RE: ADA A1C information

September 13, 2005

Harry:

When one gets out of the " normal range " -- whatever it is -- certainly

higher glycation rates seem to increase one's probability of incurring

diabetic complications. But I have not seen research indicating that once

one is in the " normal range " , additional lowering of one's A1C decreases the

probability of diabetic complications. In other words, numbers and numbers

games aren't everything. There is the law of diminishing returns. I would

classify Dr. Bernstein as one of those for whom diabetes has taken over his

life. He tends to think like the engineer he was.

Mike

ADA A1C information

>>

>>>

>>> The below is different then the range one would get if non-diabetics

>>> were

>>> tested, which is by definition the normal a1c range. The below reflects

>>> the range of views about clinical goals in treatment, not what is the

>>> normal range. Dr. Bernstein illustrates this by saying he asks every

>>> meter

>>> salesman to do a test on himself on the spot and this reveals the normal

>>> range.

>>>

>>> " I'm going to be frank: your continual harping on a normal A1C being

>>> between

>>> 4.2 and 5.2 is sheer twaddle and does a severe disservice to diabetics

>>> both

>>> old and new including yourself. For starters, it depends upon what lab

>>> you

>>> use what a " normal " A1C is. Some go between 4.8 and 6.2 (a navy lab, I

>>> believe); the National Diabetes, Digestive and Kidney Diseases Institute

>>> of

>>> the NIH say a " normal " A1C is between 4 and 6; the ADA also says this;

>>> The

>>> AACE says 3.8 to 6 and I've seen 4.2 to 6 elsewhere. In fact, there *is*

>>> no

>>> national standard for A1C measurement. "

>>>

>>> XB

>>> IC|XC

>>>

September 13, 2005

Harry:

When one gets out of the " normal range " -- whatever it is -- certainly

higher glycation rates seem to increase one's probability of incurring

diabetic complications. But I have not seen research indicating that once

one is in the " normal range " , additional lowering of one's A1C decreases the

probability of diabetic complications. In other words, numbers and numbers

games aren't everything. There is the law of diminishing returns. I would

classify Dr. Bernstein as one of those for whom diabetes has taken over his

life. He tends to think like the engineer he was.

Mike

ADA A1C information

>>

>>>

>>> The below is different then the range one would get if non-diabetics

>>> were

>>> tested, which is by definition the normal a1c range. The below reflects

>>> the range of views about clinical goals in treatment, not what is the

>>> normal range. Dr. Bernstein illustrates this by saying he asks every

>>> meter

>>> salesman to do a test on himself on the spot and this reveals the normal

>>> range.

>>>

>>> " I'm going to be frank: your continual harping on a normal A1C being

>>> between

>>> 4.2 and 5.2 is sheer twaddle and does a severe disservice to diabetics

>>> both

>>> old and new including yourself. For starters, it depends upon what lab

>>> you

>>> use what a " normal " A1C is. Some go between 4.8 and 6.2 (a navy lab, I

>>> believe); the National Diabetes, Digestive and Kidney Diseases Institute

>>> of

>>> the NIH say a " normal " A1C is between 4 and 6; the ADA also says this;

>>> The

>>> AACE says 3.8 to 6 and I've seen 4.2 to 6 elsewhere. In fact, there *is*

>>> no

>>> national standard for A1C measurement. "

>>>

>>> XB

>>> IC|XC

>>>

September 13, 2005

I have seen research on the internet, which you certainly would not trust,

since it is on the internet and not in a textbook or a newspaper or Reader's

Digest, which makes your point exactly. I believe you can look it up in the

actuareal tables or under risk management information which shows the cost

in life style for running a 5.0 is not worth it if one can run a 6.0 without

trouble. However like Dr. Bernstein, a type 1 diabetic with a 4.5 and who

is over 70 years of age, advocates running as close to possible to the

" normal range " as one can does assure one diabetic fewer diabetic

complications. So pick the A1C level that suits you. Personally, I will

strive for the A1C level for a non-diabetic. I am well versed in

statistical methods and research and any time you have a 20% difference or

greater, you are looking at a statistically significant difference. The

last time I calculated it an A1C of 6.0 is exactly 20% greater than 5.0. Of

course statistical methods are for the most part based on a large random

sample, and you must decide how random a sample of diabetics are compared to

a sample of non-diabetics. I am one diabetic with lots of medical problems,

especially heart and circulatory ones. So I figure that it would be best

for me to run A1C levels closer to the " normal range " , but for diabetics who

have no problems, they may choose to figure it is not worth it. Like that

old philosopher on the docks of New Orleans says, " You makes yo choices and

you pays the dues. "

So pick the goal that suits you.

ADA A1C information

>>>

>>>>

>>>> The below is different then the range one would get if non-diabetics

>>>> were

>>>> tested, which is by definition the normal a1c range. The below

>>>> reflects

>>>> the range of views about clinical goals in treatment, not what is the

>>>> normal range. Dr. Bernstein illustrates this by saying he asks every

>>>> meter

>>>> salesman to do a test on himself on the spot and this reveals the

>>>> normal

>>>> range.

>>>>

>>>> " I'm going to be frank: your continual harping on a normal A1C being

>>>> between

>>>> 4.2 and 5.2 is sheer twaddle and does a severe disservice to diabetics

>>>> both

>>>> old and new including yourself. For starters, it depends upon what lab

>>>> you

>>>> use what a " normal " A1C is. Some go between 4.8 and 6.2 (a navy lab, I

>>>> believe); the National Diabetes, Digestive and Kidney Diseases

>>>> Institute

>>>> of

>>>> the NIH say a " normal " A1C is between 4 and 6; the ADA also says this;

>>>> The

>>>> AACE says 3.8 to 6 and I've seen 4.2 to 6 elsewhere. In fact, there

>>>> *is*

>>>> no

>>>> national standard for A1C measurement. "

>>>>

>>>> XB

>>>> IC|XC

>>>>

September 13, 2005