Friday, April 20, 2012

The ADA just doesn't get it

Today the ADA will launch new guidelines for blood sugar management goals.  As usual the article focuses on type 2 diabetics but I'm going to assume that the new guidelines will not discriminate between the two diseases.  Historically, I firmly believe, the ADA has focused on type 2 diabetes with both their research and guideline efforts.  As a disclaimer this organization frustrates me to no end and I think the JDRF is way more valuable, ethical and with it but that's beside the point.

In this NPR article the ADA is now stating that for older/ existing cases of diabetes the target A1c can be 8 and that for newly diagnosed type 2 diabetics an A1c of 7 is ok.  As a type 1 diabetic or someone who produces no insulin, who even if they ran on a hamster wheel continuously without insulin would still have blood sugar spikes well above 300 an A1c of 8 would be an incredible failure, incredibly dangerous and overall poor for my lifestyle!

To explain, A1c is kind of the 3 month moving average of daily blood sugar values.  A person with neither type 1 nor type 2 diabetes has an A1c of around 5 which equates to an average blood sugar of 90 - 100.  An A1c of 8 equates to an average blood sugar of 183!  How that is deemed medically safe is beyond me.  If my average blood sugar is above 160 I become dehydrated, urinate more frequently, will have low level headaches and overall be flat out miserable.  I strive to achieve an A1c below 6 but at my last test my A1c was 6.3. 

I would love to know how the ADA came to this conclusion rather than suggesting more stringent guidelines to suggest better eating, exercise and lifestyle habits.  They really frustrate me to no end.