About a year ago, I met a guy named Jeff Mather. Well, we never met, personally. But we spoke many times over the phone about diabetes and how it has affected our paths in life. Jeff had lost his job, the one he had for over 10 years. The job he wanted to have since he was a little kid. According to Federal Safety Guidelines, if a trucker takes insulin - they are no longer safe to drive across state lines.
Jeff wrote letters every day. He posted to online forums. He contacted politicians and pleaded to every diabetic organization in existence to get him back on the road. And sure enough - his perseverance paid off. He took his predicament all the way from Washington D.C to National Public Radio. The story on NPR included details on how Jeff was able to qualify to drive again.
While diabetes advocates are pleased that it's now easier for truckers to keep their jobs when they go on insulin, they're not entirely happy with the way that the Federal Motor Carrier Safety Administration (FMSCSA) will decide whether a trucker is safe to drive. In order for a trucker to be considered "safe" to drive, his HgA1c must be between 7 and 10. This means that in order to keep trucking - one must sustain a blood sugar between 140 mg/dL and 200 mg/dL. Yes, this is flawed. I was going to use another choice F phrase to describe it.
FMCSA expressed it wants to see a higher test result because they feel people with lower scores who are aggressively managing their diabetes with insulin, may be more likely to have periods of very low blood sugar, or hypoglycemia, that could make them pass out or feel woozy. Diabetes expert Christopher Saudek, at Johns Hopkins Hospital, says the agency's reasoning is flawed. And he says it puts diabetics in a bind.
"Essentially what you're saying with this kind of a rule is that if you are controlling your diabetes at all well, if you get it to 6.8 or 6.5, then you're liable to lose your job," Saudek says. "So congratulations. Your A1c is in a good range, but you aren't going to be able to drive your truck anymore. That doesn't make any sense."
Jeff, I'm so proud of you for not giving-up. You're driving your truck and I'm sure you're doing it in good health. Enjoy all that you've worked so hard to regain. Best of luck to you!
1.
A. How certain is it that Jeff Mather has been diagnosed with ‘Type 2 diabetes’ rather than ‘Type 1 diabetes’ and if Jeff has been diagnosed with Type 2 diabetes … Where is the peer reviewed research the proves that Jeff’s health will be improved by injecting insulin [without C-peptide] into his body … when his pancreas is already apparently producing ‘his particular physiological requirements’ for insulin [including C-peptide]?
B. What is the most definitive study which substantiates the benefit of drug/insulin treated acute&chronic 'insulin-resistant diabetes' [Type 2] … as compared with treatment-free [drug/insulin] acute&chronic 'insulin-resistant diabetes' [ie in a ZERO drug (repeat zero) treatment control Group]? {ps please note the word written there says: “zero”}…
... Am seeking a ‘peer reviewed’ study that clearly disassociates drug/insulin treatment from any changes in Patient behaviour [eg diet/exercise] and/or categorically proves that drug/insulin treated acute&chronic 'insulin-resistant diabetes' is healthier than doing absolutely nothing [‘zero’] ie just accepting the higher [possibly beneficial] blood glucose value [and possibly beneficial “insulin resistance”]; and
C. What is the most definitive study which provides incontrovertible evidence that the apparent insulin receptor mediated down-regulation [in response to: transient supernormal glycaemia ‘TSG’] is anything substantially other than a stress-adaptive mechanism of 'local' [on a cell-by-cell basis] intracellular cyto-protection from influx of excessive [blood] circulating glucose [ie homeostasis] eg cardio muscle protective?
... My understanding is that insulin receptor mediated down-regulation ‘IRD’ [aka “insulin resistance”] is primarily an adaptive [protective/regulatory/beneficial] reply to transient [and chronically repeated] oral indulgence/stress …
eg "...healthy young students were fed a very high fat diet containing egg yolks, heavy cream, and butter, and within 2 days all of the students had blood sugar levels high enough to be labelled diabetic..."
Sweeney J. Dietary factors that influence the dextrose tolerance test: A preliminary study. Archives of Internal Medicine 1927; 40:818.
Warm thanks, Nicholas Dynes Gracey, BSc(Hons) Medical Biochemistry, Birmingham University, UK c/o www.TheDiabetesBlog.com @ 18:40hrs THU.29.MAR.2007.
Posted at 1:42PM on Mar 29th 2007 by Nicholas Dynes Gracey