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Old 01-16-2008, 11:33 AM   #1
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Update

Hello!

My pcd had me do another fasting glucose and a1c done. I got the results today. The glucose is 129 and a1c is a 7.0. (The last glucose was 126) Are these really high enough to be treated? Since both are above 125 my doctor says that I am diabetic. I am taking Glyburide 5mg X2. Is anyone else taking this and has anyone had success with taking Glyburide. Any advice or anything that I need to look forward to. I am going to see a dietician next month. I have high blood pressure, hashimoto thyroiditis, and anxiety.

Cindy

 
Old 01-16-2008, 11:55 AM   #2
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Re: Update

Quote:
Originally Posted by rockylucy05 View Post
Hello!

My pcd had me do another fasting glucose and a1c done. I got the results today. The glucose is 129 and a1c is a 7.0. (The last glucose was 126) Are these really high enough to be treated? Since both are above 125 my doctor says that I am diabetic. I am taking Glyburide 5mg X2. Is anyone else taking this and has anyone had success with taking Glyburide. Any advice or anything that I need to look forward to. I am going to see a dietician next month. I have high blood pressure, hashimoto thyroiditis, and anxiety.

Cindy
Absolutely, those numbers indicate diabetes. Sorry, but with an a1c of 7, this indicates that your average glucose level is about 170. So after meals you are most likely going quite high. Often the fasting level is the last to go and the 2 hour post prandial test is much higher than the 140 it should be.

Guidelines say that an a1c of less than 7 will give you a much lower chance of developing complications. You are definitely on the borderline for that. The lower you can get it (low 6s or even 5s) will give you a much better chance of staying healthy.

I don't know that much about the oral medcations. Keep testing (make sure to test periodically 2 hours after the start of a meal), and learn all you can from the dietitian.

Best of luck.

Cora
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Old 01-16-2008, 05:43 PM   #3
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Re: Update

Thank you so much for your reply. I didn't understand the a1c test but you explain it very well. My pcd did not recommend a glucose monitor, but I see an endocrinologist so he may write a script for the monitor and strips.

Thanks,

Cindy

 
Old 01-17-2008, 04:03 AM   #4
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Re: Update

Years ago a "7" was considered okay for a1c to my knowledge. I think they lowered the number so that more people can fit into the "sick" category and have no choice but to get on medications and stuff like that, which means more money for the pharmaceutical companies and write-offs for doctors.

What's a normal a1c level now?

 
Old 01-17-2008, 04:57 AM   #5
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Re: Update

Quote:
Originally Posted by ssjup81 View Post
Years ago a "7" was considered okay for a1c to my knowledge. I think they lowered the number so that more people can fit into the "sick" category and have no choice but to get on medications and stuff like that, which means more money for the pharmaceutical companies and write-offs for doctors.

What's a normal a1c level now?
Sorry, but this is not true. A very, very large study was done following thousands of patients over a decade. And what they found was that an a1c consistantly lower than 7 led to significantly lower chances of developing complications. I believe the decrease in the incidence of neuropathy was over 90%. The chances of developing heart disease dropped by around 85% and for kidney failure the chances were also very much decreased.

Somebody help me out here please. There were 2 studies done and I can never remember the names of them.

Anyway, a non-diabetic a1c is roughly less than 6%. It depends on your local lab. This corresponds to an average glucose level of between 115 and 130 (depending on which calculation you use). This corresponds to having numbers below 100 fasting and below 140 two hours after a meal.

You want to keep your numbers as close to normal as possible to minimize the risks of complications. Believe me, from personal experience, I can tell you that kidney failure is not a lot of fun.

Cora
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Old 01-17-2008, 06:31 AM   #6
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Re: Update

Ssjup is correct on one thing. They tell you 7.0 and under is fine (ADA CURRENTLY!!!!) that way they can keep you on blood sugar medications. (40+ billion dollar industry!).

As Cora mentioned, if you look at the many studies (no I don't have them handy either) - "NORMAL" is not in the 6 range. Good is in the 5 range and below.

Not to shock everyone here. But do you have any idea what normal is? That's to say someone who has never had ANY weight or major health related issues. The person who never gains OR loses 2-3 pounds a year and is fairly active.

Their A1C average is 4.6. This is a fact.

Studies are now indicating that for every 1 point incriment (say from 4.6 to 5.6), scientists now believe that your major health risks INCREASE 4 fold (Heart disease, kidney, eye, circulitory, cancer, etc).

When my doctor told me my A1C was 6.1 I got damn busy. 5 months later, my A1C is 5.3 with my goal being 4.9 or lower. I eat healthy now, excercise much more, listen to Cora and others who appear to have a clue and a lot to teach me.

Folks, don't settle in the 7 or even 6 range if your diet and excercise plans are not "ALL they can be". You owe it to yourself to improve. It's possible. Not only that, but you might feel better than you have your entire life. I do.

~ God's speed!

 
Old 01-17-2008, 08:39 AM   #7
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Re: Update

I don't think anyone here wants to settle for 7, but not to be worried if you do have a 7 and just work on getting it down. Now it sounds like if you're a 7, you're automatically put on insulin or something, which does mean more money for the pharmaceutical companies.

To me, it's the same with the blood pressure and the cholesterol. Those have been taken down. For years a "normal" cholesterol rate was anything under 220. Last year when I did my a1c test (in full, cost enough) since I was first diagnosed as a diabetic a few years earlier, I saw that my cholesterol level in all was 225. I wasn't worried, though, since I figured, "Well, I just have to work to get it under that 220 mark, shouldn't be difficult. The doctor that did the test told me that anything over 200 is bad. So, instead of working to get it down 5 points minimum, I have to get it down 25 points minimum. I am now considered to have a high cholesterol. I have no idea what it is now, since I have been working on it since last year, but it's sad that I am now considered to have high cholesterol. I'm just glad I still have a normal blood pressure by today's standards and the past's.

Anywho, going back on topic, thanks for the information from both you and Cora. I wouldn't mind seeing the studies.

 
Old 01-17-2008, 12:19 PM   #8
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Re: Update

Quote:
Originally Posted by ssjup81 View Post
I don't think anyone here wants to settle for 7, but not to be worried if you do have a 7 and just work on getting it down. Now it sounds like if you're a 7, you're automatically put on insulin or something, which does mean more money for the pharmaceutical companies.

To me, it's the same with the blood pressure and the cholesterol. Those have been taken down. For years a "normal" cholesterol rate was anything under 220. Last year when I did my a1c test (in full, cost enough) since I was first diagnosed as a diabetic a few years earlier, I saw that my cholesterol level in all was 225. I wasn't worried, though, since I figured, "Well, I just have to work to get it under that 220 mark, shouldn't be difficult. The doctor that did the test told me that anything over 200 is bad. So, instead of working to get it down 5 points minimum, I have to get it down 25 points minimum. I am now considered to have a high cholesterol. I have no idea what it is now, since I have been working on it since last year, but it's sad that I am now considered to have high cholesterol. I'm just glad I still have a normal blood pressure by today's standards and the past's.

Anywho, going back on topic, thanks for the information from both you and Cora. I wouldn't mind seeing the studies.

In the years when a "normal" cholesterol was up around the 220's, and they didn't even measure HDL and LDL, many people died at much earlier ages from heart disease. The average lifespan has gone up significantly over the years, and much of it is due to the new standards for managing diabetes, heart disease, etc.

If your A1c's are running over 7.0 and you can't get them down by any other means, then it's definitely time to add something...either more oral medications, or insulin. Frankly, I don't care if the pharmaceutical companies get richer, as long as I'm also NOT getting complications!

The trial Cora was referring to was the Diabetes Care and Complications Trial, also referred to as the DCCT. The results were so incredibly dramatic, that although it was originally supposed to last 10 years or longer, they published the results after only about 5 years (not sure if I have those time exactly right, but you get the picture.)

And another thing I'd like to point out...Type 2 is a PROGRESSIVE illness. Could we please stop blaming the patient when they watch their diet, exercise, etc, but their numbers still creep up? Sure, there are some people who don't manage well, but many people do and they still end up needing insulin. It's the nature of this disease. The longer you have it, the more strain it puts on the insulin-producing islet cells, and the more cells wear out. Thus, many T2's will eventually need insulin.

Ruth

 
Old 01-17-2008, 01:11 PM   #9
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Re: Update

Thanks Ruth. I was going to say that too.

Just wanted to add one small thing though - a 4.6% a1c is not feasible for someone dependant on insulin. It would involve simply too much time being hypo and that can be dangerous, especially while driving. Mid 5s to mid 6s is certainly reasonable for a T2 dependant on insulin or a T1.

Cora
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Old 01-17-2008, 09:02 PM   #10
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Re: Update

Quote:
Originally Posted by Coravh View Post
Thanks Ruth. I was going to say that too.

Just wanted to add one small thing though - a 4.6% a1c is not feasible for someone dependant on insulin. It would involve simply too much time being hypo and that can be dangerous, especially while driving. Mid 5s to mid 6s is certainly reasonable for a T2 dependant on insulin or a T1.

Cora
I can always count on you, Cora and a few others to "watch my back" so to speak...thanks for adding that. It's another thing people who are not on insulin don't seem to understand...it's much more of a balancing act when you're on insulin and sometimes you can't achieve those really, really low A1c's without also having way to many (and severe) lows. But certainly the range you mentioned, mid 5's to mid 6's is quite feasible.

Ruth

 
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