majority of diabetics
>> are NOT under the care of specialists.
>
>Majority of diabetics? Majority of diabetics who are regulars
>on this NG, maybe, but without all the people here confirming
>your statement, I really doubt
>it. But, then again, unlike you, I have new things to learn.
>
>

what are you babbling about now norm? are you claiming that
the majority of diabetics in the USA and elsewhere ARE under
the care of diabetic specialists?

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Mack©®]

On Sun, 21 Mar 2004 23:52:45 -0600, "Extreme-CC's"
<mrgantlet911(REMOVE)@yahoo.com> wrote:

>
>
>
>"Mack©®" <asdnospamhere@example.com> wrote in message
>news:pmds50hos5rmoj0p154rpa8lh4438erli7@4ax.com...
>
> You also have
>> to keep in mind that the majority of diabetics are NOT
>> under the care of specialists.
>>
>> Mack©®
>
>with 15+ million diabetics in the US alone I certainly have
>no way to know if that's true. but yes people probably would
>do better under the care of specialists.
>

if the sheer numbers don't help you understand what I just
said, nothing will.

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Mack©®]

On Mon, 22 Mar 2004 06:40:08 GMT, "Frederic E Henzi"
<f-henzi@comcast.net> wrote:

>
>"Mack©®" <asdnospamhere@example.com> wrote in message
>news:pmds50hos5rmoj0p154rpa8lh4438erli7@4ax.com...
>> have doctors who settle for less than optimal numbers
>> because they either don't want to put forth the effort to
>> motivate the individual or simply believe it is not got to
>> make any difference. You also have to keep in mind that the
>> majority of diabetics are NOT under the care of
>> specialists.
>>
>
>Hi, Four years ago when researching diabetes, I came across
>an Article by the British national health service. I stated
>that it would cost about $6000 per diabetic patient per year
>to have an specialist work with individual patients. The cost
>would ruin the system in no time. The recommendation was
>education in support groups. But how do you get people in
>denial, or who don't care to go support groups?
>
>Fred Henzi
>

In 2003 my total diabetic related health cost was well in
excess of $6k. In less than 3 months in 2004 my cost is
already above $2k. That's the total cost billed. Thankfully I
have insurance. I have not seen a doctor for anything
non-diabetic related in years other than dental care and even
that was complicated because of the diabetes.

In the USA studies conducted by insurance companies have found
that education and prevention of complications is the best way
to save the insurance companies money.

What can you do about those in denial or who don't care? Not
much, until their illness kicks them in the head. Personally I
would not object to an approach that holds them accountable.
Although I doubt it would ever be implemented because of the
amount of abuse in the current health care system.

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Mack©®]

On Mon, 22 Mar 2004 11:31:35 -0500, "Jenny"
<lottadatacarbs@hotmail.com> wrote:

>Mack,
>
>I think that we have to distinguish between the noncompliance
>that comes from denial--a real and prevalent problem, and the
>noncompliance that results when patients try the diets and
>meds their doctors prescribe only to find that they have no
>effect on their control

you are correct in making this distinction.

>
>All too often, the female patient who goes on a low fat low
>cal diet and can't lose weight is often accused of being
>"noncompliant" and told that she's lying about her diet, or
>not counting calories correctly. I have had this happen.
>When her blood sugar goes up on the 300 grams a day of carbs
>the Nutritionist prescribes, it is very easy to decide that
>diet is ineffective, degeneration the only future, so what
>the hell.
>
>The stats from articles writing about how great Avandia is
>for control are interesting. The typical patient has a
>fasting blood sugar near 200 mg/dl and with Avandia it drops
>30 mg/dl. This is hailed as a great response. But the patient
>is still way too high and feels like crap all the time. Their
>complications aren't getting better either.
>
>Finally, a lot of newly diagnosed patients are hearing from
>their doctors that type 2s will deteriorate no matter what
>they do. A lot decide that if that's the case, why starve and
>torment themselves with drugs that have nasty side effects.
>If the diet and meds prescribed make you feel like crap and
>don't do anything to control your blood sugar, yes, you will
>end up noncompliant.
>
>Give the patient a diet that works to control blood sugars
>and meds including insulin that bring down the blood sugars
>effectively, and you might see a whole different pattern with
>compliance.
>
>-- Jenny - Low Carbing for 4 years. At goal for weight.
>Type 2 diabetes, hba1c 5.2. Cut the carbs to respond to my
>email address!
>
>Low carb facts and figures, my weight-loss photos, tips,
>recipes, strategies for dealing with diabetes and more at
>http://www.geocities.com/jenny_the_bean/
>
>Looking for help controlling your blood sugar? Visit
>http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm
>
>Mack©®
Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Alan]

On Tue, 23 Mar 2004 01:14:17 -0500, Mack©®
<asdnospamhere@example.com> wrote:

>
>if the sheer numbers don't help you understand what I just
>said, nothing will.

Unfortunately, Mack, there are some people who you should
never argue with using logic or facts. It only confuses them.
So - nothing will.

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

[Mack©®]

On 22 Mar 2004 20:15:35 GMT, nospam@bogusemail.com
(gman99) wrote:

>nospam@bogusemail.com (gman99) wrote:
>> >
>> > Any idea what "level of testing" meant/means?
>> >
>> How often the subject self-tested (how many times a day /
>> how many days a week...etc).
>>
>> Still looking....
>
>Nope...this is the one....
>
>http://www.findarticles.com/cf_dls/m0CUH/6_24/76610101/p1/ar-
>ticle.jhtml

the study does NOT address what exactly should be done with
the data collected by type 2s. without using the data to
actually make changes then yes the data is useless and a waste
of time to collect. If the type 2 is going to make changes in
diet, exercise and meds based on the data collected then the
data is not a waste of time and is well worth the investment
in time and effort.

so why are you testing? to collect data and never use it to
make improvements? or are you collecting data to actually help
make changes to improve control?

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Mack©®]

On Mon, 22 Mar 2004 20:27:38 +0000 (UTC), Priscilla H Ballou
<phb@shell01.TheWorld.com> wrote:

>gman99 <nospam@bogusemail.com> quoth:
>>nospam@bogusemail.com (gman99) wrote:
>>> >
>>> > Any idea what "level of testing" meant/means?
>>> >
>>> How often the subject self-tested (how many times a day /
>>> how many days a week...etc).
>>>
>>> Still looking....
>
>>Found it...I think...
>
>>http://www.findarticles.com/cf_dls/m0CUH/11_24/80381005/p1/-
>>article.jhtml
>
>"Overall, 471 patients (17%) stated that they tested their
>blood glucose levels at home [greater than or equal to] 1
>time per day, 899 patients (31%) tested their blood glucose
>levels [greater than or equal to] 1 time per week, and 414
>patients (14%) tested their blood glucose levels <1 time per
>week, whereas 1,071 patients (38%) stated that they never
>practiced SMBG."
>
>So they placed subjects who tested just once a day into their
>category of highest testing level. Basically they were
>comparing gradations of inadequate testing.
>
>Priscilla

and never using any of the data to make any positive changes
in diabetes management.

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Mack©®]

On Mon, 22 Mar 2004 21:50:28 GMT, "The real Norm" <"The real
Norm"@socal.rr.com> wrote:

>gman99 wrote:
>> nospam@bogusemail.com (gman99) wrote:
>>
>>>>Any idea what "level of testing" meant/means?
>>>>
>>>
>>>How often the subject self-tested (how many times a day /
>>>how many days a week...etc).
>>>
>>>Still looking....
>>
>>
>> Found it...I think...
>>
>> http://www.findarticles.com/cf_dls/m0CUH/11_24/80381005/p1-
>> /article.jhtml
>
>How refreshing... to have support for something of
>importance. Thanks.
>
>However, I wonder how many here can take it at face value,
>without nit-picking words and phrases.
>
>Q of L, quality of life (diabetes-related stress, diabetes
>health distress, diabetes-related worries, and Centers for
>Epidemiologic Studies-Depression scale).
>
>This is an important issue that, IMO, isn't mentioned here
>enough, if at all. I have talked in terms of healthful
>longevity, which implied physical well-being, but mental
>well-being was in the back of my head, perhaps because of the
>effects of my undiagnosed sleep apnea, which, as indicated
>previously, scared me far more than the potential
>complications of diabetes.
>
>When I was walking around in a daze, like a zombie, I didn't
>much care if I had four limbs or not. Of course, everyone who
>comes here, is immediately warned about the complications of
>diabetes, in order to motivate them to do whatever is
>suggested here. My issue is not whether what is suggested is
>right or wrong, but, rather, whether it was appropriate at
>the time. And I see this as a significant consideration in
>the link above.
>
>And not being provided with any directly observable data, to
>support the statements, makes it even more problematic
>mental-health wise.
>
>But, it didn't motivate me, and one of these days I'm going
>to try and find time to go to the archives and get a feeling
>for how many other newbies came here, heard the party-line,
>and left, like me, but never returned. Of course, just
>because they didn't return doesn't mean they didn't take the
>advice here and live happily ever after. I just don't happen
>to think that, based on my own experience and the link above.

so can you stop writing in circles around nothing and actually
make a point?

>
>I am no longer a 'strong' person, like I was before my
>permanent cognitive deficits of 20 years ago. When I newbie
>comes to visit, there are some mind-readers and fortune
>tellers here, who think they have the ability to 'know'
>someone with one or two posts.
>
>JMO
>

sometimes I get the impression there are couple of
professional victims who play at reading the minds of long
term posters and then claim those long term posters are
playing at reading the minds of newbies.

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Gman99]

> so why are you testing? to collect data and never use it to
> make improvements? or are you collecting data to actually
> help make changes to improve control?
>
I don;t collect the data, I don't keep a log. I test to see if
a meal is to be added to my food repertoire. I test if I'm not
feeling well to see how it affects my BG. I test to see if
it's steak and green beans or steak and fries...I test and use
the results to make SHORT term decisions. I would not use my
meter test results to make medical decisions such as meds.

[Frank Roy]

Alan wrote:
>

> Anyone who says they aren't still learning is heading for
> trouble.
>
> Keep posting please, Frank. I don't always understand you
> first (or even second) time around; but it's all filed away
> to hopefully come together when I've learnt a bit more.
>
I am the same way and find benefit in re-reading articles some
time later. What used to seem like information overload
doesn't seem that way so much anymore.

Frank

[Extreme-Cc]

"Alan" <allorstarch@ozconnect.net> wrote in message
news:23pv50dh9m5d36ecrf04jqbi7s6j0en6ih@4ax.com...
> On Tue, 23 Mar 2004 01:14:17 -0500, Mack©®
> <asdnospamhere@example.com> wrote:
>
> >
> >if the sheer numbers don't help you understand what I just
> >said, nothing will.
>
> Unfortunately, Mack, there are some people who you should
> never argue with using logic or facts. It only confuses
> them. So - nothing will.

What book should i buy?

>
> Cheers, Alan, T2 d&e, Australia.
> --
> Everything in Moderation - Except Laughter.

[Mack©®]

On Tue, 23 Mar 2004 18:18:19 +1100, Alan
<allorstarch@ozconnect.net> wrote:

>On Tue, 23 Mar 2004 01:14:17 -0500, Mack©®
><asdnospamhere@example.com> wrote:
>
>>
>>if the sheer numbers don't help you understand what I just
>>said, nothing will.
>
>Unfortunately, Mack, there are some people who you should
>never argue with using logic or facts. It only confuses them.
>So - nothing will.
>
>Cheers, Alan, T2 d&e, Australia.

Thanks for the reminder Alan.

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

[Alan]

On Tue, 23 Mar 2004 09:41:00 -0600, "Extreme-CC's"
<mrgantlet911(REMOVE)@yahoo.com> wrote:

>> >if the sheer numbers don't help you understand what I just
>> >said, nothing will.
>>
>> Unfortunately, Mack, there are some people who you should
>> never argue with using logic or facts. It only confuses
>> them. So - nothing will.
>
>What book should i buy?

Well, if you want to read a fascinating account of the lives
of three generations of women over the 20th century in China
I'd thoroughly recommend "Wild Swans" by Jung Chang.
Incredible story and well worth purchasing.

But if you mean which book do I sell?

I don't; and I have no commercial interest in any book. I
presume that was the implication behind your question.

If, of course, you want to buy a book on diabetes, I
thoroughly endorse Gretchen Becker; unfortunately she doesn't
pay me to say that. I wish.

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

[Mack©®]

On 23 Mar 2004 11:40:00 GMT, nospam@bogusemail.com
(gman99) wrote:

>> so why are you testing? to collect data and never use it to
>> make improvements? or are you collecting data to actually
>> help make changes to improve control?
>>
>I don;t collect the data, I don't keep a log. I test to see
>if a meal is to be added to my food repertoire. I test if I'm
>not feeling well to see how it affects my BG. I test to see
>if it's steak and green beans or steak and fries...I test and
>use the results to make SHORT term decisions. I would not use
>my meter test results to make medical decisions such as meds.

which meds?

Mack©® Type 1 since 1975 http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt