A1C Meaningless?

[hazelrah]

What medical heresy is being promoted here?

A1C is just another biomarker among many. Understand, it is a biomarker and not the disease itself. It simply shows a path towards the disease as do all biomarkers. How important a biomarker is to any relevant disease must be taken within the proper perspective and context.

Your last paragraph is part of the medical heresy. I'm pretty sure that phrase was being used ironically. To me, the essence of the medical heresy promoted here is the idea that you, rather than your doctor, are responsible for (and in control of) your health. Widespread acceptance of that heresy would do to the medical industrial complex what Martin Luther's 95 theses did to the Catholic Church. The medical Borgias and Medicis may still remain powerful, but there will be enormous change in the health care landscape, and some of the corruption that ruins people's lives may be reduced.

Mark

[StarchHEFP]

This article may be worth the free subscription to MedPage Today:

Eight different diabetes drug classes examined in a meta-analysis failed to demonstrate improved cardiovascular or all-cause mortality compared with placebo.
Researchers analyzed 301 randomized clinical trials of patients with type 2 diabetes, and found that, metformin outperformed some other drug classes for its effect on hemoglobin A1c levels, there were no significant differences in mortality -- including when placebo was included as a drug class...

http://www.medpagetoday.com/Endocrinology/Diabetes/59182?xid=fb_o_

In other words, you can be on the fanciest, most expensive diabetic drugs, even all 8 classes of them, and lower your A1c very nicely. But that doesn't amount to a hill of beans when it comes to actual health benefit! Sound familiar? Same message with statins and also the newly approved (and researched by Cleveland Clinic) $14,000 a year injectable cholesterol drugs which lower LDL by 70% or more.

When a patient fails to respond to a whole food plant based diet and metformin and is also killing it at the gym (such as my muscle building mixed martial arts patient), I check their C-Peptide levels to see if they have run out of insulin, and if they have, they need basal/bolus insulin on top of their regimen. Sometimes adults can also have type I diabetes come on suddenly (maybe it's from autoimmunity induced by an animal-based diet) and can be detected by antibodies in the blood against islet cells.
http://care.diabetesjournals.org/content/diacare/23/8/1072.full.pdf
I'm usually not the one who orders islet cell antibodies because I can usually get the answer by C-Peptide level. Blood sugar super high, and corresponding C-Peptide super low means that body has run out of insulin. One can try to stimulate C-Peptide if the fasting doesn't give the answer by doing post-prandial C-Peptide level a few times after a 50 gram sugar bolus (roughly a 12 ounce 7-up) with the corresponding postprandial glucose.

In the end, lesson is type 2 diabetes - best treated with lifestyle changes! Those meds are uber-expensive, with the SGLT-2 drugs about $300-600 per month and the GLP-1 drugs about $500-$700 / mo. If you're going to spend that kind of money, just save up and spend 10-days at John McDougall MD's program! Or if you're in India, spend $6000 and go to Sharan India in Goa, spend 3 weeks on a WFPB diet no oil, meditation/yoga/cooking class by the beach in Goa. If you're really, really at a loss for what to do, and all else fails, spend some time at True North!

What the medical community wants you to do, is cut you open (or stick a robot in you) and rewire all your intestines and stomach to the size of a fist, so you can't eat, and poop out everything you do eat. The above research is "justification" by surgeons that diabetes is a "surgical disease". No, I'm not kidding!
https://asmbs.org/patients/surgery-for-diabetes

Metabolic and bariatric surgery is the most effective treatment for T2DM among individuals who are affected by obesity and may result in remission or improvement in nearly all cases.

No thank you ASMBS!

[Spiral]

A1C seems to be a meaningful number in the minds of the patients, at least, even if there is too much reliance on that number. My Mom told me that she is pre-diabetic because her A1C is 6.9. So, she desperately wants to prevent her A1C from going to 7.0 at which point she says she will become a type 2 diabetic. So, she says she is going to cut back on carbs to get her A1C down.

Goodness.

[LowCarbIsDeadly]

A1C seems to be a meaningful number in the minds of the patients, at least, even if there is too much reliance on that number. My Mom told me that she is pre-diabetic because her A1C is 6.9. So, she desperately wants to prevent her A1C from going to 7.0 at which point she says she will become a type 2 diabetic. So, she says she is going to cut back on carbs to get her A1C down.

Goodness.

I think chasing post meal glucose is very misguided too. It makes people make crazy food choices for the short term like thinking its healthier to eat steak and chicken than it is to eat sweet potatoes or brown rice cause the post meal numbers look good. Unfortunately they don't realize they are making themselves more insulin resistant in the long term by eating fatty meals. The numbers may be higher in the short term for a while on a Mcdougall type diet but if it cures the type 2 long term thats what you want. Most diabetics think they need to avoid carbs. Thats a shame that is what is promoted by the mainstream medical care also. I hear it all the time people saying I have to watch my carbs.

[eric3417]

Initially while adopting Mcdougalling in May this year my sugar readings post meals at 1hr can be as high as 160. As months go by, eating the same food & amount, my 1hr sugar readings gets lower & lower. Last week's reading eating the same food & quantity consistently register numbers below 140. So from my own experience, stick to it. Your insulin resistance will get better as your body cells gets less fatty. Need abit of faith & patience. My Hba1c test last week was 5.4. Improved slightly from 5.7 in May.

Cheers!