Re: Glycolation - resistance?

Trinkwasser <spam@xxxxxxxxxxxxxxxxxxx> wrote:
On Thu, 22 Apr 2010 01:16:54 -0700, "Paul M. Cook" <pmcook@xxxxxxx>
wrote:
"Lono" <londotpennelli@xxxxxxxxx> wrote in message
news:hqop1f$sdn$1@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Age 72
5' 8" and 170#
Diagnosed T2 10 years ago
Otherwise healthier than I ever expected
Metformin 1000mg, 2x
Byetta 10mcg, 2x

My eating habits are those of a non-diabetic teenager, with high carb
intake (lots of sugars, too) and postprandial peaks near 200.

My A1c is typically 5.5-5.7 -- really!

Is it possible that my hemoglobin is somehow less susceptible to
glycation? What else could account for the anomaly?

Thanks,


The HBA1C can be fooled, from my studies. If you are prone to short
duration spikes you can maintain a low A1C. However, studies have shown
that even short duration spikes can cause a lot of physical damage.
Neuropathy is not so much caused by high BG as it is by spikes in glucose.

As always, I am not a doctor. I express only what I have learned.

Very true, as your A1c reduces so the effect of postprandials vs.
fasting numbers increases. This is self-evident when explained - which
it often isn't.

Years ago there was a nice explanation of this on the ADA web pages of
advice on type 2 BG control. It's no longer where it was, and I can't
find it with a search. I guess it might have disappeared along with
the recently increased emphasis on the uselessness of doing much
testing if you're not a medication using T2.

My A1c went UP with improved BG control - because I was not only
bringing down the postprandial highs but reducing the
post-postprandial lows.

I can vaguely recall reading somewhere that the glycation the A1C
measures doesn't capture sharp short pp spikes, and that there is a
kind of soft glycation that long low BGs can undo. So removing shorter
sharp pp spikes, e.g. the kind that register on one hour but not two
hours measurements will have less effect that expected on an
"averaging" basis on the A1C. If your rebound lows were like mine they
tended to last unless interrupted with a snack or exercise. So they
would be the kind of lows which would undo some of the soft glycation
which would otherwise with slightly higher BGS have hardened into
registering on the A1C.

I used to write a lot here about why the A1C wasn't an average and
that treating it as though it was led to all sorts of mistaken
conclusions. Not only were very few interested, but the medical
profession appears to have decided for medical political reasons that
it would be a good idea to consider the A1C an average of BGs. Among
other things that paves the way towards using it diagnostically and
for treatment monitoring instead of the more expensive direct BG
testing under controlled conditions by doctors.

Of course BG self testing by patients is very cheap, but medically and
scientifically speaking one can't trust self testing by patients :-)

--
Chris Malcolm
.