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Friday, 12 September 2014
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.
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?
deconstruct Phoenix’s reply on two major points to reveal the duplicity.
Away From a HbA1C 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 HbA1C
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:
the level at which
elevated blood sugars cause permanent damage to the body. The HbA1C
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.
1 Diabetic Population Subgroups with Better Results than the Type 1 Population
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:
with the best educational provision currently available (with best practise for
carb counting, carb/insulin ratios, etc.) and withnormal eating
over a 7 year period a reduction in HbA1c of 0.3% to an average of
8.3% was achieved”.
We note that an HbA1C 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 thatnormal 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?"