Thursday, November 15, 2007

I was looking at a nursing textbook published in 1987, managing families with chronic diseases. And of course, type one diabetes took a chapter. I was most amused and bemused to note their analysis of the HbA1c. Below 9%, they said, was excellent. 9-10.5 was good. 10.5-12 was fair and greater than 12 meant that the patient needed an immediate change in regimen. They listed reasons for poor numbers; high renal thresshold, noncompliance or pseudocompliance (psuedocompliance means that the patient didn't understand what he was supposed to do and did it wrong because of ignorance) with regimen, growth spurt/ major hormonal changes. It made me think that all these people who write about getting complications despite good control, if they were writing before 1990, could have had A1cs of 8% and that was good control.

I've been thinking about buying some strips to test urine sugar to find out what my renal threshhold is because there's a strong correlation (among diabetics) between renal threshhold and development of kidney disease, especially if you control for HbA1c. The lower the renal threshhold, the greater the chance of developing kidney disease. Renal thressholds vary widely from person to person and tend to increase with age.

1 comment:

Vivian said...

Hi Jonah,

I love reading your blog, please keep it going. You are an incredible person.

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