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I know someone who works at a clinic that serves diabetics without health insurance who cannot afford routine glucose monitoring. A majority of the patients sh
by lucas_membrane 7y ago
I know someone who works at a clinic that serves diabetics without health insurance who cannot afford routine glucose monitoring. A majority of the patients show up with A1C of 10 or higher, often much higher. If uncorrected, this is tragic. A finding that most people will not find a way to comply effectively with a plan to scientifically manage T2D is not, to me, a convincing reason to make scientific management less available to all.
- SpikeDad 7y agoYep. But the key issue is that patients need to be helped into diets that will be lower in carbs and provide more effective A1C control. I think the fact that you can see what happens to your glucose after every bite of food you take is a powerful incentive to improve your diet. No meds are going to reduct A1C of 10 or higher to even moderately high levels of 8 or so without serious dietary changes. I personally got my A1C down from 11 to 5.4 in 5 months with diet, exercise and meds but from my doctors own comments and my research the meds (Metformin and Victoza) really only contribute maybe 1.5 point reduction. If I have an A1C of 9.5 instead of 11 it's not going to make much difference. But at 5.4 I'm essentially normal.
- lucas_membrane 7y agoI agree completely. What the double-digit A1c people need first is to understand where they are headed, which the test substantiates if the practitioner has the nerve to spell it out. What to do about it is a different part of the problem. I am paywalled out of the article, but the word 'routine' is grievously vague to me. It could mean anything from an annual A1c to quarterly A1c's, with glucose monitoring anywhere from hourly to never.