Guardian 'diabetes is biopsychosocial'

[Arnie Pye]

What does hba1c below 10 mean?

I understood that an ideal hba1c reading was 42mmol/mol, or lower.

A reading of '10' doesn't seem to make sense to me unless it's a finger prick Blood Glucose reading, a different test, with a different scale, where 10 would be high enough, as a one off, to diagnose diabetes, at least by some GPs, and definitely doesn't suggest good control, good control would be 4.5-6.5 - essentially a non diabetic reading,

Or perhaps the meaning of good depends on whose paying and how much?

See this link : https://www.diabetes.co.uk/downloads/HbA1c-units-conversion-chart.pdf

It depends on the units of mesurement used.

Oh, and another thing... The results considered to be good depend on whether you have been declared to be diabetic or not.

 

[rvallee]

Plus ça change, plus c'est le même drivel.

Editr is it la même drivel.

Le même

Gendered objects are a weird feature of some languages. Lady chairs and mister sofas. And completely arbitrary so it's about as frustrating to non-native speakers as the damn feature of the English language to have multiple pronunciations of the same spelling. There's just no rule there, yet it's glaring when it's wrong. Maybe it was meant to make spies more obvious? Easy tell.

 

[Wonko]

In that case a reading of 10.0 corresponds to an hba1c of 86, which is really very very bad, I've never had one that high since I started on meds, and on occasion mine has been too high for a BG meter to read in that period.

 

[Cheshire]

What does hba1c below 10 mean?

I understood that an ideal hba1c reading was 42mmol/mol, or lower.

A reading of '10' doesn't seem to make sense to me unless it's a finger prick Blood Glucose reading, a different test, with a different scale, where 10 would be high enough, as a one off, to diagnose diabetes, at least by some GPs, and definitely doesn't suggest good control, good control would be 4.5-6.5 - essentially a non diabetic reading,

Or perhaps the meaning of good depends on whose paying and how much?

Hba1c are expressed in percentage. It measures the proportion of haemoglobin cells that are loaded with sugar.

The normal range is between 4 and 6%.

 

[Arnie Pye]

In that case a reading of 10.0 corresponds to an hba1c of 86, which is really very very bad, I've never had one that high since I started on meds, and on occasion mine has been too high for a BG meter to read in that period.

I think the 10 may be fasting morning glucose. The HBA1C is a different test. But I'm not diabetic, so I'm on shaky ground here.

 

[rvallee]

BPS is a way of seeing health/illness/disability. It is a general model.

So as a comparison you have the Social Model of Disability and the Medical Model of Disability. People who agree with the Social Model see all Disability through that lens, which is about a lot of the difficulties disabled people face being located in Society (lack of adaptations, prejudice, but tending to neglect the bodily impairment itself). In contrast, Medical model people see Disability as located in the faulty bodies of individuals, it can be quite a paternalistic approach (the approach which led to lots of disabled people forced to live in large institutions).

People don’t tend to apply different models to different conditions, it’s a way of seeing the medical/disability world.

BPS is a lens like this, so it is predictable that BPS proponents will tend to think that it applies to everything (cancer and diabetes as well as ME). What probably varies is the emphasis on the different aspects (bio vs psych vs social) and the plausibility of pushing the psych side. In ME it’s clearly applied as bioPSYCHOsocial but in cancer it’s probably BIOpsychosocial. I’m not up to date on how they’re applying it to cancer, but social aspects are plausible- eg the laws/acceptability around smoking, asbestos and tanning beds.

There’s definitely an element of patient blaming with diabetes and decision making in terms of diet choices means a psychosocial side can be brought out and importantly the public will buy it. Patient blaming is the major flaw of the BPS lens (especially if there are political and financial biases). The complexity the BPS approach should have brought in could have been an advance on how we understand health. Unfortunately it is cheaper and easier to get the individual to do CBT and make different diet choices than to invest in biomedical advances or address complex society level issues

[Also, while on this topic, none of the current models of health/illness/disability seem to be a good fit for our experience as people with ME or other Spoonie conditions. Which also means the professionals we interact with likely don’t see us through an appropriate lens]

I think an intellectually honest BPS model has a place in medicine. But the current model is 99% psychosocial and pretty much 90% psychological. The bio part is added to pretend they incorporate biology but then they make no cooperation or even dialogue with the biomedical researchers.

When the very name of an idea is deliberately misleading, it's almost guaranteed to be wrong.

 

[Wonko]

I think the 10 may be fasting morning glucose. The HBA1C is a different test. But I'm not diabetic, so I'm on shaky ground here.

That is the only thing that makes sense to me, but a reading of 10 is still higher than I have most days, and I don't consider my control 'good'.

ETA - given that chart starts at 20, giving an hba1c of 4% if this is in any way comparable to the BG test then reading it the other way an hba1c of 10 mmol/mol would indicate a BG level of around 2%, and probably have someone in a coma, so my conclusion is, as stated, that the reading of 10 doesn't refer to an hba1c result, if 10 is considered 'good'.

 

[alex3619]

What does hba1c below 10 mean?

Different countries use different units for their tests, its not standardised. Below 10 means something in Australia, for example.

 

[Invisible Woman]

A number of years ago when I had a young (teen) diabetic living in my house we were told to be aiming for a HBA1C of 9 or lower, but given the teens 9 was okay.

When testing the blood sugar levels during the day we were told 10 was the ceiling and four was the floor and we should aim to keep results between those.

Edited - that was a type 1 diabetic. I can't remember the exact figure but results 12.5 (HBA1C) indicated long term damage was being done. Obviously this has a cumulative effect so consistently keeping the HBA1C down is better in the long run.

I was also told it was unlikely for a type 1 diabetic to have a reading of 8 (HBA1C) or lower. It wasn't impossible, but probably was only achievable by overcontrolling blood sugar levels. This means the diabetic is probably experiencing hypos.

 

[AR68]

Hba1c are expressed in percentage. It measures the proportion of haemoglobin cells that are loaded with sugar.

The normal range is between 4 and 6%.

Not being picky (!) but the limit, in my experience, appears to vary. Originally I was told 6 mmol/L (newly diagnosed insulin-dependent diabetic), then 7 then I was told that 8 is OK and then 7.5!

There seems to be a bit of confusion about the upper limit.

 

[AndyPandy]

I’m a skinny type 2 diabetic for over 20 years.

I’ve got the genes for types 1 and 2.

Pretty sure mine is a medical condition

 

[AR68]

I’m a skinny type 2 diabetic for over 20 years.

I’ve got the genes for types 1 and 2.

Pretty sure mine is a medical condition

Cells in the pancreas stop working, the BPS crowd own it and The Guardian prints without question. I give up.

 

[Mithriel]

In the UK, the measurements for HBA1C are different but the goal is under 50 but under 60 is considered not bad for type 1 (I am 52 and they are happy with that). Blood sugar reading are good if under 7 two hours after meals, under 4 is hypoglycaemia. You are classed as diabetic if your blood glucose is over 10 after an overnight fast then a specified amount of glucose (a beer glass full of sugary water, yuck)