3 ms·

> ). But it takes 3 months to see if my A1C goes down (a measure of the past 3 months of blood sugar), so I won't know for a couple more months. Yes, though de

> ). But it takes 3 months to see if my A1C goes down (a measure of the past 3 months of blood sugar), so I won't know for a couple more months. Yes, though depending on what your diagnosis is, you may be able to get a monitor which allows you to track your blood sugar in near-realtime. The technology has advanced a lot in the last 20 years.

didgeoridoo 3y ago
A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. Even if you could measure it at home, it wouldn’t change fast enough for rapid tracking to be meaningful. You need to wait for red blood cells to be replaced (hence the 3 month cadence) before expecting any change in A1C.
- chimeracoder 3y ago
  > A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. You're not measuring HbA1C in real-time; you're measuring the blood sugar in real-time. HbA1C is a lagging indicator, used because it's a convenient and non-invasive diagnostic and a summary statistic. It's not the way you measure the short-term or medium-term effectiveness of interventions.
  - didgeoridoo 3y ago
    Ah I misread your comment — thought you were suggesting measuring A1C at home, which wouldn’t get you anything. Re-reading, you definitely meant measure blood glucose itself. I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Would be interesting to see if there is research showing that CGM area under the curve is a better (or worse) predictor of clinical outcomes than A1C.
    - chimeracoder 3y ago
      > I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Both metrics have their own use. Continuous glucose monitoring is better for measuring the short-term impact of interventions, but it's also more invasive (albeit less so than it used to be) and more expensive. HbA1C is still measured for diabetic patients who have continuous glucose monitoring. One downside of A1C is that the baseline values actually vary, and it's known to be either downward biased or a particularly lagging indicator for certain groups that are predisposed to Type 2 diabetes (e.g. South Asians and people of African descent).
- deleted 3y ago
  [deleted]
SubiculumCode 3y ago
Ancedotally, a friend spent 3 months on a keto diet, and yes they eventually quit. However, their carb shock thirst tiredness that they used to have after a modest meal stopped occurring, and persisted after stopping keto. I've heard that there is some evidence of regeneration of receptors with ketogenic diet.. perhaps occasional bouts of keto can be therapeutic?
dpeck 3y ago
For anyone new to it, the words you’re looking for are “continuous glucose monitor” (GCM), and “flash glucose monitor”. Popular brands of it in the US are Freestyle Libre and Dexcom. Their final cost to you will vary hugely by your insurance provider. Some with little to no cost, and others several dollars per day. If you like data and are analytical by nature, and since you’re on HN that’s fairly likely, I’d highly recommend using them for a little while if you can afford it. They’re great for newly diagnosed people to understand in near real time without repeated finger pricking. But those are no terrible either and much better than not managing and monitoring! Slightly annoying at first but it is something that most people can get used to fairly easily.

didgeoridoo 3y ago

A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. Even if you could measure it at home, it wouldn’t change fast enough for rapid tracking to be meaningful. You need to wait for red blood cells to be replaced (hence the 3 month cadence) before expecting any change in A1C.

chimeracoder 3y ago
> A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. You're not measuring HbA1C in real-time; you're measuring the blood sugar in real-time. HbA1C is a lagging indicator, used because it's a convenient and non-invasive diagnostic and a summary statistic. It's not the way you measure the short-term or medium-term effectiveness of interventions.
- didgeoridoo 3y ago
  Ah I misread your comment — thought you were suggesting measuring A1C at home, which wouldn’t get you anything. Re-reading, you definitely meant measure blood glucose itself. I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Would be interesting to see if there is research showing that CGM area under the curve is a better (or worse) predictor of clinical outcomes than A1C.
  - chimeracoder 3y ago
    > I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Both metrics have their own use. Continuous glucose monitoring is better for measuring the short-term impact of interventions, but it's also more invasive (albeit less so than it used to be) and more expensive. HbA1C is still measured for diabetic patients who have continuous glucose monitoring. One downside of A1C is that the baseline values actually vary, and it's known to be either downward biased or a particularly lagging indicator for certain groups that are predisposed to Type 2 diabetes (e.g. South Asians and people of African descent).
deleted 3y ago
[deleted]

SubiculumCode 3y ago

Ancedotally, a friend spent 3 months on a keto diet, and yes they eventually quit. However, their carb shock thirst tiredness that they used to have after a modest meal stopped occurring, and persisted after stopping keto. I've heard that there is some evidence of regeneration of receptors with ketogenic diet.. perhaps occasional bouts of keto can be therapeutic?

dpeck 3y ago

For anyone new to it, the words you’re looking for are “continuous glucose monitor” (GCM), and “flash glucose monitor”. Popular brands of it in the US are Freestyle Libre and Dexcom. Their final cost to you will vary hugely by your insurance provider. Some with little to no cost, and others several dollars per day. If you like data and are analytical by nature, and since you’re on HN that’s fairly likely, I’d highly recommend using them for a little while if you can afford it. They’re great for newly diagnosed people to understand in near real time without repeated finger pricking. But those are no terrible either and much better than not managing and monitoring! Slightly annoying at first but it is something that most people can get used to fairly easily.