From the "Are you serious?" file

New Diabetes Target Will Waste Resources And May Be Harmful

wow, just wow. This ranks right up with that VP from the ADA saying something similar a few years ago

Does that mean doctors are paid based on their patients’ A1c numbers? That’s an interesting idea… had never heard of that!

In the UK, yes. That is their performance metric. The US docs get paid on an appointment basis, whether or not the treatments are successful. It is totally up to the patient to achieve success, whereas in the UK the doctor also has a vested interest in the patients success.

Sounds like a better system to me (though I guess all systems have their flaws).

Sorry, by the way, I agree with your comment, just this part of the article caught my eye.

I guess that so much of the A1c relies on the PATIENT rather than the doctor, but a doctor who cares about the results is a good thing (I hope they care apart from compensation as well though!!).

I agree, paying based on results does seem like a little better model

Does this story proof once again , that we have to advocate for ourselves and advocate for those, that are unable to advocate for themselves ?

An interesting concept, but it all depends on who’s paying the doctors. I doubt it would work in the US. In the US, under this model, I could see plenty of less affluent patients targeting a 7.1% A1C, or worse, because they just can’t afford (monetarily) to let their blood sugars get any better.

True in the current US model, however the UK system totally covers supplies I believe.

I guess the big thing that really caught my eye was not so much that testing wasn’t needed for these patients as it was that it was too expensive to provide. the “it might be harmful” part seemed to be put in there as an after thought. They must be thinking two things (1) we’d rather pay to treat the complications than the condition because (2) most of these folks probably won’t live long enough to develop complications. I just found that to be obscene

yeah, it does. (: I love the National Health Service over here. (Except that the guidelines for pump approval are very strict, and the NHS don’t even HAVE guidelines for CGMS approval…)

…then the system would therefore penalize on poor performance, or penalize a doctor for seeing a non-compliant or brittle patients (who could use more help), maybe then doctors would be firing patients, not the other way around, or I could be smoking dope =)

for every rule there seems to be an equal and opposite exploitation

on topic: I know it sure sounds dumb. The premise is dumb of course it’s healthier to have an a1c below 7%, but these studies are all based on pure statistics. Depending on what’s “in” and what’s “out” of scope could make all the difference. Sure as hell - if all your patients had to be under 7% then medical expenses and supplies and meds will go up, perhaps substantially. So what they are saying is provable. There are even stats that prove that intensive insulin therapy increases hypo reactions, so even the BS about it being dangerous is provable. What seems to be out of scope is what about the costs of hospitalizations and care and surgery and medication for all of the diabetic complications… that’s the complete f-up in my opinion.

Dear Scott.

Funny, shows that it is difficult to legislate common sense. Here in Canada doctor (general practitioner) is paid based on the number of patients he see per day regardless of results so the optimum is 2 minutes maximum per patient. You can judge for yourself what kind of results you get from instant medecine. I don’t go to old GP anymore because not only it is useless it is harmful. Endo you have at least 15 minutes must be different sort of renumeration. Pay based on results is kind of capitalistic but look at CEOs and wall street super high renumeration resulting in 1929 type of crash.

Our state here in Canada has that attitude they will not live long enough to develop complications. I am not sure, when my son was mushed in a car crash there were a lot of people in the lobby or outside smoking with freshly amputated feet. I asked one why? Diabetes he said. You can subsidise a lot of test strip instead of paying for one amputation. The smoking could too be reduced with diabetes education classes. But all this is too commie for our state govt. they are pure right wingers.

And that’s exactly what we can get minimized with early diagnosis and treatment for prediabetes. I like to differ with those who think expenses will go up substantially. Those strips can be negotiated downward with more users and more use. With appropriate coaching of diets + use of the strips, we’re going to see FAR less complications.

I think this website is priceless because people are getting together and sharing knowledge. I have learned more on here than I have anywhere else, and I include Jenny’s book in this, because I was told about it here.
I still don’t know what the heck I am doing with managing my diabetes, but I am doing Atkins, and I feel much better now.
My kids once had two white lab rats as pets, named Harry Potter and Mr. Stumpy ( who had a stumped finger on his hand.)

Mr. Stumpy was never the most active rat, but he grew very obese. He would just look at me with these eyes, so I took him to the vet. She told me a lot of rats are bred to have diabetes for research. She drew blood, and yes, his liver enzymes were up. He was a sick guy. When we brought him home, his brother Harry would not let us touch him. He got in front of Stumpy as if to say, “You’re not taking him again…he TOLD me what they did to him!”

It all got worse, and we had to put Stumpy to sleep. I had him gassed so he would not feel the injection. His brother was very depressed. Rats are very much like dogs and cats. Intelligent and give unconditional love. So they can bred them to have diabetes, so it’s genetic. So much is genetic, but it seems like there could be more help than we are getting.