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How often do you worry about diabetes complications?

May 23rd, 2012
Category:
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You may be at risk for diabetes if...

 

Anyone else here bristle when you are presented with these statements?

 

I mean, no $4!†, Sherlock. I have diabetes. I am no longer at risk for the condition, it exists in me.

 

So why does my lab's A1c, if it exceeds 5.8, say "You are at risk for diabetes" rather than "You are within guidelines for someone with diabetes"? Did my diabetes suddenly go away just because I don't need to take pills or shots to control it?

 

Now, I know I'd be really peeved if I didn't have diabetes and a 5.8 A1c read, "You have excellent control of your diabetes" -- but come on, some contextual information, please -- or better yet, placing 5.8 in the "higher than reference normal" category and letting my doctor do the talking.

 

...you are a woman who has had a baby weighing more than 9 pounds at birth

 

Considering how many of my once-pregnant younger friends and colleagues stated their doctors wanted their full-term newborns to weigh more than eight pounds to begin with, isn't that pretty much every woman under 40 who has borne a child? (Back when I was born, the typical weight of a full-term baby was between five and a half and seven pounds. Most babies weighing more than eight pounds -- what few of them there were -- had to be delivered by Caesarian section. There's a story in here, but not one which I've researched.)

 

...you are 65 years of age or older

 

Based on the Diabetes Detection Initiative's checklist, that alone is enough risk that just sitting on your butt most of the day means you're at high risk for diabetes. Just by getting old?

 

I'm going to skip the rest of the scare tactics, because many are right on the money -- including the note,

 

Even without these signs [the typical type 1 presentation], you could still have diabetes.

 

Awareness is a good thing. Screening is a good thing. Treatment is a good thing.

 

But why tell me I'm "at risk" for something I already have?




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You are absolutely right. I am a General Practitioner in South Africa (Durbanville, Western Cape)with a special interest in Diabetes and find that "plain speak" is the only way to go. I our terms an HbA1c of 5.8 is stunning. I struggle to get most of my Type 2 diabetics to get to an HbA1c of 7 or lower.

Keep blogging, I am learning a tremendous amount!


At what point are your Type 2 patients diagnosed? (What sort of bgs, A1cs, complications, comorbid conditions?) The earlier T2DM is diagnosed, and the fewer/less-severe the comorbids, the easier it is to get it under control. Also, is income (can't afford healthy food) or culture (won't change diet, can't/won't exercise for cultural/family-responsibility reasons) an issue? Care seems to be most effectively delivered in context of the rest of the patient's life

Brenda Bell (T`Mana)
T2 D&E dx 07/16/2002
T3 to 2 T2s (metformin/other
oral)


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Lindsey Guerin
Lindsey GuerinLindsey is a typical, yet unique, Texas girl who loves shopping, movies and reading. She loves to travel and take risks. She dreams of diabetes cures, never-ending cheesecake and her own airplane. The rest you can discover in her blog! (Read More)
Carey Potash
Carey PotashCarey is a full-time hater of diabetes. The benefits stink. His 7-year-old son, Charlie, has been giving he and his wife the finger since November of 2003. Carey's parenting humor has appeared in various websites and print magazines. He resides in the suburbs of Philadelphia with his wife and three children. (Read More)
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