The A1c is the standard of care as far as those with diabetes are concerned. New England Journal of Medicine (1993); 329: pp. 977-986. Lower A1c levels are associated with lower incidence of complications.
But when compared those treated with intensive program verses those who had conventional care of that era that had identical A1c values, the conventional group had 2.5 times the rate of retinopathy. These were people who had an A1c of over 9.0. All these data are from the DCCT noted in the reference in the first paragraph.
With further evaluation it seems that the likely difference is that the range of glucose fluctuation was greater in conventional care as opposed to those who practiced intensive care.
With all the newer ways to control diabetes with newer insulin available today, newer tests to gauge after meal glucose changes and just plain testing for glucose one or two hours after a meal, we have all the technology we need to decrease the complication rater even more.
The outcomes, complications and significance for type 1 and type 2 are discussed in the E-News for these groups discussed today. These are subscription newsletters.
Sunday, July 09, 2006
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