No one is as keen to talk about their health as me, but

[papasmurf]

Well done on the weight loss
Was it semaglutide?

No.

[Ratcliff]

I get "subpoenas" from the local health centre to attend appointments/tests with various specialist nurses about every three months. (Plus telephone based appointments.)
Last  March my wife and I were called in to see a specialist nurse, (apparently the only one in Cornwall) to counsel us both about my "volunteering" for an experimental treatment. (The choice was volunteer or die.)
Thus far the treatment does seem to be working my mmol/mol reading (whatever that is) has dropped from  84 to 37 and I have lost nearly 19kg in weight.

Well done on the weight loss
Was it semaglutide?

[johnofgwent]

I suggest if you don't like the current method complain to the NHS and Diabetes UK.

I have made Diabetes UK aware. As you say, the test has replaced the periodic fasting glucose because the same people that determine what drugs are best for you on the basis of how cheap they are decree this is the test that will be done

Which astronaut was who said he was sitting on a bomb assembled by the lowest bidder ??

[papasmurf]

As your chart shows, a glycosylated haemoglobin count of that number is estimated, via those dodgy and error prone mathematical assumptions that make no allowance for variation in enzymic and other liver activity, to equate to 5.5 which is the blood sugar equivalent of a blood pressure of 120/80

All know is that measure is apparently used nationally, at the time of the blood test my BP was 121/60, the urine test also showed no problems.
I suggest if you don't like the current method complain to the NHS and Diabetes UK.

[johnofgwent]

Well that is ok. If it is a matter of a bung to the local quacks then I am all for it. It is all this talking through the issues and well meaning do goodery that makes my piles bleed.

The trouble is, it's a mix of both

[johnofgwent]

Obviously Borchester you know zero about it.
HbA1C New  37 = 5.5% HbA1c Old

Now I'm a tad worried. I take it those "old" and "new" columns are actually trying to say "the way we used to do it" versus "the way we do it now" because the fact is, the tests for those two columns of readings are quite different, are predicated on two utterly unrelated paradigms (see, I CAN bullshit like a GP) and now speaking as a biochemist, measure two totally different physical issues.

One measures free glucose in the blood right now. There are certain contaminants that can give a false reading but it is what it is, a genuine reading of live events. The newest technique for this type of test is the device that you "wear" for two months at a time, you press it to your skin and it sticks a Lancet in to take readings, and the whole thing is sealed against your skin with a transparent adhesive patch. You wave a smartphone over it, and it gives an instant reading.

I saw one last week on the arm of the practice nurse who is type 1 injecting. She suggested I think about having one prescribed. Because they do give instant and continuous readings they are the way to go when you need to inject and titrate your insulin

They also utterly overcome the shortcomings of the "new" test. The "new" test relies on the fact that haemoglobin is denatured and tendered ineffective by having a sugar molecule attached to it.

The test is predicated on the assumption that the red cell is a leaky bag and sugar in the blood is freely exchanged across the membrane where once inside it comes into close contact with the intracellular haemoglobin and poisons it.

The healthy liver recycles red blood cells into bile pigments viral to titrate the excess acid in digested food passing from the stomach to the duodenum. Failure to produce enough is the number one way you get duodenal ulcers.

The HBA1C test relies on the assumption your liver is chewing its way through them and your spleen and bone marrow are making fresh ones.

It uses a raft of assumptions to backtrack a measurement at a point in time of the physical percentage of glycosylated blood now, to estimated blood sugar levels in the past 14 days.

There are literally a dozen ways this calculation could be utter, utter rocking horse poo. The most worrying of them us the fact liver damage will reduce the destruction rate of old cells, giving abnormally high HBA1C readings not because you are diabetic but because you are failing to remove aged and failing blood cells.

The alert GP will test for such failure at the time they do the HBA1C test. The ignorant, the overworked, the cash strapped or the blood sample tube rationed GP won't.

The consequences of giving a liver that is failing  to do its job MORE work by forcing it to shovel shitloads of Metformin out of the way is frankly too effing terrifying to worry about.

B's comment stands. Without knowing whether your quoted number was a measure of free glucose rva measure of glycosylated haemoglobin, and assuming the former, it is a fact that a fasting free glucose level that high on waking is a sign you are headed for a box and a rideout with Meatloaf and Steinman .....

As your chart shows, a glycosylated haemoglobin count of that number is estimated, via those dodgy and error prone mathematical assumptions that make no allowance for variation in enzymic and other liver activity, to equate to 5.5 which is the blood sugar equivalent of a blood pressure of 120/80

[papasmurf]

If your blood sugar level is 37 Pappy, you are what is known as dead. Either get a new test kit or a new doctor or both.

Obviously Borchester you know zero about it.
HbA1C New  37 = 5.5% HbA1c Old

[Borchester]

Mine is 37 and I had the booster so long ago, I am due for another vaccination.

If your blood sugar level is 37 Pappy, you are what is known as dead. Either get a new test kit or a new doctor or both.

[Borchester]

Your practice manager has been approached with a bribe to tick some boxes. If you don't attend they won't get the promised wonga. I suggest hiding from the vans wandering down your street they are probably there to kidnap you and drag you there by force

Well that is ok. If it is a matter of a bung to the local quacks then I am all for it. It is all this talking through the issues and well meaning do goodery that makes my piles bleed.

[papasmurf]

HBA1C values below 42 are "ok"

Mine is 37 and I had the booster so long ago, I am due for another vaccination.

[johnofgwent]

But naf all to me, I had to get a conversion chart from Diabetes UK so my wife could understand it.

Christ almighty are we talking blood sugar levels then

They SHOULD be 4.7 first thing after a nights fast and up to about 15-25 two hours after eating.

Mine are sadly free running at about 13-19 thanks to the other shyte in my life

My brother who is a type 1 injecting diabetic can see the values rocket to 60 if he does not keep a firm hold

BUT

HBA1C values below 42 are "ok"

HBA1C for those who do not know measures the amount of red blood cell haemoglobin taken down by a sugar stuck on it the same way carbon monoxide poisons it.

I have increasing HBA1C measurements that for a while I strongly think we're down to failure of my liver to destroy old blood cells, as judged by red blood counts and fasting free glucose levels. 

In recent weeks I think those free glucose tests have shown rises that align to more recent HBA1C levels.

The Pfizer booster wreaks havoc with both tests btw.

[papasmurf]

 Hence the popular terms mmol/l and mmol/ml and these terms mean something to pharmacists, microbiologists, biochemists and doctors alike. 

But naf all to me, I had to get a conversion chart from Diabetes UK so my wife could understand it.

[johnofgwent]

Thus far the treatment does seem to be working my mmol/mol reading (whatever that is) has dropped from  84 to 37 and I have lost nearly 19kg in weight.

It will be mmol/l or mmol/ml

A mole in chemistry is Avogadro's number of molecules. 6.023 X 10 to the power of 23 of them.

It is in reality as many grams as the atomic mass. So 14 grams of carbon is one mole.

A molar solution of something soluble is one mole of that substance dissolved in an amount of water that at 25 degrees C measures exactly one litre

Taking exactly one litre of water and adding a mole of substance such that you now have fractionally more than a litre of fluid is a MOLAL solution.

A one millimolar solution has one thousandth of a mole of substance in one litre. A one molar solution has a thousandth of a mole in a thousandth of a litre. Hence the popular terms mmol/l and mmol/ml and these terms mean something to pharmacists, microbiologists, biochemists and doctors alike. Getting them mixed up kills people which is why my former profession generally treated anyone citing anything in terms other than per litre the way Sharia treats gays. Because in general you will survive rampant dilution of anything administered by IV. Rabid overconcentration however means you'd better be a half decent biker because you're joining Meatloaf and Steinman.....

I shall be frank. Speaking as someone who wrote the book on culturing cells outside the body, literally, my 1982 publication citing the mixtures to keep isolated liver cells in culture for weeks made our team famous for the materials and methods section,  I know of no vital blood chemical whose concentration in those ranges is a good thing !

[papasmurf]

I have just received this from the local Health Centre..

I get "subpoenas" from the local health centre to attend appointments/tests with various specialist nurses about every three months. (Plus telephone based appointments.)
Last  March my wife and I were called in to see a specialist nurse, (apparently the only one in Cornwall) to counsel us both about my "volunteering" for an experimental treatment. (The choice was volunteer or die.)
Thus far the treatment does seem to be working my mmol/mol reading (whatever that is) has dropped from  84 to 37 and I have lost nearly 19kg in weight.

[johnofgwent]

I have just received this from the local Health Centre..

Dear Mr blah blah
XXX Diabetes UK Community Group Support for people with diabetes living in XXX through shared experience and learning from other people with diabetes, talks from experts and increased knowledge of local services for people with diabetes.

It is open to anyone with Diabetes (either Type 1 or Type 2) and you don't have to live in XXX.
Group meeting virtually on zoom the third Monday of each month from 3.30-5.00pm.

So it is a nice thought. Very kind in them I am sure, but what is there to discuss? The bad news is that everything aches. The better news is that a few paracetamols solve that. And the best news of all is that I piss like a horse which is great for the compost heap.

So, nice thought but what is with all this endless talking about every ailment? What happened to the good old days when you went to the doctor and he said mmh, take an aspirin, some brandy and if you are no better in the morning  then you are probably dead anyway?

I don't care what they say, modern medicine has not been all progress.

Your practice manager has been approached with a bribe to tick some boxes. If you don't attend they won't get the promised wonga. I suggest hiding from the vans wandering down your street they are probably there to kidnap you and drag you there by force