Phoenix the FlimFlam Poster

In the past Eddie and Graham have often remarked on the misleading nature of Phoenix’s posts Indeed, in comparison, Noblehead is merely the lowly sorcerer’s apprentice in the craft of duplicity. A perfect example of the work of the sorcerer is given in the following post.

http://www.diabetes.co.uk/forum/threads/how-highly-would-you-recommend-eating-low-carb.64220/page-9

A poster, LucySW, asked:

I hadn't seen that observation about 95% of T1s not achieving a good enough HbA1c, and it rather horrifies me, particularly as I'm starting to realise how unpredictable bolus-ing is going to be when I have to do it. I'm having difficulty understanding it. And please, what IS the reason?

We shall deconstruct Phoenix’s reply on two major points to reveal the duplicity.

Divert Attention Away From a HbA_1C Target Figure of 6.5%

First the NICE target is
Targets for clinical monitoring
HbA1c < 7.5 %
If increased arterial risk: HbA1c = 6.5 %

The reason the HbA_1C target figure of 6.5% is important is because this figure maps to an average blood glucose figure of 7.8 mmol/L. The reason the 7.8 mmol/L is important is because it is:

https://www.aace.com/files/dccwhitepaper.pdf

the level at which elevated blood sugars cause permanent damage to the body. The HbA_1C of 7.5% to which Phoenix is diverting attention [because more Type 1 diabetics achieve this figure but nowhere near the majority] maps to an average blood glucose figure of 9.4 mmol/L with greater dangers of permanent body damage.

Considering Type 1 Diabetic Population Subgroups with Better Results than the Type 1 Population Average

In England, the percentage of adults under 55 with T1 who achieve the 7.5% target is 34.8%
6.4% achieve less than 6.5%
The figures for the over 55s at 35.7% and 9.2% are slightly better.

By definition if there are some diabetic population subgroups with better results than the diabetic population average there are also subgroups with WORSE results than the population average. We note she doesn’t quote the results for these subgroups.

There are other issues of compliance (they’re not taking their insulin?) and education but not food intake. Such issues are addressed in:

http://thelowcarbdiabetic.blogspot.co.uk/2014/09/why-is-blood-glucose-control-of-type-1.html

From the above post: 

“So with the best educational provision currently available (with best practise for carb counting, carb/insulin ratios, etc.) and with normal eating over a 7 year period a reduction in HbA_1c of 0.3% to an average of 8.3% was achieved”.

We note that an HbA_1C maps to an average blood glucose figure of 10.6 mmol/L with subsequent dangers of permanent body damage

Again from the above post: 

“We conclude that the reason why blood glucose control of Type 1 diabetics in England and Wales is so poor is that normal eating is not a lifestyle that is ‘user friendly’ for diabetics. Of course, there are Type 1 diabetic forum members achieving HbA1c < 6.5%. Examples include: Fergus, Dillinger, Pneu and others. What is the factor that links Fergus, Dillinger and Pneu?"

A suitable signature for Phoenix: 

Caveat Lector