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Idiots. Just got a monthly newsletter from my BlueCross provider and they have an article in there that says "you should aim for an A1C of 7 or lower":crazy:

Using the A1C-BG calculator on bloodsugar101 that's an AVERAGE bg of 155... when damage starts about 140.

They preach prevention but are just killing people with their advice. Might as well put folks on a conveyor belt into big pharma and hospitals.

Ticks me off.:mad:
 
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YEP! And guess what? A certain Daily forum owner also runs a discussion on FB (which is bizarre b/c the people on his FB threads are always WAY more high carb for some odd reason than the ones on the forum! But ... HE condescendingly told me, that 7 or under is because lower puts people in more danger of hypos.

Does he ever read his own forums? Or is he just another industry shill?

I unfriended them there.
 

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lol under 7 ranges from 6.9 to 0

yes if you do go much lower you will hypo....but even if you aimed for 5 you'd be safe...

surely aiming for the normal range of non-diabetics is preferred...logic would say that's optimum
 

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Discussion Starter · #5 ·
A1C - BG conversion

Some handy conversions from the bloodsugar101 calculator:

A1C Avg. BG
5.0 97
5.5 112
5.8 120 <-- I am here
6.0 126
6.5 140
6.7 146 <-- I was here July
6.8 149
7.0 155
7.5 169
8.0 183
 

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My sister-in-law said her doc told her as long as she stays around 7, she's fine. She won't listen to me 'cause I don't have a medical degree. To top that off, she weighs about 300 pounds. I'm concerned that one day soon we will be getting that dreaded phone call.
 

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BlueCross provider and they have an article in there that says "you should aim for an A1C of 7 or lower":
I understand it's all about the money for them, but it still makes no sense. Maybe they pay for fewer supplies or drugs w/ higher A1Cs - but then later they have to pay for foot amputations.

Now that's thrifty.
 
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I understand it's all about the money for them, but it still makes no sense. Maybe they pay for fewer supplies or drugs w/ higher A1Cs - but then later they have to pay for foot amputations.

Now that's thrifty.
I do think they're genuinely--and incorrectly--afraid of hypoglycemia. My own doctor told me to aim to be in the 120s before bed because I might have hypoglycemia in my sleep. My other doctor told me his patients feel better over 100 and that I should be concerned if I drop into the 70s. I'm just on Metformin.

Also, because hypoglycemia poses short-term risks and high blood sugar usually causes long-term damage, they'd rather you run high.

One time I confronted my doctor about this. I was crabby that day, and I regret saying it, but I argued, "You don't care if my blood sugar is high now because you won't be my doctor in 10 years when I need my foot amputated." Many physicians and diabetic organizations have trouble conceiving a diabetic who maintains normal blood sugar without either starving or hypoglycemia. For some reason, simply averaging below 100 scares my doctor and I'm having trouble convincing him that I don't feel sick and I am never in danger when my blood sugar drops into that range.
 

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I do think they're genuinely--and incorrectly--afraid of hypoglycemia.
Yes, unfortunately they aren't discriminating on this though - giving the same advice to T2s on metformin, or on no meds. And they tell all of us to eat lots of carbs which creates need for more insulin and more chance of hypos.

So there's no consistency I can see except for uniformly bad information (there are exceptions of course, but I'm speaking institutionally) coming from some very smart people so the question continues to be why? That's when I go to follow-the-money motives.

Bah - am I overly cynical? I've never been more disgusted with pharma - just read a bit about putting kids on statins and it put me in a bad mood!
 
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There's definitely a fear of having a patient keel over from a severe hypo, because it looks bad on their record & might even be a malpractice risk. So I applaud you for speaking the truth to your doc, Miss Blue. I follow the money too . . . and then there's their half-witted allegiance to ADA dogma. :mad:
 

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I can't really explain "why" they continue to push misinformation, except that medicine is largely based on precedent and consensus, and that even desperately needed change is slow. Once standards become institutionalized, they're hard to change, and doctors are eager to follow established practices even when they know that they're probably wrong if only to prevent lawsuits.

And maybe I'm wrong, but I've had a number of doctors over the past few years who have given me the impression that they just think I'm hopeless. I've kept my A1c below 5.5% the entire time, I've taken my medication, I've never skipped a doctor's appointment, and I've lost ~100 pounds, but for some reason they treat me like complications are inevitable and diabetes will shorten my life.

In short: they're managing me, keeping me alive right now, not trying to help me live as long as I would've without diabetes. I suspect they think it's a foregone conclusion that I will die younger and that I have to be unhealthy, so rather than assisting me in tightly controlling blood sugar and supporting my diet (a diet they believe is questionable in the first place), they'd rather just help me avoid dying in my sleep of low blood sugar.

Sadly, these diabetic forums are full of people who are unusual because of how much they care and how hard they work. Doctors don't see diabetics like us often enough and then the poorly controlled diabetic becomes a reinforced stereotype. They give bad advice, their diabetic patients are uncontrolled and sick, therefore all diabetics are uncontrolled and sick and nothing can be done.

My doctor saw my BG log, told me that I had the best blood sugar he'd probably see in a diabetic in the next ten years (huh?), and then talked to me about how I didn't have kidney damage because I haven't been diabetic long enough. I'm like, do you even know what causes kidney disease in a diabetic?
 

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Once standards become institutionalized, they're hard to change, and doctors are eager to follow established practices even when they know that they're probably wrong if only to prevent lawsuits.
Yes, and I think it's also a certain laziness. They know what they know, are busy in their practice, and don't continue learning, esp if it has to do with challenging what they consider basics.

Sadly, these diabetic forums are full of people who are unusual because of how much they care and how hard they work. Doctors don't see diabetics like us often enough and then the poorly controlled diabetic becomes a reinforced stereotype.
Excellent point. When I went on a rant with one of my retinologists I know well, about how the advice we are given keeps so many of us sick, he said the same thing, asking rhetorically how many diabetics are like me and would follow tighter guidelines.

You're doing such a great job at control - my goal is to be like you w/ my A1C lower and more weight gone. Kudos!
 
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You have a great A1c! I'm really impressed that you could go from 14.7% to 5.6% in under a year.

The weight loss has taken me three years with ups and downs, and I'm still not done. Feels like it's taking forever!
 

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I believe Miss Blue hit it on target. All the diabetics I know are pretty careless in their own care. I'm hoping to convert one of them, if she'll read Bernstein as she promised. But that may not happen. It does take a bit of concentration I admit since our doctors in the main have nothing but the ADA advice to give us.
 

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they are idiots.saint vincent er is the only hospital that wants an a1c of lower than 6.5
 

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Two things my HMO does right ... prescribe proper meds and dosages and set an A1c goal of below 6.0.

They do, however, expect me to accomplish that feat (plus lose an unspecified amount of weight) whilst eating their ADA-approved diet. Now, to be fair, that just might work in a nearby universe with slightly different laws of physics. Maybe I should switch regional offices?
 
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