HbA1c Test

[Patricia21]

Good evening friends.
Please give me a bit of advice.
My HbA1c test in June was 53 mmol,my DN said she was happy with that and dosent want to see me until October and I will be sent an appointment.
I am on 1x500mg Metformin a day.I was advised to cut out fats as my LDL was 2.5 and to high for a diabetic.
Looking round this forum Im not to happy with my readings. I have got a moniter and started a LCHF diet regardles of my DNs advice,I have gone from 10 stone to 9 stone,
I am 5ft 6ins tall and dont want to lose any more weight .
I am testing between 5 and 8 at the moment.
Am I right not being happy with 53 mmol?

 

[douglas99]

I like a lower figure.
But your DN sees a lot of people that can't achieve it, so their target isn't going to be yours.
Set your self one you want, and go for it.
The best way is to test, and see if you can get the 8 down a bit.

 

[Patricia21]

Thanks Douglas.
I am surprised she hasnt put me on more meds,I wouldnt have known much about targets if I didnt have this site,

 

[douglas99]

Meds are always catch up.
If you are put on too many, too fast, there's nowhere to go later.
And a slow controlled change is better than a fast drop.
You know about this site, your DN probably has to prise Mars Bars out of other patients hands, and sets targets accordingly.
If you prove her wrong, you'll both get something beneficial from it.
So set a target, and go for it.
(I'm no expert though, it took me over a year to find my way, but the fact I tried from the start was recognised, and supported by my medical team. Now I'm reducing meds. )

 

[Patricia21]

Good for you reducing meds.
I wont know how I have gone on until my next test in Oct ,I only got the moniter after I joined this site in June,Im a bit concerned about the weight
being thin dosent look to good on an older person,I will have to watch that.

 

[douglas99]

Good for you reducing meds.
I wont know how I have gone on until my next test in Oct ,I only got the moniter after I joined this site in June,Im a bit concerned about the weight
being thin dosent look to good on an older person,I will have to watch that.

That's always a hard one.
I lost so much I looked ill.
So I put a bit back on. (enjoyed that bit).
So it's all about balance. BS, weight, lifestyle, food, meds, it's whatever mix you choose, to suit you.
You've already got an idea what BS you would like to see, you know what weight you want to be, but you need to allow yourself time to achieve it, and not beat yourself up if it's not achievable tomorrow.
It took me 12 months.
(and if you have reviews every 3 to 4 months, you are doing very well out of the NHS)

 

[jack412]

Good evening friends.
Please give me a bit of advice.
My HbA1c test in June was 53 mmol,my DN said she was happy with that and dosent want to see me until October and I will be sent an appointment.
I am on 1x500mg Metformin a day.I was advised to cut out fats as my LDL was 2.5 and to high for a diabetic.
Looking round this forum Im not to happy with my readings. I have got a moniter and started a LCHF diet regardles of my DNs advice,I have gone from 10 stone to 9 stone,
I am 5ft 6ins tall and dont want to lose any more weight .
I am testing between 5 and 8 at the moment.
Am I right not being happy with 53 mmol?

on the diet she suggested, low fat high carb...53 is brilliant and you would be one of her better diabetics on just 500 met

your 5-8 is good,

curious why you are only on 500 met, that's normally a starter dose to build up to 1000,1500 0r 2000, ( are you trying to drop met and be just diet controlled?)
more met may allow more carb if you want ..
for weight, make sure you have enough fat in your diet to make up for the less carbs or you will just keep on losing once you get to what your body wants to run at (may be more or less than you want)
myfitnesspal is good as is http://www.fatsecret.com.au/calories-nutrition/
I also double check on google because MFP is user database and some are wrong, also usa carbs are more than uk carbs because the fiber isn't already deducted

this ldl fat myth search will give the positive about fat and google bad will give the bad side, it's who you think is right
https://www.google.com.au/#q=ldl and fats myths
they say high fat diet will reduce your triglycerides fats and increase your good HDL fats, your LDL is a variable, some go up some come down and the size of the fat molecule matters

 

[Patricia21]

Morning Jack and thanks.
I dont know how long I have been diabetic,only found out because I moved house and changed Doctors and had the usual MOT.but I have known for a year now.
I will never go off Metformin as it took me 6 months to get used to it and I have no intention of going through that again at a later date.
I will keep to the LCHF until I have the blood test and it will be intresting to see what the LDL is if its gone up I will have to think again.
Reguarding carbs,I was a child during the war years and we were told bread was the staff of life,and our main diet was bread potatoes and rice pudding as there wasnt much of anything else,I dont remember any over weight person in my school and my generation are living longer,just a thought,

 

[Bluetit1802]

Hi,

I understand that an HbA1c of 53 is the target set for most type 2's and that nurses will be happy with it. However, it actually translates to an average of 8.6mmol/l (the same units you see on your meter). In my opinion, an average of 8.6mmol/l is too high. The odd spike up to that level is fine, but an average? That could mean lots of spikes in to double figures. Set yourself your own target and try to get rid of those 8 readings if you can.

I was "only" 53 on diagnosis and Metformin wasn't even mentioned. Just diet and exercise.

Also, my cholesterol levels all improved on low carb/moderate fats. I eat butter, full yogurts, mayonnaise, cheese etc. but I don't go overboard.

 

[Patricia21]

Thanks Bluetit.
I want to aim for 48 HbA1c if I can, reading round the forum that seems to be the norm.that people aim for.
I am now eating fats,but dont go out of my way to eat them,just as I have always been used to.I perhaps need to cut down on fruit,but I think of the nutrition and vitamins which Im sure we need.
I take no other medication ,and appart from needing a new hip 6th Oct,I am healthy.
I get some anxiety pangs which last a minuite or so ,then I sweat for a few minuits after,I have put that down to diabetes,but it dosent happen with either high or low BS .same applies to hot cold or numb feet.

 

[sanguine]

Hi Patricia

48 is a good target for your next test, but there's no reason why in the longer term you can't achieve something in the 43-47 (prediabetic) range or even lower. The lower you get the better the long term benefits are.

 

[Bluetit1802]

Hi Patricia,

If you want to continue eating fruit, try to have it as part of a meal rather than on its own as a snack. The other foods (fats) eaten at that meal should slow down the digestion and level out the spike. Berries are a good choice, but only a few, not a whole punnet!

 

[Patricia21]

.Good advice Bluetit I will have fruit as part of my meal,I was having it as snacks.
Sanguine I will see what my next blood test is.but I am not wanting to lose any more weight.,

 

[jack412]

how many calories are you eating a day, have you used a counter?
if you are getting too skinny, you either increase your fat intake up to the recommended calorie intake, or you increase the carb. you can't go low carb and low fat for too long
I think of it like a seesaw, as one comes down the other has to go up......, so its calorie balanced. And add your 50 odd grams of protein

 

[Patricia21]

Jack I havent been counting calories,I just eat enough to satisfy me,I dont go hungry as it would not be sustainable,I have just cut most carbs I eat all veg except potatoes,no rice pasta cakes sweets.
I dont know what would make 50 grams of protein.I dont realy understand grams.

 

[Bluetit1802]

If you find you are still losing weight, you need to increase your calories. You can only do this by increasing carbs or fats or proteins, or a mixture of all 3. Fats are generally the most calorific. Extra cheese is a good start. I am struggling to stop losing weight myself and am trying different options.

 

[jack412]

what blue said too

I would enter what I ate for a few days into my fitness pal, you may be surprised by the result.
If you are getting too skinny, you need to eat more....or a thyroid or other problem

 

[Patricia21]

Thank you all for your help.
Jack the fatsecret site is good.
Sanquine your LDL is higher than mine if I am reading it right,my DN was more concerned about that than the diabetes I dont know a thing about trigs but mine was 1.2, total cholesterol 4.8 HDL1.8 LDL2.5 all very confusing.

 

[sanguine]

Thank you all for your help.

Sanquine your LDL is higher than mine if I am reading it right,my DN was more concerned about that than the diabetes I dont know a thing about trigs but mine was 1.2, total cholesterol 4.8 HDL1.8 LDL2.5 all very confusing.

You're quite right, my LDL does need to come down further, as do the triglycerides (although you should have seen what they were before!). It's work in progress.

 

[AndBreathe]

Patricia - I used this site, and referred to it when I recently had a discussion with my GP about cholesterol. She was content the site was "appropriate". The site also evaluates each of the values entered, and when I put yours in, they're in great shape.

When I had the discussion with my GP, we talked about all sorts, then she came in with what she felt was the killer blow; that NICE guidelines recommend statins for all diagnosed diabetics. Nice (as opposed to NICE). My argument, at which point she conceded, was that all of my HbA1c scores, aside from the single one, at diagnosis, have been in the non-diabetic range, so where do we place me?

We eventually agree that if I wasn't keen on statins, we would do nothing, and look again in 3 months. I think she might be better prepared for that call. I just hope my levels moderate a bit. They're not as good as yours, unfortunately, but I'm really not keen on statins, being female, of a "certain age", with no pre-existing cardio vascular disease.

I wrote about it here: http://www.diabetes.co.uk/forum/threads/anything-else-update.63298/#post-617814 I'm not suggesting you adopt my approach, or anything else, just not repeating myself.

I hope you achieve what you want.