You note that the diabetics in this study now have A1c values in the 7 range, but this is strictly irrelevant to the results, since as you also note, most of these patients had diabetes long before the home glucometer was available.  As one of those early patients, I can remember trips to a leading diabetes center where my blood sugar was usually measured at 240 mg/%, but I was always reassured that that was not a bad result, since the average recorded at that institution was typically 270 mg/%, corresponding to an A1c value of 15.  Thus I had values in this extremely elevated range for 20 years before my first home glucometer, yet I am still alive and have only manageable complications 44 years post-onset.  I have to smile when today's patients panic over a single result in excess of 180 mg/%.

Another study similar to the one you cite, by G. Gill, et al, "Insulin Dependent Diabetes of Over 50 Years Duration," Practical Diabetes International, vol. 10, no. 2, p. 60 (2005), found that the A1c values of the patients in its survey averaged above 10.  Assuming that the patients' control was no better prior to the study, these patients have endured a surplus glucose burden -- the amount of A1c-measured glucose above the normal of 5 -- of 5 times 50 years, or 250, in contrast to many patients who are dead of diabetic nephropathy at age 38, 25 years post-onset, with an average A1c of 7, or a net surplus glucose burden of 50, which is a mere 20% of the hyperglycemia burden on those who survive into old age with enormously high blood glucose.  This difference is extreme and challenges conventional approaches to the disease.

The likely explanation is that in some patients AGE-formation in response to hyperglycemia is suppressed, and so for them hyperglycemia is not a seriously pathological state.  This is consistent with the fact that some animals, such as hummingbirds, have extremely high A1c values and yet they show not even microscopic traces of the typical damage from hyperglycemia seen in humans.  The pro-vitamin Benfotiamine, an extremely non-toxic substance which has been available over-the-counter in Europe for many decades with no ill effects reported, has been demonstrated to interfere with AGE-formation in response to hyperglycemia, and over 60 studies reported on PubMed now confirm that it also opposes the formation of vascular and neurological complications in diabetics.  Why this is not universally used in clinical practice remains a mystery.  The preference for punishing patients with the pressure of constant monitoring of blood sugar, diet, activity, and injections, 'strict control,' and frequent hypoglycemic emergencies, over improving diabetes' fate with the harmless and simple intervention of Benfotiamine therapy, may have more to do with the psychology of diabetologists than with the rational treatment of disease. 

Ann Bartlett, Health Guide

4/21/11 11:00am

Hi Pavy!

Thanks for adding you thoughts!  I have to say that my A1c has always been in the low to mid 6 and some low 7s, since I started having them done in the late 80s! For a brief time I was in the high 7s and personally, I didn't feel well at all! I often had what felt like heartburn and my whole body was tight from the acidic level, so from a personally experience I can't imagine that one feels as good at 10 then they do at 7.

My comment about the 7.7 was the fact that it was so much higher then I anticipated because of the guidelines we know now, but the reality was exactly as you said, not surprising given the length of time they have had diabetes and initially the management was so different.  If you've had diabetes 44 years, then you must have been similar to me: two shots a day nph and regular mixed in one syringe! Urine tests 4 times a day and low sugar and carbs and that was pretty much diabetes management! 

My focus on AGEs was simply because that is their first comment, but I think it must be more complex. And as for benfontiamine, I saw this mentioned, but for the purpose of keeping this post focused, I left it alone. 

Thanks for adding that to the depth of this post!