Re: what is the real range of numbers for the FBG?

kohlrabi_croce <kohlrabi_croce@xxxxxxxxxxx> wrote:

Gantlet wrote:
"Wes Groleau" <groleau+news@xxxxxxxxxxxxx> wrote in message news:tvxpg.183
Don't just listen to Jenny OR Kurt--look up the documents and studies
they cite and evaluate them yourself.

--
Wes Groleau


i have to admit...
i wouldnt take the advice of a total newbie on their evaluation of studies.
i wouldnt want that same newbie to take it either.
if a newbie feels they are qualified to evaluate studies, most of the time i
think they are wrong


It looks to me like it doesn't take that much smarts to look at the
results of one's blood test in the morning on a empty stomach,
see that it is 116, look at the "official range" of 100 to 126,
(for pre-diabetes), then ask oneself: gee, where does 116 fall
within that range? Could it be...in the middle?

Sorry to get snarky here, but geez!

Or are you saying that the 100 to 126 range is not correct?
If it isn't, would somebody please direct me to the medical
oraganization that has a better grip on it than eith the ADA
or the NIH? Because if neither of them have a good enough
grip on it, how could I expect any doctor to?

As far as official recommendations are concerned, they're probably as
good as any, although in the case of divergences from the position of
the Association of Clinical Endocrinologists I'd prefer the
latter.

But you need to consider the dynamics of these views. Scientific
opinions change with time, sometimes slowly and gradually, sometimes
more quickly and radically. As a very rough guide I'd say that it
takes about five years for a consensus of the best researchers to
become reflected in the position of an authoritative national body,
and another five years for that to become reflected in the textbooks
which they use in the transmogrification of medical students into
doctors.

Now you have to add to that the very wide variation among doctors in
their natural habitats of the consulting room and the golf
course. Some are scrupulous about taking the opportunities offered
them of updating their medical knowledge. Some aren't.

So far so good. To this very simplified picture you now have to add
the nasty possibility of scientific controversy, either in diabetic
research itself, or related areas, such as human nutrition. That can
badly skew the above timetables for the filtering down of research
results into authoritative national guidelines.

It would not be unreasonable to suspect, for example, that the current
publicity being given to the rising rates of diabetes and obesity,
both sometimes rather sensationally and inaccurately referred to as
"epidemics", could be a clue to underlying scientific
controversies. As the philosopher of science Thomas Kuhn has observed
(in "The Structure of Scientific Revolutions") scientists are also
human beings, and in some scientific controversies you literally have
to wait for the elderly die-hard authoritative professors to die
before the consensus swings across to the new views the old die-hards
successfully fought against.

If you wish to step beyond the official national guidelines in the
diagnosis and treatment of diabetes, e.g. a step strongly recommended
by the respected but radical diabetologist Dr Bernstein, then you will
find folk here willing and able to discuss the pros and cons of his
and other minority views.

One of the nice things about a chronic illness is that it gives you
time, if you have the inclination and ability, to become an expert in
your own disorder. While it takes roughly seven years of full time
study to become a medical doctor (or indeed most other kinds of
doctor), becoming knowledgeable enough in one disease to know more
than most doctors about it is not too hard. Of course there's huge
individual variations between people and diseases, but as a very rough
guide I'd put it vaguely in the ball park of six months of part time
post-graduate study.

Diabetes is most unusual in chronic illnesses in that we all now have
access to home blood glucose meters with which we can check our own
blood glucose readings every day, or even every fifteen minutes to
plot your own individual post-prandial blood glucose graph. This gives
us quite unrivalled opportunities, if we're so inclined, to carry out
our own experiments on ourselves, discover if we're the average
diabetic described in the textbooks, and if not, devise our own
treatment plans based on our own measured responses to various
interventions.

IMHO that makes diabetes one of the most interesting chronic disorders
to have, an interest that could have rather good payoffs in our later
future health.

Who am I to say all this?

As you may have begun to suspect, I'm a boring old retired academic
given to tedious patronising lectures. It's hard to break the
professional habits of a lifetime :-) I took early retirement because
of serious health problems which turned out to be quite probably
related to undiagnosed late-onset T2 diabetes. Since that's what my
mother developed and there are heritable factors, I'd been asking my
doctors for decades to check whether I was diabetic. They'd been
reassuring me for decades that I wasn't diabetic because my fasting
blood glucose tests were fine. So you can understand that I'm a bit
annoyed with the official diagnostic guidelines my doctor has
apologised for being required by his employers to follow.

Welcome to medical politics and interesting controversies :-)

--
Chris Malcolm cam@xxxxxxxxxxxxxxxxxxxx +44 (0)131 651 3445 DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

.

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