I mean obviously a steady and normal blood sugar without any treatment is optimal, right? But once you’ve hit that point, I question whether a person could be classified as T2D.
The fact is that almost no type 2s can achieve normoglycemia or anywhere near it without taking at least one, if not two, medications. So it feels pretty relevant.
I guess you could still ask about whether a type 2 who is only taking insulin would also be similarly harmed. In that case, it really seems tied to whether you could achieve normal blood sugar with no hypos.
Data from an earlier study showed higher all-cause mortality in T1s and T2s treated with insulin that was temporally tied to hypos:
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I think we are in violent agreement here. Anyone that thinks an observation study that finds an association is able to be extracted into an absolute care treatment guideline is misguided. Unfortunately most of the media reporting on these types of studies makes exactly these mistakes in their writing. The study referenced should only be used to guide individual decisions in consultation with a well read physician, and only when the definitive study is completed should (would) an absolute statement about A1c be warranted.
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I concur fully.
And most of the readers, including the really smart ones. Humans are just so strongly wired to infer causality…
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Love that comment.
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Do not currently have access CGM as Medicare doesn’t take into account once daily injections of long acting insulin (Tujeo). If I let my fasting BG >105, the numbness of the neuropathy in my feet interferes with my ability to find the brake pedal automatically, and severely limits my ability to drive safely! Keeping a tighter control and using TENS on my feet keeps me going
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