Alan Mackenzie wrote:

Lets look at it logically. In 1978, home BS testing was still five
years in the future. You say, you had one injection per day -
Lente/Soluble[*]? What was the doctors' recommendation at the time?

Actually I don't know. I just have those stories how brave my parents
fought for the one-injection-therapy and some paper that "the child got
this therapy against medical advice".

Alan Mackenzie wrote:

Lets look at it logically. In 1978, home BS testing was still five
years in the future. You say, you had one injection per day -
Lente/Soluble[*]? What was the doctors' recommendation at the time?

Actually I don't know. I just have those stories how brave my parents
fought for the one-injection-therapy and some paper that "the child got
this therapy against medical advice".

I think if I were your Dad, I'd have given up trying to get through to
you long ago. "Facts", whatever that might have meant in this case,
simply don't come into it. Your parents wouldn't have had "facts"
available to them (unless one of them was a doctor, or moved in such
circles, or such like). It would have been a case of blind trust in
the doctor or trusting to instinct and their own knowledge.

Again the question about the hot plate and someone else's knowledge.
And, the facts proof that doctors right and my parents wrong. I did not
have this story book childhood they intended and my health IS ruined.

I think that by "facts" you just mean medical facts, and by "talking"
you really just want to beat them up verbally.

No. These debates started abot 15 years ago and part of what and how I
am now is the effect of what I've been through.

The thing is, what you call "facts" here aren't facts at all in wider
society (including Usenet ;-). They're merely doctors' professional
opinions, however objectively true they may be.

I am not talking about wider society, I am talking about my doctors at
that time. And as I can clearly see from my health here and today they
were absolutely right.

There is no guilt. They don't see the point.

I very much doubt that's true.

I expected that. But let me ask: Who had those talks for about 15
years? You or me?

And if it is, you could do with learning from them and applying it to
your rage and resentment. It _wasn't_ your mum and dad that caused
your medical problems. They're something that just happened, and it
looks like they'd have happened sooner or later anyway.

The problems could have been prevented or at least their outcome could
have been decades later... when there could be another way of handling
them.

What have they told you about that fateful decision 27 years ago?

That they only wanted the best for me and spare me the multiple
injections.

Well, childhood wasn't story book, my BG went dancing tango and when I
started ICT, apart the first few days there never was a problem with
injections... it required 8 times a day. I know you differ on that but
to me it just doesn't matter.

The thing is, considering things from a wider perspective, from other
people's point of view makes it more difficult to hang on to rage and
resentment.

I've got lots of them. The contact to many other diabetics helped me
very much those years. But this remaining in the past and lamenting
what could have all been if this or that had taken a different way is
useless.

That's the way it should be. And it should never be forced on those
that don't want it. Something you surely wouldn't do yourself as a
pump-loving doctor? ;-)

No ;-) But the problem are the prejudices with which people regard
different therapies.

And there are not only Alans or only Anjas in the world so each one has
to find his/her own way. It's just a shame that this way is often
misguided by prejudice, missing information or missing perspectives of
life.

Anja
(off for the weekend)

Never let a doctor bully you into doing more BS testing
than you can cope with.

Alan S <loralweightandcarbs@optusnet.com.au> wrote on Thu, 10 Nov 2005
09:48:21 +1100:

Hi All

Hi, Alan!

Forgive me Alan, yet again, when I weigh in on a different slant. I know
what you'll think about my post, so if you can't be bothered replying to
it, I'll take your reaction as implicit and understood - and I respect
it.

For the newbies who don't know me, I've been a T1 for 40 years, without
physical complications of DM, but with severe psychological problems
caused by it.

I noticed we've had quite a few newbies lately, and they are probably a
little confused at our pro- and anti- ADA arguments here.

To give some balance for the newbies, here are some recent guidelines
from a respected independent source, the American Association of
Clinical Endocrinologists. Their web-site is at http://www.aace.com

I don't think endocrinologists are that well versed in psychology. Be
careful that optimising your endocrine system doesn't wreck your life.

Anyone having problems with doctors who think an A1c of under 7% is OK,
or self-testing is unnecessary, may find it useful to print the quoted
web-page out. Of course, it doesn't go far enough in my opinion but at
least it heads in the right direction.

There is no binary cut-off point where an HbA1c is "OK" or "NOT OK". 7%
is not "NOT OK", rather it's on the high side, and it'd be worth while
looking for improvements in one's DM treatment. But it's certainly not
grounds for panic.

Self-testing (meaning presumably continual and frequent blood sugar
testing) isn't necessary. If it were, I'd have been dead nearly 40 years
ago. It's helpful, very helpful, but necessary it ain't. Never forget
that BS testing involves repeated violent injury to one's body, and the
long term consequences, emotional as well as physical, of this have never
been studied. Never let a doctor bully you into doing more BS testing
than you can cope with.

"Guidelines reaffirm ACE/AACE’s tighter standard for A1C
target
http://www.aace.com/pub/press/releases/index.php?r=20050916

Jacksonville, FL - September 15, 2005 – The American College of
Endocrinology (ACE) and the American Association of Clinical
Endocrinologists (AACE) applaud the International Diabetes Federation
(IDF) for formally endorsing an A1C standard of below 6.5%, at the
European Association for the Study of Diabetes (EASD) meeting Tuesday.
ACE/AACE is proud to be the first major medical organization to
officially adopt a goal of A1C less than 6.5% at our diabetes treatment
consensus conference in 2001 followed by an implementation conference
in 2005.

Again, I oppose the adoption of any goal in hBa1C level, since this
measurement is not causally linked to any diabetic complications. It's
merely correlated with them. It's akin to trying to reduce the incidence
suicide by discouraging church membership (these things are also
correlated). Adopting an hBa1C level as a goal means diverting attention
from things which _are_ intrinsically damaging. And it allows
second-rate doctors to offload their responsibility onto their patients
by saying "what do you expect me to do when you've got such a \"bad\"
HbA1c?".

It's so easy for organisations like the ACE to "applaud" such changes.
They don't have to cope with the anxiety disruption and worry that such
"one-size-fits-all" pronouncements cause. Remember that controlling
diabetes means keeping blood sugar under control, not HbA1c.

ACE and AACE encourage patients not only in the United States, but
throughout the world, to embrace the following recommendations for
glucose control:

* Early intervention and treatment: Early screening of
at-risk patients (beginning at age 30) and aggressive and
sustained treatment of patients with existing diabetes ....

Can't agree. It was partly "aggressiveness" which did me so much damage
40 years ago. It's an offensive insulting word, suggesting a doctor
standing in front of you and punching you in the face till you do what he
says. "Aggresive and sustained" usually describes blows being delivered
by a gang beating somebody up. That's a most unhelpful way of treating
diabetes.

.... can improve quality of life and significantly reduce the risk of
later complications.

The two are not the same. "Aggressive" intervention in somebody's life
tends to reduce its quality, not increase it. There's much, much more to
quality of live than reduction of risk of complications.

This may involve utilizing multiple complementary medications in
addition to lifestyle changes.

Or, translated into English, other drugs might help too, and get your fat
backside off that armchair!

* Education: Education is critical for patients with
diabetes. KNOWLEDGE IS POWER. The more you know about the
disease, the better chance you have of living a longer and
healthier life.

Agree whole-heartedly with this one.

* Self monitoring of blood glucose: Frequent blood
glucose monitoring allows you and your healthcare team to
make more informed decisions about therapy and understand
the effects of eating and exercise on your glucose control.
Good control means keeping blood sugar levels below 110
before eating and below 140 two hours after eating.

Yes, but over-frequent BS testing drains your wallet (which is a massive
health hazard in itself) if you have to pay for it yourself, and can lead
to worry and anxiety and "over-control": jerky instantaneous "solutions"
to things which aren't really problems. One's body must find its own
rhythm, and one must be careful not to disturb that rhythm by
over-frequent testing.

* A1C: A1C test should be performed at least quarterly.

Perhaps in the early stages of DM. In my experience, it seems excessive,
particularly if each result is the same as the previous one.

* Control your eating: Learn how to quantify what you
eat and know when and how to make adjustments.

Or, eat less and eat better. Each of these is far better than
quantifying what you eat.

* Daily exercise: Include daily aerobic exercise in the
management of your diabetes.

Or, expressed in English, get your fat backside out of that armchair!

* Medication: There are many medications that, in
conjunction with lifestyle modifications, can help you
manage your condition. Follow the regimen prescribed by your
physician. Medications will not cure diabetes, but they will
almost always allow you to control your diabetes well and
safely.

The ACE/AACE Road Map to optimal outpatient diabetes care,
released earlier this week, further outlines how the medical
community can assist patients in achieving the ACE/AACE
guideline recommendations."

The AACE "Road Map" mentioned here is available in Adobe
form from
http://www.aace.com/pub/odimplementation/roadmap.pdf. I have
some problems with it, as the road map tends to be about
medication rather than lifestyle change, despite the mention
of diet and SMBG above.

Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.

Alan S <loralweightandcarbs@optusnet.com.au> wrote on Thu, 10 Nov 2005
09:48:21 +1100:

Hi All

Hi, Alan!

Forgive me Alan, yet again, when I weigh in on a different slant. I know
what you'll think about my post, so if you can't be bothered replying to
it, I'll take your reaction as implicit and understood - and I respect
it.

For the newbies who don't know me, I've been a T1 for 40 years, without
physical complications of DM, but with severe psychological problems
caused by it.

I noticed we've had quite a few newbies lately, and they are probably a
little confused at our pro- and anti- ADA arguments here.

To give some balance for the newbies, here are some recent guidelines
from a respected independent source, the American Association of
Clinical Endocrinologists. Their web-site is at http://www.aace.com

I don't think endocrinologists are that well versed in psychology. Be
careful that optimising your endocrine system doesn't wreck your life.

Anyone having problems with doctors who think an A1c of under 7% is OK,
or self-testing is unnecessary, may find it useful to print the quoted
web-page out. Of course, it doesn't go far enough in my opinion but at
least it heads in the right direction.

There is no binary cut-off point where an HbA1c is "OK" or "NOT OK".

is not "NOT OK", rather it's on the high side, and it'd be worth while
looking for improvements in one's DM treatment. But it's certainly not
grounds for panic.

Self-testing (meaning presumably continual and frequent blood sugar
testing) isn't necessary.

ago.

that BS testing involves repeated violent injury to one's body,

long term consequences, emotional as well as physical, of this have never
been studied.

than you can cope with.

"Guidelines reaffirm ACE/AACEs tighter standard for a!c
target
http:??WWW>AACE>COM?PUB?PRESS?RELEASES?INDEX>PHP?R+@))%)(!^

JACKSONVILLE< FL _ SEPTEMBER !%< @))% The American College of
Endocrinology (ACE) and the American Association of Clinical
Endocrinologists (AACE) applaud the International Diabetes Federation
(IDF) for formally endorsing an A1C standard of below 6.5%, at the
European Association for the Study of Diabetes (EASD) meeting Tuesday.
ACE/AACE is proud to be the first major medical organization to
officially adopt a goal of A1C less than 6.5% at our diabetes treatment
consensus conference in 2001 followed by an implementation conference
in 2005.

Again, I oppose the adoption of any goal in hBa1C level, since this
measurement is not causally linked to any diabetic complications.

merely correlated with them.

suicide by discouraging church membership (these things are also
correlated).

from things which _are_ intrinsically damaging.

second-rate doctors to offload their responsibility onto their patients
by saying "what do you expect me to do when you've got such a \"bad\"
HbA1c?".

It's so easy for organisations like the ACE to "applaud" such changes.
They don't have to cope with the anxiety disruption and worry that such
"one-size-fits-all" pronouncements cause.

diabetes means keeping blood sugar under control, not HbA1c.

ACE and AACE encourage patients not only in the United States, but
throughout the world, to embrace the following recommendations for
glucose control:

* Early intervention and treatment: Early screening of
at-risk patients (beginning at age 30) and aggressive and
sustained treatment of patients with existing diabetes ....

Can't agree. It was partly "aggressiveness" which did me so much damage
40 years ago.

standing in front of you and punching you in the face till you do what he
says.

by a gang beating somebody up. That's a most unhelpful way of treating
diabetes.

.... can improve quality of life and significantly reduce the risk of
later complications.

The two are not the same. "Aggressive" intervention in somebody's life
tends to reduce its quality, not increase it.

quality of live than reduction of risk of complications.

This may involve utilizing multiple complementary medications in
addition to lifestyle changes.

Or, translated into English, other drugs might help too, and get your fat
backside off that armchair!

* Education: Education is critical for patients with
diabetes. KNOWLEDGE IS POWER. The more you know about the
disease, the better chance you have of living a longer and
healthier life.

Agree whole-heartedly with this one.

* Self monitoring of blood glucose: Frequent blood
glucose monitoring allows you and your healthcare team to
make more informed decisions about therapy and understand
the effects of eating and exercise on your glucose control.
Good control means keeping blood sugar levels below 110
before eating and below 140 two hours after eating.

Yes, but over-frequent BS testing drains your wallet (which is a massive
health hazard in itself)

to worry and anxiety and "over-control": jerky instantaneous "solutions"
to things which aren't really problems. One's body must find its own
rhythm, and one must be careful not to disturb that rhythm by
over-frequent testing.

* A1C: A1C test should be performed at least quarterly.

Perhaps in the early stages of DM. In my experience, it seems excessive,
particularly if each result is the same as the previous one.

* Control your eating: Learn how to quantify what you
eat and know when and how to make adjustments.

Or, eat less and eat better. Each of these is far better than
quantifying what you eat.

* Daily exercise: Include daily aerobic exercise in the
management of your diabetes.

Or, expressed in English, get your fat backside out of that armchair!

Considering that no lancing device has ever been subjected to a proper
study, how can you say that? If you take two fingers of the same age,
one of which has been repeatedly lanced over a period of 20 years, the
other one not, are you saying that the conditions of these fingers would
be indistinguishable?