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Medical Forum / Diseases and Disorders / Diabetes / December 2006Should I be concerned?
I've been Type II diabeteic for several years. I take 1000 MG of Metformin twice daily. For the past year or so my A1C has been 5.5 and my BG average is 88. I eat a very balanced diet, but depending on particular foods I do get occasional BG spikes. Should I be concerned? FWIW, my doctor seems unconcerned. TIA  SignatureWayne Boatwright __________________________________________________ (...a short musical interlude...) > I've been Type II diabeteic for several years. I take 1000 MG of > Metformin twice daily. For the past year or so my A1C has been 5.5 > and my BG average is 88. I eat a very balanced diet, but depending > on particular foods I do get occasional BG spikes. Should I be > concerned? FWIW, my doctor seems unconcerned. I think most well controlled type 2's would get the occasional spike. If this was after every meal it would be more worrisome, if only occasionally I don't think I would be worrying, personally. We are after all diabetics, just well controlled ones, but I don't forgo the occasional pleasures. I just don't do it often enough to be a problem. > I've been Type II diabeteic for several years. I take 1000 MG of > Metformin [quoted text clipped - 3 lines] > get occasional BG spikes. Should I be concerned? FWIW, my doctor seems > unconcerned. Depends how high, how long, and how often - and whether you believe height of spike or area under the curve is more important. Personally, I try not to go over 140 ever, but sometimes carbs happen... Nicky. SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg > >> I've been Type II diabeteic for several years. I take 1000 MG of [quoted text clipped - 13 lines] > Nicky. > Wayne, I've been having server issues so I never saw your original post. There is no clear uniform rule about BG readings. I'm between docs (my employer is dropping my HMO, plus my current physician is switching jobs within the HMO, so he's not my doc for the next 3 weeks or so that I'm still with HMO). My former doc follows ADA guidelines which are apparently 180 or below is OK. He agrees that shooting for better is fine, but is concerned about me "getting frustrated." Others around here (the newsgroup) cite medical studies that indicate exceeding 140 ever for any length of time has adverse consequences. In January I'll start Endo shopping (I have 4 docs identified but I don't think I should talk to them until I'm actually on the new insurance). THAT will be interesting. mt SignatureT2 dx May 2005 with A1c 10.1 1000 mg Metformin 2x day 1000 mg Fish Oil (Omega 3) 2x day 500 mg Niacin 1x day last A1c: 5.0 (Oct 2006) > My former doc follows ADA guidelines which are apparently 180 or below is > OK. He agrees that shooting for better is fine, but is concerned about me > "getting frustrated." He's OK with you going blind, getting neuropathy and / or kidney failure then? Nicky. SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg > >> My former doc follows ADA guidelines which are apparently 180 or below is [quoted text clipped - 7 lines] > Nicky. > If the ADA is okay with it, why shouldn't he be? SignatureT2 dx May 2005 with A1c 10.1 1000 mg Metformin 2x day 1000 mg Fish Oil (Omega 3) 2x day 500 mg Niacin 1x day last A1c: 5.0 (Oct 2006) >>> My former doc follows ADA guidelines which are apparently 180 or >>> below is OK. He agrees that shooting for better is fine, but is >>> concerned about me "getting frustrated." >> [quoted text clipped - 4 lines] >> > If the ADA is okay with it, why shouldn't he be? There are many peer reviewed trials that show that numbers that high cause complications. For me personally, I like to take some control over what happens to my body rather than leaving my care in the hands of people who don't have a vested interest in my health. The ADA even has those same trial results in their archives on their website. A body or doctor telling you something is ok doesn't necessarily mean it truly is ok. Maybe your doctor thinks it is the best you can do. Is it? In my opinion "getting frustrated" isn't a logical reason for not trying to keep complications at bay. Complications present at quite low numbers, just a tad above normal non diabetic numbers. "Under 180" leaves a large range of bg numbers, most of which are not conducive to complication prevention. As always though, tis your body not mine. > >> [quoted text clipped - 44 lines] > mine. > I agree. My BG goal is to never exceed 120. But I have other goals as well, and conflicting goals sometimes mean I don't meet my BG goal. But that doesn't mean I don't "aim low". My now-former-doc is okay with me aiming for 120 peak BG. But that doesn't mean he recommends it universally. Sorry, my previous comment ("If the ADA is okay with it, why shouldn't he be?") warranted a smiley or some other sarcasm indicator. mt SignatureT2 dx May 2005 with A1c 10.1 1000 mg Metformin 2x day 1000 mg Fish Oil (Omega 3) 2x day 500 mg Niacin 1x day last A1c: 5.0 (Oct 2006) >I agree. My BG goal is to never exceed 120. But I have other goals as >well, and conflicting goals sometimes mean I don't meet my BG goal. But [quoted text clipped - 5 lines] > >mt Whew! ;-) -- BlueBrooke T2/D&E/June 2005 The things that come to those who wait will be the things left by those who got there first. >>I agree. My BG goal is to never exceed 120. But I have other goals as >>well, and conflicting goals sometimes mean I don't meet my BG goal. But [quoted text clipped - 8 lines] > > Whew! ;-) Yeah! Nicky. SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg >Sorry, my previous comment ("If the ADA is okay with it, why shouldn't >he be?") warranted a smiley or some other sarcasm indicator. Yep:-) But maybe some lurkers will benefit from the replies. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Epidaurus >> >>> My former doc follows ADA guidelines which are apparently 180 or below is [quoted text clipped - 8 lines] >> >If the ADA is okay with it, why shouldn't he be? Hi Michael One reason I started blogging was because questions like this come up regularly. So I wrote this: Blood Glucose Targets http://loraldiabetes.blogspot.com/2006/12/hi-all-one-of-things-that-becomes.html One of the things that becomes obvious when speaking to other diabetics is the confusion and variation in their understanding of "tight control" or "good control" of their blood glucose numbers. That's not surprising when you start investigating and find that the major medical authorities neither agree on the targets, nor on the need to make the patient clearly aware of them - or on whether the patient should even try to improve them by their own actions. The ADA web-site includes this section on "tight control": http://www.diabetes.org/type-2-diabetes/tight-control.jsp "Good control means getting as close to a normal (nondiabetic) blood glucose level as you safely can. Ideally, this means levels between 90 and 130 mg/dl before meals, and < 180 two hours after starting a meal, with a glycated hemoglobin level < 7 percent." However, the ADA is not the only respected authority out there. Nor do they seem to have the same concept of non-diabetic numbers that the others have. In 2002 The American Association of Clinical Endocrinologists published "Medical Guidelines for the Management of Diabetes Mellitus: The AACE System of Intensive Diabetes Self-Management—2002 Update". You can find it at http://www.aace.com/pub/pdf/guidelines/diabetes_2002.pdf This is an extract: "For each patient, therapy should be individualized to maximize the likelihood of attaining and maintaining the appropriate goal and reducing the frequency of side effects or adverse reactions. To date, several studies have found a significant advantage associated with a decrease in glycosylated hemoglobin levels to 7.0% (normal, 3.8 to 6%), or lower if possible (1,3-6). Both preprandial and postprandial blood glucose targets are useful. The ACE Diabetes Mellitus Consensus Conference in August 2001 established the following goals: HbA1c level of 6.5% or less; preprandial glucose of 110 mg/dL or less; and the post prandial glucose of 140 mg/dL or less.(6a)" Then, in their 2005 Implementation Conference for ACE Outpatient Diabetes Mellitus Consensus Conference Recommendations they included this Position Statement: http://www.aace.com/pub/pdf/guidelines/OutpatientImplementationPositionStatement.pdf "A1C < 6.5% Fasting/Preprandial plasma glucose < 110 mg/dl (6.1mmol/L) 2-hr Postprandial plasma glucose < 140 mg/dl (7.8mmol/L)" and they reinforced the need for SMBG: "Self-monitoring of blood glucose (SMBG) is a critical resource for the management of diabetes. When performed with sufficient frequency, SMBG readings allow patients and their healthcare professionals to make informed decisions about lifestyle choices and adjustments in pharmacologic therapy. SMBG can also provide ongoing feedback to patients about their nutrition and physical activity. It is a very important educational tool. A key obstacle, however, to implementing effective interventions is a lack of supportive healthcare systems." That's a paragraph that many health insurance companies and the governmental Health bureaucrats would do well to read. In my opinion, we could do with the head of the AACE on the ADA board. I say "we", because, although I am Australian the decisions and guidelines of the ADA often tend to re-appear as policy of Diabetes Australia. Or you could try the Joslin advice. It's still not as tight as most I know aim for, but they are just as reputable an authority as the ADA: http://joslin.org/Beginners_guide_523.asp "Goals for Blood Glucose Control People who have diabetes should be testing their blood glucose regularly at home. Regular blood glucose testing helps you determine how well your diabetes management program of meal planning, exercising and medication (if necessary) is doing to keep your blood glucose as close to normal as possible. The results of the nationwide Diabetes Control and Complications Trial (DCCT) show that the closer you keep your blood glucose to normal, the more likely you are to prevent diabetes complications such as eye disease, nerve damage, and other problems. For some people, other medical conditions, age, or other issues may cause your physician to establish somewhat higher blood glucose targets for you. The following chart outlines the usual blood glucose ranges for a person who does and does not have diabetes. Use this as a guide to work with your physician and your healthcare team to determine what your target goals should be, and to develop a program of regular blood glucose monitoring to manage your condition. " (modified to post here; wo=without diabetes, wd=with diabetes) Before breakfast (fasting): wo < 110; wd 90 - 130 Before lunch, supper and snack: wo < 110; wd 90 - 130 Two hours after meals: wo < 140; wd < 160 Bedtime: wo < 120; wd 110 - 150 A1C (also called glycosylated hemoglobin A1c, HbA1c or glycohemoglobin A1c: wo < 6% ; wd < 7%" To summarise: mg/dl: ...................pre-meal......2hr PP.....A1c ADA ...........90-130....... <180.... ...<7% Joslin..........90-130.......<160.......<7% AACE..........<110...........<140......<6.5% Or, in mmol/L, rounded ...................pre-meal......2hr PP.....A1c ADA ...........5.0-7.0.......<10.0......<7% Joslin..........5.0-7.0.......<9.0.......<7% AACE.............<6...........<8.0......<6.5% The AACE give the tightest targets. I doubt that anyone would consider the AACE, which is an organisation of 5200 endocrinologists, as a bunch of fanatical radicals. Nor would they be promulgating guidelines impossible to be attained by the majority. Unfortunately, nobody but us talks about 1hr PP targets. My personal logic is that I treat their 2hr as my recommended max peak for any post-prandial, as I discussed in "When To Test. One-hour or Two-hour?" http://loraldiabetes.blogspot.com/2006/11/when-to-test-one-hour-or-two-hour.html Those AACE guidelines then agree very closely with the "Newly Diagnosed" http://www.alt-support-diabetes.org/NewlyDiagnosed.htm advice by Jennifer. Make your own judgment on which of those guidelines you think will lead to fewer complications. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Epidaurus > >> My former doc follows ADA guidelines which are apparently 180 or below is > >> OK. He agrees that shooting for better is fine, but is concerned about me > >> "getting frustrated." > If the ADA is okay with it, why shouldn't he be? Michael, You should know that many in here are very anti-ADA and you will get a lot of incorrect information because of it. For instance they will tell you that the ADA recommends that one's A1c should be 7% which is not the truth at all. Here's what they say... "The better your glucose control, the less likely you are to develop complications of diabetes. An A1C in the sevens (7s), however, does not represent good control. The ADA goal is less than 7 percent. The closer your A1C is to the normal range (less than 6 percent), the lower your chances of complications." As far as the 180 number, that is the maximum but not the ideal. They recommend that one keeps their bg numbers as near normal as possible. The ADA also recommends that one works with their doctor (I personally advise people to seek out a good endo who specializes in diabetes) to determine their personal needs. In your case your doctor is recommending you aim for lower than the maximum, as does mine, and must feel you are able to do that. Just my 2 cents. Best of health, Kurt Was Should I be concerned? >> >> My former doc follows ADA guidelines which are apparently 180 or below is >> >> OK. He agrees that shooting for better is fine, but is concerned about me [quoted text clipped - 26 lines] >Best of health, >Kurt Hi Kurt How about you save up your 2 cents until you can give the ADA a call and tell them to bring the rest of their web-site in line with that quote? Incidentally - what was the url for that page? What links does a newby have to wade through to get to it? I know - because I found it under "myths" - yet it's a myth perpetuated by the organisation itself. Here it is: http://www.diabetes.org/diabetes-myths.jsp To get to that, I had to skip past "Type 2 Diabetes" on the relevant pages and select "Diabetes Myths". Which is a newby likely to go to first? Why does it appear in "myths" and nowhere else?. So, lets say I'm a brand new type 2 and I go to the home page: http://www.diabetes.org/home.jsp I see a menu on the left. Right at the top is "All About Diabetes". Great - I can learn! So I select "Type 2 Diabetes" from the menu. As a T2 searching for knowledge - which am I most likely to click on - "Type 2 Diabetes" or "Myths"? On the page that loads, I click on "Conditions & Treatment". That gives me many choices, but I want to know about BG's and A1c, so I click on "Managing Your Blood Glucose" That gives me three choices: Checking Your Blood Glucose http://www.diabetes.org/type-2-diabetes/blood-glucose-checks.jsp To summarise the table there, the goals given are: A1c <7% Preprandial plasma glucose 90–130 mg/dl (5.0–7.2 mmol/l) Postprandial plasma glucose <180 mg/dl (<10.0 mmol/l) But, I could choose: Tight Diabetes Control Here is the relevant bit on A1c and BG's there: http://www.diabetes.org/type-2-diabetes/tight-control.jsp By the Numbers Good control means getting as close to a normal (nondiabetic) blood glucose level as you safely can. Ideally, this means levels between 90 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, with a glycated hemoglobin level less than 7 percent. But, I could choose: A1C Test http://www.diabetes.org/type-2-diabetes/a1c-test.jsp No mention of <7% or even <6.5% - in fact no targets at all. After a lot of waffle including "A1C (also known as glycated hemoglobin or HbA1c) test gives you a picture of your average blood glucose control for the past 2 to 3 months" are these pearls: "It is important to know that different labs measure A1C levels in different ways. If you sent one sample of your blood to four different labs, you might get back four different test results. For example, an 8 at one lab might mean that blood glucose levels have been in the near-normal range. At a second lab, a 9 might be a sign that, on average, blood glucose was high. This doesn't mean that any of the results are wrong. It does mean that what your results say depends on the way the lab does the test." The fact that they are a big organisaton does not excuse such poor work on the web-site. If I can pick this out - why can't some highly paid computer geek at the ADA do the same. And if these are their new guidelines - where else have they published them? Oh - and "an 8 at one lab might mean that blood glucose levels have been in the near-normal range." No, if my doctor accepted that it would mean that I need a new doctor or a new lab or both. Myths indeed. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Epidaurus > Was Should I be concerned? Wow, you really have some serious control issues, don't you Alan? > >> >> My former doc follows ADA guidelines which are apparently 180 or below is > >> >> OK. He agrees that shooting for better is fine, but is concerned about me [quoted text clipped - 117 lines] > > Myths indeed. Actually, I think the ADA would rather one work with their doctor than to get their diabetes care based on their ability, or inability, to navigate a website. It's a resource, not a hospital. I think the ADA is smart in the way they set up their website and provide their "recommendations." They don't crowd it all on the first page and provide information in a easy to follow and sequential way, with lots of paths to follow depending on what one is looking for. And a pretty nifty search engine that will provide specific information links for specific queries. They are also smart not to be so heavy handed with pushing their way or the highway on diabetics. They realize what you don't seem to - that everyone is different and the best person to determine individual needs is the professional doctor and the diabetic who works with them. You seem to want everything to be so absolute. Since you have been pretty busy posting your amateur blog then let's compare the two, shall we? ADA - A professional organization made up of endos, doctors, diabetes educators, and nutritionists. ALAN - Amateur party of one ADA - Many years as a major diabetes organization ALAN - Diabetic for a few years...but seems to know everything ADA - Advises the diabetic to work with their doctor to find out their individual needs ALAN - Is suspicious of all doctors and thinks his information is better ADA - Helps millions of diabetics the world over every day ALAN - Gets excited when his hit-o-meter racks up a dozen "surfers" ADA - Advises different diet plans, makes general dietary recommendations based on much research, and advises people to work with a nutritionist to find what works for them ALAN - Bases all of his dietary recommendations on what he and a few of his kindred spirits in here eat ADA - A professional website with lots of resources ALAN - A free blog that features links to other amateur opinions on diabetes So, maybe I should change the title of this thread to: The Choice is Easy Hmmmm? Kurt >> Was Should I be concerned? > >Wow, you really have some serious control issues, don't you Alan? ???? <snip> >> Myths indeed. > [quoted text clipped - 9 lines] >links for specific queries. They are also smart not to be so heavy >handed with pushing their way or the highway on diabetics. The sad thing is that you probably fervently believe what you write. > They >realize what you don't seem to - that everyone is different and the [quoted text clipped - 36 lines] > >Kurt No problems Kurt. Feel free to change it to whatever you wish. This thread is about the ADA Tight Control Recommendations. But, as you seem to want to avoid that subject and change it to some sort of comparison between an elephant(ADA) and a comparatively microscopic ant(me) I'll let other Type 2's judge for themselves. I have never, at any time, considered myself in competiton with the ADA - or anyone else on this subject. I started the blog mainly because, like many here, I seemed to be repeating myself and decided to put my own experiences in one place that I could refer to. Then, I received a little encouragement so I expanded it a little. Why don't you do the same? With my enormous resources of a.s.d, m.h.d. (actually, quite significant resources there) one tired computer and a limited single human brain: http://loraldiabetes.blogspot.com/index.html Opening with a caveat: "Ideas based on my personal experiences in learning how to manage type 2 diabetes. I stress that I am a diabetic, not a doctor nor a dietician. I have no medical qualifications beyond my own experience. Nothing written here is intended as medical advice, and any ideas you may decide to use should be discussed first with your doctor." and including a post saying: "To be clear, I think that both DA and the American Diabetes Association are marvellous, worthy organisations doing sterling work for diabetics in both countries. My only disagreement is specifically to do with their dietary and testing guidelines. The dietary advice and guidelines promoted by DA is effectively a rubber-stamp of that issued by the ADA; so the same comments apply to both." ADA: http://www.diabetes.org/home.jsp "The American Diabetes Association is the nation's leading nonprofit health organization providing diabetes research, information and advocacy. Founded in 1940, the American Diabetes Association conducts programs in all 50 states and the District of Columbia, reaching hundreds of communities. Find out what is happening in your area. The mission of the Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. To fulfill this mission, the American Diabetes Association funds research, publishes scientific findings, provides information and other services to people with diabetes, their families, health professionals and the public. The Association is also actively involved in advocating for scientific research and for the rights of people with diabetes." Pick any post. Compare with an equivalent ADA guideline. Give an opinion. Kurt, do you think they are succeeding in their mission "to prevent and cure diabetes and to improve the lives of all people affected by diabetes"? You're right - I was pleased when the first dozen "page views" showed up in the stats; what new blog author wouldn't be? Someone is actually reading your words. Then, when it became a dozen a day, then per hour - hey, you're right again, it's fun. But I get more excited thinking of the many thousands who have clicked on Jennifer's words or Jenny's pages, some of whom I sent there. And nearly all of whom are healthier today as a result. Ask the web-site owners for the page clicks on those sites. Then read xita's story. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Epidaurus "Alan S" <loralgtweightandcarbs@gmail.com> wrote in message > > No problems Kurt. Feel free to change it to whatever you > wish. [quoted text clipped - 3 lines] > to some sort of comparison between an elephant(ADA) and a > comparatively microscopic ant(me) wow Alan that is more than I expected. > I have never, at any time, considered myself in competiton > with the ADA you just think you know more. - or anyone else on this subject. I started the > blog mainly because, like many here, I seemed to be > repeating myself and decided to put my own experiences in > one place that I could refer to. lol after all its not like you like repeating yourself. >Then, I received a little > encouragement so I expanded it a little. Why don't you do > the same? probably because he does not have as much free time. > With my enormous resources of a.s.d, m.h.d. (actually, quite > significant resources there) one tired computer and a [quoted text clipped - 4 lines] > manage type 2 diabetes. I stress that I am a diabetic, not a > doctor nor a dietician. you just think you know more than any that does not promote low carb or agree with you. >I have no medical qualifications Very true >Nothing written here is intended > as medical advice, and any ideas you may decide to use [quoted text clipped - 9 lines] > promoted by DA is effectively a rubber-stamp of that issued > by the ADA; so the same comments apply to both." if you follow the advice of the ADA the numbers on the site are worthless because you will be working with your doctor not a page on the internet. but what should they do? should they say nothing? I think the ADA knows that people come to the internet seeking advice - so they basically have to go against their own grain and post advice or let spammers like Atkins be the only ones giving advice to newbies. if you go to their web site and think of it as a place to set your number goals in anything you are not following their advice because you should be doing that with a doctor. > Kurt, do you think they are succeeding in their mission "to > prevent and cure diabetes and to improve the lives of all > people affected by diabetes"? they have helped improved the life of diabetics, they know how to prevent many from becoming type 2. is it their fault that those that get it from being obese and very inactive? I will let you answer your question about a cure. but will say. with the money they spend on research they are our best shot. Tom [Default] On Sat, 09 Dec 2006 23:16:11 GMT, "Gantlet" <Tom@TomsDiabeticDiary.com> Giggled into the madness of usenet: >they know how to prevent many from becoming type 2. name 1. just 1. >is it their fault that those that get it from being obese and very inactive? I can name a few who became type 2 who were never over weight or inactive. type 2 is not caused by weight. weight is only an aggravating factor. >I will let you answer your question about a cure. >but will say. with the money they spend on research they are our best shot. they've been claiming that cure is around the corner in 10 years since the ADA was founded. That was over 30+ years ago. I know, I've been hearing that same lie now for that long. >Tom I hope your holidays are less toxic than your's and Kurt's personalities are here in ASD. SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://www.pandora.com enter "Jason & Demarco" "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... . : [Default] On Sat, 09 Dec 2006 23:16:11 GMT, "Gantlet" : <Tom@TomsDiabeticDiary.com> Giggled into the madness of usenet: [quoted text clipped - 4 lines] : inactive. type 2 is not caused by weight. weight is only an : aggravating factor. actually Mack, I'm going to have to semily disagree with you on this one now that I've been watching whats going on with my own daughter. she's been tested.. she does NOT hold the gene(s) for Type 2. (the ones they've found already) thankfully our insurance AFTER our doctor's bitching that the long run cost will be FAR less to test her now then to treat her later, they paid for over $3,000.00 worth of genetic testing.. which also put my mind to much ease. but the overall result is that she still has a two fold issue. she still has Hashi's which causes the excessive weight gain and when her TSH isn't below .8 then she cannot lose no matter how much she exercises or we watch what she eats (yes, I put her on a low carb diet!) same goes for the fact that she also has PCOS which causes weight gain and excessive IR (proof in her DHEA/Fasting Insulin levels/C-Peptide) --- I've watched in the last 4 months her A1C go from 5.1 to 5.7 and her glucose going from mid 80's to low 100's. I watch... what I see is that the weight causes IR.. without the weight there is NO IR.. proof in the lab results... therefore, be it genetic or not.. the weight does cause IR, at least for Danni I've found this to be true. Reisa, T1 pumping w/Animas IR1250 [Default] On Mon, 11 Dec 2006 21:43:43 -0500, "rk" <p_haha_medium@gmail.com> Giggled into the madness of usenet: >: [Default] On Sat, 09 Dec 2006 23:16:11 GMT, "Gantlet" >: <Tom@TomsDiabeticDiary.com> Giggled into the madness of usenet: [quoted text clipped - 29 lines] > >Reisa, T1 pumping w/Animas IR1250 "causes" IR or "aggravates" what is caused by other problems? In Danni's case, you haven't proven anything one way or the other. That's not good or bad. In Danni's case, or anyone like her who has more than one autoimmune disease there may never be one clear cut "cause" of IR. Each one aggravates IR. IR causes weight gain. Weight gain aggravates IR. It all combines to form a very vicious cycle. Your approach to treating it, however, is the best approach along with the appropriate meds for each disease, (when warranted) that we have available to someone with IR. SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://www.pandora.com enter "Jason & Demarco" "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... . : [Default] On Mon, 11 Dec 2006 21:43:43 -0500, "rk" : <p_haha_medium@gmail.com> Giggled into the madness of usenet: [quoted text clipped - 43 lines] : the appropriate meds for each disease, (when warranted) that we have : available to someone with IR. Please.. allow me to quote my own daughter... "I began to gain weight about 7mons after I had the flu." I would think she would know "when" she first began to gain weight. Which is what we both believe caused our autoimmune issues, her's being Hashi's. It was clearly her thyroid that caused her weight gain. Where the PCOS came from.... that we still have NO clue! I've been tested as well for PCOS, and I'm completely clear. My hormones are exactly where they should be for my age. Both Danni and I believe it was her thyroid that caused the weight gain, which started the cycle of the IR which knocked the rest of her hormones out of kilter. This reasoning because of so many that have PCOS also have thryoid issues be them autoimmune or not. But yes, one certainly aggravates the other and is a vicious cycle nonetheless. > [Default] On Sat, 09 Dec 2006 23:16:11 GMT, "Gantlet" > <Tom@TomsDiabeticDiary.com> Giggled into the madness of usenet: > >I will let you answer your question about a cure. > >but will say. with the money they spend on research they are our best shot. > > they've been claiming that cure is around the corner in 10 years since > the ADA was founded. That was over 30+ years ago. I know, I've been > hearing that same lie now for that long. I was told that by many people when I was first diagnosed and have been disappointed by the reality of it not being true as the pages of the calendar have flown by. It's pretty obvious that the magical cure is not right around the corner. I think stem cell research is our best hope and even with that it's going to take many years for that to be a viable cure. Developments like the pump, better glucose meters, laser treatments for the eyes, better medications, and other advancements have at least given us all a fighting chance against the terrible complications. I'm thankful for those but really wish the promised cure would have happened by now. The ADA is as much at fault for dangling that carrot as anyone else. I think the line from "The Shawshank Redemption" is worth quoting here: "RED: Let me tell you something my friend. Hope is a dangerous thing. Hope can drive a man insane." > I hope your holidays are less toxic than your's and Kurt's > personalities are here in ASD. Wow, there are so many things I could say after reading a comment like that, but instead I'll just say this: "I sincerely wish the best of health and life to you and yours this holiday season, Mack." Kurt [Default] On 11 Dec 2006 20:25:08 -0800, "Kurt" <kurtwheeling1965@hotmail.com> Giggled into the madness of usenet: >> [Default] On Sat, 09 Dec 2006 23:16:11 GMT, "Gantlet" >> <Tom@TomsDiabeticDiary.com> Giggled into the madness of usenet: [quoted text clipped - 30 lines] > >Kurt "The biggest fault, is to see none in the mirror." SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://www.pandora.com enter "Jason & Demarco" "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... . Well said Kurt. -- Cheri Kurt wrote in message speaking of a cure. <1165897508.351205.167570@79g2000cws.googlegroups.com>... I was told that by many people when I was first diagnosed and have been disappointed by the reality of it not being true as the pages of the calendar have flown by. It's pretty obvious that the magical cure is not right around the corner. I think stem cell research is our best hope and even with that it's going to take many years for that to be a viable cure. Developments like the pump, better glucose meters, laser treatments for the eyes, better medications, and other advancements have at least given us all a fighting chance against the terrible complications. I'm thankful for those but really wish the promised cure would have happened by now. The ADA is as much at fault for dangling that carrot as anyone else. I think the line from "The Shawshank Redemption" is worth quoting here: "RED: Let me tell you something my friend. Hope is a dangerous thing. Hope can drive a man insane." > Actually, I think the ADA would rather one work with their doctor than *One* works with *one's* doctor. *They* work with *their* doctor. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] [cites from his blog about BG control recommendations] > Since you have been pretty busy posting your amateur blog then let's > compare the two, shall we? > ADA - A professional organization made up of endos, doctors, diabetes > educators, and nutritionists. > ALAN - Amateur party of one > ADA - Many years as a major diabetes organization > ALAN - Diabetic for a few years...but seems to know everything > ADA - Advises the diabetic to work with their doctor to find out their > individual needs > ALAN - Is suspicious of all doctors and thinks his information is > better > ADA - Helps millions of diabetics the world over every day > ALAN - Gets excited when his hit-o-meter racks up a dozen "surfers" > ADA - Advises different diet plans, makes general dietary > recommendations based on much research, and advises people to work with > a nutritionist to find what works for them > ALAN - Bases all of his dietary recommendations on what he and a few of > his kindred spirits in here eat > ADA - A professional website with lots of resources > ALAN - A free blog that features links to other amateur opinions on > diabetes > So, maybe I should change the title of this thread to: The Choice is > Easy Kurt, you started out saying you were going to compare the ADA's advice with Alan's. But all you've offered us is ad hominem argument and appeals to authority. You do realise that the ad hominem argument, and the appeal to authority, were famously debunked as forms of invalid argument over two thousand years ago? They are both of course better than nothing if for some reason you are incapable of comparing the two advices, but you did specifically say you were going to compare them. If you can do that comparison, I think it would be a useful service to the newsgroup, not to menton the ADA. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] > You do realise that the ad hominem argument, > and the appeal to authority, were famously debunked as forms of > invalid argument over two thousand years ago? It's all Greek to him :D Nicky. SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg Regarding info provided by the ada and that in this newsgroup: "Since you have been pretty busy posting your amateur blog then let's compare the two, shall we?" Lots of irrelevant info snipped. The real way to compare the two is by results. As a benchmark for that we can use the ada worst case goal of an a1c of less then 6. How many ada guided folk achieve this goal and how many following the kinds of guidelines discussed here on a daily basis? Something like 70 percent have an a1c nationwide of over 7, unknown what impact ada has on their individual results but their doctors are very well aquainted with ada guidelines. Or maybe not, many are still saying below 7 is ok from the old guidelines. Hi Alan, I certainly agree with you.that it is unfortunate that the ADA is not consistent throughout its website on what blood sugar goals should be. To some extent the website aims at a cross section of the populace including the thousands of newly diagnosed who log on every month, and the result is that the up-front advice to the newly diagnosed is not always as nuanced as their recommendations actually are. To some extent it seems dumbed down to reach the lowest common denominator. However, the Myths page, which I had never seen, is NOT the only place on its website that the ADA recomends tigher control, which I have seen. The ADA recommends the setting of individual goals with a patient's doctors. The recommendations for the doctors are rather clear on the subject, and summarized in the table posted at http://care.diabetesjournals.org/cgi/content/full/29/suppl_1/s4#T6 These do list the same numbers that you quoted, but contain the same proviso that Kurt noted: "Goals should be individualized · Certain populations (children, pregnant women, and elderly) require special considerations · More stringent glycemic goals (i.e., a normal A1C, <6%) may further reduce complications at the cost of increased risk of hypoglycemia · Less intensive glycemic goals may be indicated in patients with severe or frequent hypoglycemia · Postprandial glucose may be targeted if A1C goals are not met despite reaching preprandial glucose goals" You probably would be surprised, as was I, that they even recommend, or at least strongly imply, that post prandial testing should aim for the peak number: "Postprandial glucose measurements should be made 1-2 h after the beginning of the meal, generally peak levels in patients with diabetes." In the position paper from which this table is taken, it states that: "# The A1C goal for patients in general is an A1C goal of <7%. # The A1C goal for the individual patient is an A1C as close to normal (<6%) as possible without significant hypoglycemia. # Less stringent treatment goals may be appropriate for patients with a history of severe hypoglycemia, patients with limited life expectancies, very young children or older adults, and individuals with comorbid conditions." And just below that: "The goal of therapy is to acheive an A1C as close to normal as possible (representing normal fasting and postprandial glucose concentrations) in the absence of hypoglycemia...More stringent goals (i.e., a normal A1C, <6%) should be considered in individual patients based on epidemiological analyses suggesting that there is no lower limit of A1C at which further lowering does not reduce the risk of complications, at the risk of increased hypoglycemia (particularly in those with type 1 diabetes).' I look forward, hopefully with justified optimism, that these factors will be featured on the pages you cited the next time they revamp the web site.. But rhetorical flourishes aside, it simply is not accurate to say that the only place they list them now is on the Myths page. Morris > Was Should I be concerned? > [quoted text clipped - 127 lines] > http://loraltravel.blogspot.com/ > latest: Epidaurus >Hi Alan, > [quoted text clipped - 58 lines] > >Morris I accept your point. How is the reader directed to that page from the ADA web-site? Which guidelines does your own doctor follow? Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Epidaurus "Alan S" <loralgtweightandcarbs@gmail.com> wrote in message > I accept your point. How is the reader directed to that page > from the ADA web-site? > > Which guidelines does your own doctor follow? I am willing to bet that his doctor follows the guidlines that say work with your doctor to set bg and wieght goals. :) Tom > Cheers, Alan, T2, Australia. > d&e, metformin 1000mg, ezetrol 10mg [quoted text clipped - 3 lines] > http://loraltravel.blogspot.com/ > latest: Epidaurus I'll take that bet. Do you think a "doctor" would say...don't work with your "doctor"? How much money are we actually talking here? Do you take mastercard? :-) -- Cheri Gantlet wrote in message ... >I am willing to bet that his doctor follows the guidlines that say >work with your doctor to set bg and wieght goals. > >:) >I accept your point. How is the reader directed to that page from the ADA web-site? >>>Not sure. I bookmarked it long ago. It is on the "For Health Professionals and Scientists" tab, under "Clinical Practice Recommendations." So doctors and educators would be likely to find that page while your average newly diagnosed person would not. Which may be just as well because it is written in terms that most of them could not fathom, kind of like many of the studies you are fond of citing. <g> > Which guidelines does your own doctor follow? >>>I haven't asked him in about 3 years. He is very happy with what I am doing, with a 5.0 average A1c over 3 years with almost no variation, and currently 4.9, that we rarely discuss it. About a year and a half ago he was concerned with the lows I was getting, and we cut back on my meds. If I remember correctly when he explained it to me, he said that 70-90 is normal before eating, and up to 110-120 after eating, and urged me to aim for normal numbers. I don't think we ever discussed 1 hr. vs. 2 hr. testing. He is a relatively young, maybe early 30s, internist who seems to know his stuff every time I have double-checked. Morris > >Hi Alan, > > [quoted text clipped - 71 lines] > http://loraltravel.blogspot.com/ > latest: Epidaurus >>I accept your point. How is the reader directed to that page from the ADA web-site? > >Not sure. I bookmarked it long ago. It is on the "For Health Professionals and Scientists" tab, under "Clinical Practice Recommendations." So doctors and educators would be likely to find that page while your average newly diagnosed person would not. Which may be just as well because it is written in terms that most of them could not fathom, kind of like many of the studies you are fond of citing. <g> So, what justifies the section in lay terms being different? There is a difference between dumbing down and changing completely. It would only take them a couple of days to search through the web-site so that there was a conformance; something that should be done every time guidelines are changed. Either the information they provide to the lay public should be correct - by their own standards - or it should not be provided at all. If the logic is to simply "see your doctor and/or dietician" then why provide misleading or inaccurate additional information at all. >> Which guidelines does your own doctor follow? >I haven't asked him in about 3 years. He is very happy with what I am doing, with a 5.0 average A1c over 3 years with almost no variation, and currently 4.9, that we rarely discuss it. About a year and a half ago he was concerned with the lows I was getting, and we cut back on my meds. If I remember correctly when he explained it to me, he said that 70-90 is normal before eating, and up to 110-120 after eating, and urged me to aim for normal numbers. I don't think we ever discussed 1 hr. vs. 2 hr. testing. He is a relatively young, maybe early 30s, internist who seems to know his stuff every time I have double-checked. Good one. Sounds like a keeper. Unfortunately, as you've read here - and on the ADA forum - from the newbies as they arrive it's a mixed bag out there. And it shouldn't be. Cheers, Alan, T2, Australia. d&e, metformin 1000mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Epidaurus Al;an, I certainly cannot defend inconsistency, and as I noted, hope they update the frest of the site soon to reflect the clinical recommendations. Morris > >>I accept your point. How is the reader directed to that page from the ADA web-site? > > [quoted text clipped - 27 lines] > http://loraltravel.blogspot.com/ > latest: Epidaurus >>>I accept your point. How is the reader directed to that page from the ADA web-site? >> [quoted text clipped - 6 lines] > something that should be done every time guidelines are > changed. > Either the information they provide to the lay public should > be correct - by their own standards - or it should not be > provided at all. If the logic is to simply "see your doctor > and/or dietician" then why provide misleading or inaccurate > additional information at all. >>> Which guidelines does your own doctor follow? >>I haven't asked him in about 3 years. He is very happy with what I am doing, with a 5.0 average A1c over 3 years with almost no variation, and currently 4.9, that we rarely discuss it. About a year and a half ago he was concerned with the lows I was getting, and we cut back on my meds. If I remember correctly when he explained it to me, he said that 70-90 is normal before eating, and up to 110-120 after eating, and urged me to aim for normal numbers. I don't think we ever discussed 1 hr. vs. 2 hr. testing. He is a relatively young, maybe early 30s, internist who seems to know his stuff every time I have double-checked. >>> > Good one. Sounds like a keeper. Unfortunately, as you've > read here - and on the ADA forum - from the newbies as they > arrive it's a mixed bag out there. And it shouldn't be. The problems with the inconsistency and patchy updating on the ADA web pages is more than that they can mislead newbies who don't carefully work their way through the entire web site. It's quite clear that they also mislead some doctors who are much too busy to do more than take simple obvious easily found statements at their apparent face value, and end up reassuring their patients that they're doing fine, no need to worry about anything, when their A1C is 6.9% or their two hour pp BGs are under 180. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] > The problems with the inconsistency and patchy updating on the ADA web > pages is more than that they can mislead newbies Well, someone who doesn't understand the difference between beans and whole grains might easily be mislead. The fact that you hardly ever test shows me that you didn't get very much from the ADA site, that is if you've ever really looked at it. It's quite possible that you are just going by what everybody else says about it...that happens here a lot. Now see if you can find any grammar errors in my post so you have something to respond to. And please use Strunk & White's "Elements of Style" when doing so. There's your assignment, Professor, now off you go. Kurt >> The problems with the inconsistency and patchy updating on the ADA web >> pages is more than that they can mislead newbies > Well, someone who doesn't understand the difference between beans and > whole grains might easily be mislead. You've twisted that one nicely. I never suggested beans were grains. I used "whole grain" to refer not just to the seeds of cereal grasses, but to small hard edible seeds of other kinds. That's probably an archaic usage in your world, but that doesn't make it wrong. It's still current usage in the UK, e.g. the jars of "Whole Grain Mustard" I can buy in any supermarket. It's a usage sanctioned by the OED, which you clearly don't have access to, or you wouldn't have persisted in this misconceived sneer. > The fact that you hardly ever > test shows me that you didn't get very much from the ADA site, Hardly ever test? Don't you ever read my posts? When I test a meal I usually take at least six readings, one before and five after. I'll often take ten. What you've probably misunderstood is that I don't test every day or every week. But when I do test I don't compare readings at one hour or two hours pp, I compare complete graphs. My diet consists of a set of standard meals and snacks. I've taken detailed BG graphs of all of them. Every now and then I take another complete graph and compare it in detail with all the others. It's a much more thorough method of testing than just taking spot tests at a fixed time like one or two hours pp. It's far too much bother for most people, and I don't recommend it to anyone who's not an experimental obsessive like me. I've spent half my working life in laboratories and detailed testing is second nature to me. > that is > if you've ever really looked at it. You've got a very poor memory. After a lot of your taunts at my criticisms of it not being based on a good careful look at it I posted the results of a careful investigation of the ADA web site which checked methodically through a sequence of pages, citing every one. > It's quite possible that you are > just going by what everybody else says about it...that happens here a > lot. It may well do, but I very carefully and specifically provided you with the evidence that I was not doing that. I looked carefully and found evidence which contradicted some of your frequent claims. I explained the evidence clearly and posed a question to you about it. Characteristically you ignored the question and simply mocked the time I'd spent on providing the evidence. Characteristically you still persist in your suggestions that maybe I've never looked at the ADA web site. You've also failed to notice that I sometimes cite the ADA web site as an authority, e.g. in a recent argument about diagnostic procedures I was the first person to provide an ADA reference and detailed quotation, and I did that because I was familiar with it. Criticise me by all means, but do please base your criticisms on actually reading my posts rather than just making stuff up. That's a waste of everyone's time and just makes you look foolish. > Now see if you can find any grammar errors in my post so you have > something to respond to. And please use Strunk & White's "Elements of > Style" when doing so. There's your assignment, Professor, now off you > go. You underestimate me if you think I'd use Strunk & Whyte. If you're really interested and not just posing, check out the early years of alt.usage.english, where before the idiots took over I used to argue with Strunk & Whyte followers. I'll correct persistent errors of yours if they're annoyingly frequent. I can't be bothered correcting every simple error like the one in your first quoted sentence. That was probably carelessness rather than ignorance. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] > > Now see if you can find any grammar errors in my post so you have > > something to respond to. And please use Strunk & White's "Elements of > > Style" when doing so. There's your assignment, Professor, now off you > > go. > > You underestimate me if you think I'd use Strunk & Whyte. I was referring to Strunk & White. Not sure who Whyte is. >If you're > really interested and not just posing, check out the early years of > alt.usage.english, where before the idiots took over I used to argue > with Strunk & Whyte followers. The setup is just too easy...too many punchlines come to mind. > I'll correct persistent errors of yours if they're annoyingly > frequent. I can't be bothered correcting every simple error like the > one in your first quoted sentence. Why do you feel this need to correct errors on Usenet? Seriously, Chris, Usenet is a very conversational kind of bulletin board community. People in these kinds of communities write as if they are speaking to another person, rather than writing to them. Sure, it's a text driven forum, but it's more like a coffee house than a school room. Part of the problem with your posts is that they are written as if you're giving a lecture instead of just having a casual and friendly conversation. Another inherent problem here is that in addition to a fairly philosophical difference we have about everything, the grammatical rules you follow in your region differ greatly from where I live. What I can be accused of...is spending this much time discussing grammar usage on Usenet. My bad. True dat. A'ight? Kurt >> > Now see if you can find any grammar errors in my post so you have >> > something to respond to. And please use Strunk & White's "Elements of >> > Style" when doing so. There's your assignment, Professor, now off you >> > go. >> >> You underestimate me if you think I'd use Strunk & Whyte. > I was referring to Strunk & White. Not sure who Whyte is. Sorry. There's a Whyte I often refer to and my fingers did the familiar thing. I meant Strunk & White of course. If you weren't able to guess that google would have pointed it out to you. >> If you're >> really interested and not just posing, check out the early years of >> alt.usage.english, where before the idiots took over I used to argue >> with Strunk & Whyte followers. > The setup is just too easy...too many punchlines come to mind. You're not interested in discussion are you? To you this is all a repartee competition. That also seems unfortunately to be true for you of the topics of diabetes and diet. >> I'll correct persistent errors of yours if they're annoyingly >> frequent. I can't be bothered correcting every simple error like the >> one in your first quoted sentence. > Why do you feel this need to correct errors on Usenet? Where on earth did you get the idea that I did? How many errors have you ever seen me correct? It's something I do very rarely, and only under very specific circumstances. > Seriously, > Chris, Usenet is a very conversational kind of bulletin board > community. THat may be what it is for you, and for most people. That's not what it is for me, and there are a sufficient number of people who play my kind of game in newsgroups often enough to encourage my continued participation. I feel no need to behave like most people. I'm one of those newsgroup posters who consider that the differences between newsgroups, which I like, and bulletin boards, which I don't, are very important. IMHO people who consider newsgroups to be a kind of bulletin board are not only mistaken, but do newsgroups a disservice by acting as though they were bulletin boards. > People in these kinds of communities write as if they are > speaking to another person, rather than writing to them. You're over generalising. Firstly there are important distinctions here between bulletin boards and newsgroups. It's true that most people do treat them as you describe. It's not what all people do in newsgroups. You can get a much better education from newsgroups if you treat them as a written medium rather than a written proxy for speech. They have specific features, inherited from their original conception and developed over long usage, which facilitate that kind of communication. That's not true of bulletin boards. > Sure, it's a > text driven forum, but it's more like a coffee house than a school > room. Part of the problem with your posts is that they are written as > if you're giving a lecture instead of just having a casual and friendly > conversation. I'm a university academic. Some of us talk like that in coffee houses. It goes with the territory. Get used to it or ignore it. Newsgroups were originally started by university academics for academic purposes. The influx of the chattering mob hasn't yet driven all of us away. I've explained before that I don't treat newsgroups like a schoolroom. I outgrew the schoolroom a long time ago. I treat them as university tutorial rooms. That's how I get the most benefit from them. > Another inherent problem here is that in addition to a > fairly philosophical difference we have about everything, the > grammatical rules you follow in your region differ greatly from where I > live. I'm well aware of regional differences. I've found them interesting enough to have studied them and even a few books on them. I don't bother correcting anything which is a regional difference in correct English usage. Nor do I bother correcting careless users of English who clearly don't give a damn. Your frequent references to your tertiary education in English made me think you did care. > What I can be accused of...is spending this much time discussing > grammar usage on Usenet. My bad. True dat. A'ight? Too much time discussing grammar? It happens to be a special interest of mine. It happens to be the professional career interest of some of my colleagues. There are usenet newsgroups where grammar is is on-topic and discussed in very finical detail. You really should spend more time on newsgroups before making all these sweeping and inaccurate generalisations about them. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] : > > Now see if you can find any grammar errors in my post so you have : > > something to respond to. And please use Strunk & White's "Elements of [quoted text clipped - 32 lines] : : Kurt LOL damn u homey! u shld be kickin' wiff da boyz down in da hood! No bustin' capz wiff yer broz in da twinklez? LMAO!!! I'd LOVE to see his response after a convo wth a few frnds... it's where the "internet lingo" actually came from. (2pt to the correct answer) LOL RK > : > > Now see if you can find any grammar errors in my post so you have > : > > something to respond to. And please use Strunk & White's "Elements of [quoted text clipped - 32 lines] > : > : Kurt > LOL damn u homey! u shld be kickin' wiff da boyz down in da hood! > No bustin' capz wiff yer broz in da twinklez? > LMAO!!! I'd LOVE to see his response after a convo wth a few frnds... > it's where the "internet lingo" actually came from. (2pt to the correct > answer) LOL Oh dear. Another ignorant American who thinks the rest of the wired world is so insignificantly small that the internet can safely be regarded as American. Not to mention the fact that those who coined the phrase "internet lingo" are talking about the whole leetspeak culture of chat rooms, bulletin boards, blogs, ICQ, SMS text messaging, gaming, Micros**t emailing, etc.. That's quite a different culture from the much older and more specific "internet" of the phrase "internet newsgroups". That much more specific "internet" and it's conventions has its important roots elsewhere, e.g. where the ">" quotation conventions came from. The "internet lingo" Reisa speakes is a historically later leakage into the newsgroup world from those other cultures. I'm not going to mention where the ">" was because Reisa would find that too inflammatory a suggestion, and she's already probably got me killfiled because I've too often mocked some of the more egregious lacunae in her medical education and logic :-) SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] In alt.support.diabetes on 16 Dec 2006 10:25:37 GMT in Msg.# <4uhvt1F184899U1@mid.individual.net>, Chris Malcolm <cam@holyrood.ed.ac.uk> wrote: > Oh dear. Another ignorant American who thinks the rest of the wired > world is so insignificantly small that the internet can safely be [quoted text clipped - 4 lines] > culture from the much older and more specific "internet" of the phrase > "internet newsgroups". But, it's not a truly appropriate phrase. The phrase is really Usenet, or Usenet newsgroups, or even 'News', although that's not specific enough for some people to get. > That much more specific "internet" and it's > conventions has its important roots elsewhere, e.g. where the ">" > quotation conventions came from. The "internet lingo" Reisa speakes is > a historically later leakage into the newsgroup world from those other > cultures. Why call it 'lingo'? Why not call it what it is: jargon. Language has jargon for many many many different uses. > I'm not going to mention where the ">" was because Reisa would find > that too inflammatory a suggestion, and she's already probably got me > killfiled because I've too often mocked some of the more egregious > lacunae in her medical education and logic :-) But, then, I have no idea what this little argument is about, or what it has to do with ADA Tight Control Recommendations. SignatureDonnaB : ^> shallotpeel <*> Yahoo Messenger: shallotpeel http://www.ajc.com/news/mplayer/panda cub /6371 : In alt.support.diabetes on 16 Dec 2006 10:25:37 GMT in Msg.# : <4uhvt1F184899U1@mid.individual.net>, Chris Malcolm <cam@holyrood.ed.ac.uk> : wrote: well this just goes to show ya just how stupid Chris really is.. either way.. at least Americans have mastered Dentistry LOL > > : > > Now see if you can find any grammar errors in my post so you have > > : > > something to respond to. And please use Strunk & White's "Elements of [quoted text clipped - 39 lines] > > it's where the "internet lingo" actually came from. (2pt to the correct > > answer) LOL Good God, I thought this thread was dead, especially this part of it. Leave it to Chris to revive it and extend the ridiculous argument over language. > Oh dear. Another ignorant American who thinks the rest of the wired > world is so insignificantly small that the internet can safely be > regarded as American. There is that word "ignorant" again, along with "dumb" and "stupid" that have become a mainstay of your posts. It's pretty obvious that you consider yourself so much smarter than others here, but personally I find your words full of sound and fury...well you know the whole citation. What disturbs me more than your constant put downs of people's intelligence is your America bashing. It permeates many of your posts and no doubt reflects your true hatred of the United States. Guess you're not alone there, but in an international community like this one it is, borrowing a word from you, ignorant. My country, like yours and others who post here, is comprised of many people of diverse cultural, political, and intellectual thoughts. We're not all Wubya, just as your countryman are not a bunch of golf playing drunkards who pee in their kilts. Stereotypes and mass labeling of a country is usually done so by a narrow mind. >Not to mention the fact that those who coined > the phrase "internet lingo" are talking about the whole leetspeak [quoted text clipped - 11 lines] > killfiled because I've too often mocked some of the more egregious > lacunae in her medical education and logic :-) The above could be considered "exhibit A" in the case against you being out of touch. This is not a classroom, lecture hall, or textbook that should need a glossary of terms to navigate. This is Usenet, a text driven forum that has evolved into casual conversations between people of all types. Think of it as a cyber coffee house where people come to chat. Your insisting that it is some sort of formal debate forum that should live up to anitquated rules of grammar and geekspeak is, to borrow your word again, ignorant. Done with this thread... Peace, out. My brother from another. Kurt "When you got a subject and a predacit. Add it on a dope beat And that'll make you think. Some suckaz just tickle me pink To my stomach. 'Cause they don't flow like this one. You know what? I won't hesitate to dis one Or two before I'm through. So don't try to sing this! Some drop science While I'm droppin' English. Even if Yella Makes it a-capella" --from "Express Yourself" by N.W.A. >> > : Why do you feel this need to correct errors on Usenet? Seriously, >> > : Chris, Usenet is a very conversational kind of bulletin board [quoted text clipped - 12 lines] >> > : >> > : Kurt >> > LOL damn u homey! u shld be kickin' wiff da boyz down in da hood! >> > No bustin' capz wiff yer broz in da twinklez? >> >> > LMAO!!! I'd LOVE to see his response after a convo wth a few frnds... >> > it's where the "internet lingo" actually came from. (2pt to the correct >> > answer) LOL > Good God, I thought this thread was dead, especially this part of it. > Leave it to Chris to revive it and extend the ridiculous argument over > language. Obviously you're one of these impatient youngsters for whom a topic which has lain quiet for all of three whole long days of a full 24 hours each is so very very dead that its resuscitation is worthy of astonished comment. Some of us older newsgroup posters still adhere to the older more civilised standards of newsgroup behaviour, one of which was that instead of dashing in to have your shout on every topic which pressed your buttons, one sometimes paused for a few days to see if anyone else might want to make a contribution. After all, some folk don't even read the newsgroup every day, and some like a day or two to think a reply over. Hard for you impatient youngsters to believe that, isn't it? >> Oh dear. Another ignorant American who thinks the rest of the wired >> world is so insignificantly small that the internet can safely be >> regarded as American. > There is that word "ignorant" again, along with "dumb" and "stupid" > that have become a mainstay of your posts. There is another poster to asd who uses those words much more frequently than I do, and interestingly enough many of my uses of such words in asd are in posts criticising that person's inappropriate use of such words. Yet you've never criticised that poster's much more frequent use of such words. Odd, that, isn't it? > It's pretty obvious that > you consider yourself so much smarter than others here, but personally > I find your words full of sound and fury...well you know the whole > citation. I know it's very scary to start discussing facts and ideas instead of people's personalities and attitudes, but if you're interested in learning something I do recommend it. > What disturbs me more than your constant put downs of people's > intelligence is your America bashing. It permeates many of your posts > and no doubt reflects your true hatred of the United States. Grow up Kurt. In other newsgroups I've poked a lot more fun and criticism at the English from a Scottish point of view just as my English friends and relatives poke a lot of fun and criticism at Scots. The fact that most of the stupid posters to asd are Americans is a simple statistical consequence of the fact that most of the posters to asd are American. Don't let your sensitivity to the idea of a stupid American cloud your judgment. > My country, like yours and > others who post here, is comprised of many people of diverse cultural, > political, and intellectual thoughts. We're not all Wubya, just as > your countryman are not a bunch of golf playing drunkards who pee in > their kilts. Exactly, which is why you should grow up and stop taking offence at foreigners laughing at stereotypical American foibles. I don't take offence at Americans laughing at European or British or Scottish foibles. In my home town of Edinburgh we laugh at Glaswegian stereotypical foibles, and they laugh at Edinburgensian stereotypical foibles. In fact at my northern end of Edinburgh we poke fun at the stereotpyical foibles of folk from the southern end and vice versa. No offence intended or taken. That's how multicultural diversity works. > Stereotypes and mass labeling of a country is usually > done so by a narrow mind. It's also usually done (with of course better grammar) by intelligent broad minded minority group humorists, but maybe you've never encountered New York Jewish humour. >> Not to mention the fact that those who coined >> the phrase "internet lingo" are talking about the whole leetspeak [quoted text clipped - 11 lines] >> killfiled because I've too often mocked some of the more egregious >> lacunae in her medical education and logic :-) > The above could be considered "exhibit A" in the case against you being > out of touch. This is not a classroom, lecture hall, or textbook that > should need a glossary of terms to navigate. This is Usenet, a text > driven forum that has evolved into casual conversations between people > of all types. That's one recently developed aspect of it. I wouldn't bother posting here (or anywhere else) if there weren't still enough folk around who still adhere to the older more civilised and academic standards of newsgroup behaviour to make it worth my while. You do realise that you're not the only poster I reply to, and who replies to me? > Think of it as a cyber coffee house where people come to > chat. Feel free to think of it as anything you like that works for you. That's how newsgroups work. But you also have to accept that what works for others works too. As I've pointed out here before there are coffee houses and coffee houses. You'd probably be appalled by the high standards of literacy and argument to be found in some of the coffee houses I frequent. > Your insisting that it is some sort of formal debate forum that > should live up to anitquated rules of grammar and geekspeak is, to > borrow your word again, ignorant. I don't have to insist on it. It's simply another aspect of newsgroup culture that's still alive, despite your disapproval. If you want to call posters ignorant who employ higher standards of literacy and argument than yours then that's your prerogative. You'll probably be disgusted to discover that even when I text people on my mobile phone (US: cell phone) I do so using complete sentences and properly spelt words. But most of the people I text are old folk like me who text the same way. It's a popular enough style that there's even software to help us do it easily and quickly, despite the disbelieving horror of schoolkids that anyone could bear to be so embarrassingly unfashionable. SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >The fact that they are a big organisaton does not excuse >such poor work on the web-site. If I can pick this out - why >can't some highly paid computer geek at the ADA do the same. Probably because the computer geek isn't the subject matter expert :D > The fact that they are a big organisaton does not excuse > such poor work on the web-site. If I can pick this out - why > can't some highly paid computer geek at the ADA do the same. Webmistresses are highly overpaid in Oz compared to the UK and the US. I know this because my brother offered to pay me what his webmistress would earn the last time I fixed a glitch on his web site - astounding! The ADA's webperson probably earns a little more than the office typist, making their lack of knowledge of diabetes at least a little more understandable. Their ignorance of usability is less forgivable. Nicky. SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg Yeah, some docs are. And some other health professionals are so ignorant it's painful. My DH was in the ER last week with a broken femur. Didn't get a bed upstairs for 10 hours but that is another story. Anyway, we told everybody we dealt with that he is diabetic II, 30 years duration. He was never offered food during the 10 hours and about 6 hours in an RN came with the official blood meter. Jim scored 200+!!! (yes, I understand that stress can do this) and she said that was "OK". Yipes! Our world views are so different. Jim said that his average for the past 3 months is 104 and she said, "Oh, well then I guess 200 *is* high for you." ??? Well, yeah. H-ello??? Also, Jim's PCP who is also supposedly a diabetic specialist and has Type I and wears/uses a pump, has said several times that I have heard that anything below 180 long term is OK. We don't really accept this and are more in tune with ASD but this guy is good at getting things done w/ ins and bureauocracy so we keep him on Jim's list. Actually, we get better advice from the VA primary and renal dept. SignatureNancy IF, SoCal Christ, Chorus, Cats, Computers > >> My former doc follows ADA guidelines which are apparently 180 or below is [quoted text clipped - 5 lines] > > Nicky. >> >>> I've been Type II diabeteic for several years. I take 1000 MG of [quoted text clipped - 22 lines] >guidelines which are apparently 180 or below is OK. He agrees that >shooting for better is fine, but is concerned about me "getting frustrated." 180 is OK???? To me, 180 is one hell of a spike - grab the novolog. >Others around here (the newsgroup) cite medical studies that indicate >exceeding 140 ever for any length of time has adverse consequences. You will spike. But, you have to minimize the duration and intensity of the spike. _____________________________________ http://www.healthdiabeticsoftware.com/ Free |
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