Replies to This Discussion

Permalink Reply by Brian (bsc) on January 12, 2010 at 7:46am

I'm sorry to hear about your problems. If you believe your heart problems were at least partly to due to elevated blood sugar (which I would tend to do), then clealry an HbA1c in the 8s is bad news. The DCCT study clearly showed that complications were at higher risks with a HbA1c above 7% and more recent studies (UKPDS, VADT and EPIC-NORFOLK) indicate that risks are further reduced with lower HbA1c. In certain complications, risks reduction was observed all the way down to an HbA1c of 5.5%. The American Association of Clinical Endocrinologists (AACE) recommends that you lower your HbA1c below 6.5%.

Personally, I believe that everyone is different. Some people can walk around forever with an HbA1c of 10%. Myself, I already have Carpal Tunnel Syndrome and the first signs of peripheral neuropathy and the worst HbA1c I ever had was 8%. I'm targetting to get my HbA1c below 6% and preferably below 5.5%. I appear to be susceptible to complications. In your case, you may well make the same conclusion. I believe there is merit in lowering your HbA1c as low as possible without risking complications due to hypoglycemia (or from the medications).

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Permalink Reply by Marps on January 12, 2010 at 7:55am

BSC always gives great answers and suggestions.

I, too, am sorry to hear about your complications. It's a terrible disease to deal with, mostly because it is chronic and no matter how "well" we think we are doing, we can always be doing better and there are always issues lurking around the corner.

It sounds like you are taking control and that you are working hard.

I'm type 1 for 11 years and am at my lowest ever of 8.5% A1c right now. I'm 25 years old and I'm seeing first stages of retinopathy already. But, I'm still working hard to lower it to the target range of 6.5 or below. Would love to get it down even lower, but I have some issues that prevent me from doing so... for now.

So, good luck! What you're seeing is definitely linked, but I wouldn't say 8.3% is CAUSING your heart attacks... but it's definitely not HELPING them. Diabetics have a serious issue with heart disease and heart attacks. Comes with high blood pressure, high cholesterol, etc that all comes along with this glorious disease.

Please keep us posted. We will help as much as we can.

(I'm not a doctor, just a fellow diabetic)

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Permalink Reply by john owen-jones on January 12, 2010 at 10:07am

is carpel tunnel diabetes related ? had that diagnosed a few months back it hurts all the time in the cold.

first stages of retinopathy I just googled that byetta does wonders for me but i'm type II and still make my own insulin. Hopefully things are getting better for type !'s as well.

The more we get it right, the less damage we do to ourselves.

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Permalink Reply by The Diabetic Welfare Queen on January 12, 2010 at 10:19am

I think having an endocrine illness makes anyone more likely to get carpal tunnel, or arthritis. I have Hypothyroidism and got Carpal Tunnel from it in both my arms, way before I got Diabetes. It mostly comes from a bad deficiency in vitamin B, caused by poor diet, and poor absorption. I used a natural treatment once, with a high dose of vitamin B6 for about 6 months, and my massive flare ups I was having went away... I do get sore, from time to time, but with regular physical therapy exercises, and good nutrition, I don't have any of those huge pain flare up issues anymore. http://www.mothernature.com/Library/Bookshelf/Books/10/43.cfm

My A1C right now is 5.6%, if I go by my monthly average of 113 mg/dL. But I've cut down on the carbs in my diet to about 90 or less a day, as this will keep my sugar levels at 120 or less postprandial.

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Permalink Reply by john owen-jones on January 14, 2010 at 1:47am

surprise surprise , my bloods show I am low in B vitamins.

I can fix that


Marmite on toast for breakfast

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Permalink Reply by Brian (bsc) on January 12, 2010 at 10:43am

Well, Carpal Tunnel Syndrome (CTS) occurs with much greater frequency in diabetics. People with a diagnosis of CTS are 36% more likely to be later diagnosed with diabetes (than non-CTS sufferers) (http://care.diabetesjournals.org/content/29/8/1929.extract). I have come to believe that the high blood sugars from diabetes causes two things which lead to CTS, thickening of tendons leading to impingement in the tunnels in the wrist and second, inflamation of the nerves, the same mechanisms involved with other diabetic neuropathies.

CTS s*cks. I've been diligent about my exercises, I have great wrist and forearm strength, but my CTS is back with a vengeance. I'm forced to wear braces at night, and I can nearly see the day when I'll require surgery.

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Permalink Reply by Kelly Rawlings on January 12, 2010 at 10:21am

Congrats on working hard to achieve your level of control! We know it's not easy.

When it comes to type 2 and complications (especially macrovascular complications that affect the heart) managing blood pressure and blood lipids (cholesterol, triglycerides) are really important, too.

Have you and your health care provider talked about a safe A1C goal for you? If not, I urge you to. As bsc wisely notes, A1C goals should be personalized. An overall guideline may not fit your needs and situation.

Best wishes & thinks for inspiring me to keep up my own self management!

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