Re: The Ticking-Clock Hypothesis?

Larry wrote:
Metabolic Syndrome patients who also

developes Type 2 Diabetes compared to otherwise healthy T2s diagnosed
in mid 60s+ age for example is like comparing apples and oranges. Is it
accurate to say that an otherwise healthy 65 yr old marathon runner
recently diagnosed with mild T2 (aside from limited longevity due to
age alone) is in the same bowl of fish as an overweight, hypertensive
T2 in terms of mortality.

There are many populations of people with Type 2 as you suggest.

Unfortunately, the A1c is not a good guide to diagnosis. Even the ADA does not recommend using it as a diagnostic test.

Not only do you have your 62 year old marathoner with glycemic excursions, you also have your otherwise healthy 39 year old with low post meal excursions but high fasting blood sugar (I live with him <sigh>. And you have your older women with normal fasting blood sugar, nasty post-meal numbers, reasonable A1cs and a high risk for heart attack (Rancho Bernardo study.)

The study of neuropathy and its relationship to blood sugar levels which I cite somewhere on http://www.geocities.com/lottadata4u found NO relationship between neuropathy and fasting blood sugar results or A1c, but a strong straight line relationship to 2 hr glucose tolerance test results.

It is worth noting, BTW, that when the pedal hits the metal and doctors REALLY want to know if a person has abnormal blood sugar because lives are at stake, the test they use IS the 2 hr Glucose tolerance test. That is the case both with pregnant women and with candidates for kidney transplant.

And it is also worth mentioning that unfortunately, the mortality of your 62 year old may be worse than you think, since a fatal heart attack is often the FIRST symptom of diabetes. It was for my 61 year old, non-overweight uncle. By the same token, there are people who have walked around for a decade or more with horrendously high blood sugars (one who is (or maybe, was) a regular here) who survive and even get some of their health back after establishing good control.

It's a VERY complex issue that can't be reduced to a single number, though doctors driven by cost-cutting insurance companies try to do just that.
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