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Tuesday, January 5, 2010

[diabetes_int] Digest Number 8515

Messages In This Digest (4 Messages)

Messages

1a.

Re: Sad news about Ron Sebol

Posted by: "Joseph Navarro" demokratia@cox.net   demokratia2003

Mon Jan 4, 2010 2:42 am (PST)



>I have heard that Ron Sebol, the moderator and co-owner of the DSM
>list, has passed away. Ron was a phenomenal person who devoted much
>of his life to helping other diabetics achieve control. His
>background in engineering gave him the skills needed to approach this
>task with both precision and great care.
>
>Ron cared so deeply for all of the people he met and helped over the
>years. I enjoyed my talks with him and regret greatly that we never
>managed to get our schedules together for that lunch we talked about
>despite living quite close to each other.
>
>Even though I rarely participated in the discussions, I always read
>the list and I will miss his posts which were always business like,
>information packed, painfully accurate and, as we all know, never
>ending. It always amused me when Ron would loosen up a bit and post a
>somewhat personal, humorous post. It gave you a small glimpse of his
>true personality which was a caring, generous, genuine person with a
>great sense of humor. Offline, his posts were always entertaining.
>
>I wanted to pass on this sad news because I know Ron touched many
>lives. He will be greatly missed. The DSM list will not be the same
>without him.
>
>Laura K.

====================================================================

I read the posts to DSM and I particularly enjoyed Ron's posts. Yes,
he had an engineering approach to diabetes just as Bernstein does.
He was not a one word person, or his posts were rarely a sentence or
two. I have not read everything he wrote and hope the archives to
DSM will continue to be available as I plan to read his posts. I
never contributed to his list owing to the laziness on my part of
learning how to get a post through and he set enough barriers to make
his point that he only wanted constructive posts that would be edited
by him before allowing them to be read by the list. In theory, the
whole thing sounded a little too controlled for me and I am sure for
others but in reality it was not all that tight.

I recognize the engineer imprint very quickly having commiserated
with them for many years in math and other courses in preparation for
the engineering major. Back in the 60s of the last century, I was at
Cal Poly, the trade school at San Luis Obispo so highly revered by
foreign students and yes you have to have a knack for minutiae in
problem solving that generates a kind of obsession that makes some
impatient, as I recall many of these students were up all night
pondering their problems. Ron's list resembled a blue print or a
computer flow chart. Yes, I learned from his posts and I am sorry to
hear his posts will stop coming in.

Thanks for your message Laura,

Joe

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2.

OT: Your Furry Xmas Gift Warning!

Posted by: "rogerhlmn@aol.com" rogerhlmn@aol.com   rogerhlmn

Mon Jan 4, 2010 5:59 am (PST)




From "MedPage Today" newsletter ---

OK, I just couldn't resist passing this along.
Hope you are having a good new year.

Roger, T2, etc...
_______________________________________

Eye Protection Urged for Tarantula Handlers
Which Christmas gift poses the greater danger to your eyes -- an Official Red Ryder 200-Shot Carbine Air Rifle or a pet tarantula? It might be a toss-up, researchers suggested.

Early last year, a young British man developed a mysterious inflammation in his right eye, eventually traced to "urticating hairs" that his Chilean Rose tarantula companion sprayed at him, ...
... These hairs were too fine to be removed with microforceps, so the man was treated with "intensive topical steroids," ... wrote in the Jan. 2 issue of The Lancet.
Six months later, the patient was much improved but still complained of mild discomfort and intermittent "floaters."
"We suggest that tarantula keepers be advised to routinely wear eye protection when handling these animals," ...
... Hairs on the hind end of the Chilean Rose tarantula and certain other large, furry spiders are barbed at the tips, apparently a defense mechanism against predators. When threatened, the animal rubs its hind legs against its abdomen, releasing a blast of these hairs ...

[Non-text portions of this message have been removed]

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3a.

Re: New ADA Guidelines Urge A1C Test for Diabetes Diagnosis

Posted by: "Margo Patrick" mpatrick@seaside.ns.ca   margopatrickbarn

Mon Jan 4, 2010 11:23 am (PST)



Joe, I appreciate this use of the A1C, but even there I wonder at its
validity. I think it is probably a good test to use as part of the
diagnosis of glucose metabolism problems. However as a test to measure how
well a diabetes person is doing - well I wonder. I work with many people
who have this problem and as I may have said on previous occasions, one is a
T1. He claims that his A1C is in the high 4 - low 5 range on testing. This
is a person who runs from 2`s(36) to 22`s (400) in the same day - and
regularly. He goes low, overeats to compensate (sugar cubes, pepsi,
chocolate bars), goes high, shoots more insulin, bottoms out again, eats a
huge meal (not carb counted) and so on. This is a regular thing. Others
think they are doing well with (when they test) sugars in the 7-9 range
(126-162 pre-eating), and then if they are following a diet at all, the CDA
diet with whole wheat bread, etc. Then there is myself, a lone person who
runs in the 5`s and to quote most of them `you eat so healthy all the
time``, eats low carb. Now if you as a physician were to look at all these
A1c`s , and if you are like my doctor and just really glance at the number
and not question the patient as to the life style, would you pick up the
irregularities in the health of all these patients.

Margo, T2, whose computer has decided that the shift key will choose any
letter it wants to use.

On Behalf Of Joseph Navarro
It seems that the A1C scores had some relationship complications.
Once our chronic disorder starts complications can surface if too
much glucose courses our circulation.

[Non-text portions of this message have been removed]

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Messages in this topic (6)
3b.

Re: New ADA Guidelines Urge A1C Test for Diabetes Diagnosis

Posted by: "Joseph Navarro" demokratia@cox.net   demokratia2003

Mon Jan 4, 2010 8:40 pm (PST)



Margo wrote:

>Joe, I appreciate this use of the A1C, but even there I wonder at its
>validity. I think it is probably a good test to use as part of the
>diagnosis of glucose metabolism problems. However as a test to measure how
>well a diabetes person is doing - well I wonder. I work with many people
>who have this problem and as I may have said on previous occasions, one is a
>T1. He claims that his A1C is in the high 4 - low 5 range on testing. This
>is a person who runs from 2`s(36) to 22`s (400) in the same day - and
>regularly. He goes low, overeats to compensate (sugar cubes, pepsi,
>chocolate bars), goes high, shoots more insulin, bottoms out again, eats a
>huge meal (not carb counted) and so on. This is a regular thing. Others
>think they are doing well with (when they test) sugars in the 7-9 range
>(126-162 pre-eating), and then if they are following a diet at all, the CDA
>diet with whole wheat bread, etc. Then there is myself, a lone person who
>runs in the 5`s and to quote most of them `you eat so healthy all the
>time``, eats low carb. Now if you as a physician were to look at all these
>A1c`s , and if you are like my doctor and just really glance at the number
>and not question the patient as to the life style, would you pick up the
>irregularities in the health of all these patients.

I don't know about the doc finding irregularities in the patient's
reviews. What can the doc do if the patient is irregular. My first
doc bossed me around and being the type that does not like that kind
of doc, well I went to others who accommodated my then bad attitude.
Laying diabetics with a 'naughty boy' trip is clumsy if not stupid
but then what can be done if diabetics will not do as they are asked
by their doc?

What is needed is to define diabetic and several ways of confirming
that diabetic is really diabetic. In the case of blood pressure, I
was told by a physician that only one measurement is enough. I asked
what happens if the blood pressure returns to normal, would the
medication for hypertension be removed? The practice is that once on
the meds, forever on the meds. Time is not set aside to make sure
the bp has not returned to normal levels. Thank God we don't have
tests showing how various doctors diagnose and treat their patients.
We have a weird situation, evidently endos are in short supply and so
docs are given guidelines by the endos to give ongoing evaluations of
diabetics. I would not want to know what the generalists do in
diabetic care, I am sure there are communication problems and strange
measures taken to keep patients in control.

The DCCT encouraged diabetics to take care of themselves. The trial
revealed that the better the diabetic controlled his diabetes, the
better his overall performance. Before the DCCT, it could not be
said for certainty, that control paid off. I would like to see a
test of how accurate the A1C is and if the scores reveal the impact
on the complications, at least, some specific impact. This is a
foggy issue and we know that diabetics depreciate differently. But
bad care eventually rears its ugly head.

Things get flaky when a diabetic is diagnosed as diabetic but denies
the reality. The painless nature of the disease encourages defiance
and denial but using a variety of tests including the A1C should help
diagnosis. If the bgs return to normal without meds, etc. then the
doc has to keep on checking until the bg scores fall into the
diabetic zone.

Yes, the bgs can be erratic as in the case you described but people
who are not diabetic have pancreas and sensors in the blood that keep
the bgs in the normal zone. Those diabetics whose bgs are all over
the place are not large in numbers but there are ways of diagnosing
them. It may be nice to reduce diabetes to numbers and clear cut
measurements that point clearly to what needs to be done. Some
people have no problem for many years. Then control is no longer
simple arithmetic but multivariable calculus.

Joe

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