Replies to This Discussion

Permalink Reply by Libby on July 13, 2008 at 9:33am

I don't think most Type 1s have a set point because they are not producing insulin but Type 2s and us LADA types who are still honeymooning might. I think it's to do with the balance between basal insulin secretion and glucogen production- counter-regulation. Normal folks definitely have a set fasting rate of around 80. I have often thought about this because regardless of how much insulin I take or (within reason) what I eat- very low carb- mine comes back to a certain number. It used to be 97- which is about 5. However, when I eat really well-mostly raw foods- and get lots of exercise, my fasting rate goes down. I joke with my husband that "85 is the new 97".

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Permalink Reply by Hana Rous on July 13, 2008 at 2:28pm

I hover around that 5, although I prefer to go lower, which I can do if I use another medication on top of my ,Metformin. Because of the way Metformin works, I would suspect it's bringing me back to my set point

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Permalink Reply by Jonah on July 13, 2008 at 3:22pm

Even type 1s have a point at which their bodies react as though they were too low and the liver starts dumping sugar and so forth.
Whatever is just above the low end of the range that your body has been at recently is what your body will try to get to.

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Permalink Reply by Alan S on July 17, 2008 at 5:05am

I don't think there is a set point as such, just minima below which we get symptoms of lows and maxima it's not wise to exceed. I don't see 4(72) as particularly low unless you are getting hypo symptoms.

On testing, try to get a few more strips out of the parsimonious NHS. There was a petition which closed a few months back, http://petitions.pm.gov.uk/T2Diabetes/, hopefully that may have a result, but I doubt it. If you can get them, consider using them like this to get the best value from them: http://loraldiabetes.blogspot.com/2007/04/teting-on-budget.html

Cheers, Alan, T2, Australia

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Permalink Reply by Hana Rous on July 17, 2008 at 6:37am

I wrote to a lot of people and got the word from them that NICE ( National Institute for health and Clinical Excellence) hasn't actually advised this cutback in testing, but that several local health authorities are going on a Very Flawed Irish study of newly diagnosed type 2 diabetics, where the self testers and the non testers had similar aoutcomes after 6 months. Excepth that the testers had more depression.( to quote one doctor rebel"who wouldn't if seeing those high numbers hadn't been taught what tto do about it") they've taken this to mean that type 2s don't need to test. I'm going to take a copy of the NICE document to my doctor next time I see him. Don't know when that will be.. I am alarmingly well at the moment. Loads of exercise and not much food seems to suit me.

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Permalink Reply by Alan S on July 17, 2008 at 9:15am

G'day Hana

I can't recall the Scottish study; this is the bit of nonsense that my friends on asd.uk think may be part of the excuse:
BMJ, doi: 10.1136/bmj.39247.447431.BE, (Published 25 June 2007)
Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial
http://www.bmj.com/cgi/content/full/bmj.39247.447431.BEv1

You'll find my response with several other asd.uk'ers in the Ready Responses. That paper came out after similar flawed studies in Western Australia and Canada. I think it's no coincidence that all three countries subsidise test strip supplies. So far our NDSS is still doing the right thing.

NICE, of course, only set the National guidelines. Unfortunately, at the local level the postcode lottery over there already makes SMBG very difficult in some regions and no problem in others. I sympathise.

Cheers, Alan, T2, Australia

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Permalink Reply by Hana Rous on July 17, 2008 at 9:57am

Thanks for that. My problem with this question is that although I understand Exactly what I'm doing and am moivated to keep to very tight control, I know that many diabetics are not bothered and are happy to "take the medicine and believe the doctors" No-one seems to have investigated the differences in outcomes for motivated and less compliant patients. since I'm a low carber, I couldn't be called compliant either. I simply won't eat all that starch.

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Permalink Reply by Hana Rous on July 17, 2008 at 10:02am

can you give me a link for the asd.uk please? i keep finding things i don't want

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Permalink Reply by Alan S on July 17, 2008 at 6:45pm

asd.uk is a usenet group: alt.support.diabetes.uk. Usenet is not the same as the web; it can be accessed by Google groups but is best accessed via a newsreader such as Outook Express or Forte Agent.

If you drop in for a look, keep in mind that usenet is effectively unmoderated and anarchic, full of kooks, spam and flame wars. Sometimes you have to wade through a lot of rubbish to find the good people; most learn the use of killfiles to make it work. But I learnt more on alt.support.diabetes, misc.health.diabetes and alt.support.diabetes.uk than on all the various forums I read. Sadly, the spam and the kooks are slowly strangling usenet now.

This is the google link to asd.uk:
http://tinyurl.com/5qxu4h
and this is the associated web-page for alt.support.diabetes:
http://www.alt-support-diabetes.org/

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Permalink Reply by elaine peterson on July 17, 2008 at 11:27am

I have noticed that the #'s I see in a day seem to repeat. I am T1 using MDI's and I have wondered if the amount of Lantus I inject each evening (it varies due to hormones and weight loss/gain,) creates a set point for the next 20 or so hours. Either that, or my meter tends to repeat #'s? It is too frequent to be coincidental.

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Permalink Reply by John on July 17, 2008 at 2:12pm

http://tinyurl.com/2lshrb gives the mean continuous blood glucose for 21 non-diabetic subjects

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Permalink Reply by elaine peterson on July 17, 2008 at 4:32pm

Very interesting....thanks.

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