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How low is too low for an HbA1c?
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<blockquote data-quote="Caleb Murdock" data-source="post: 223352" data-attributes="member: 37907"><p>Grant, about regular vs. fast-acting, the regular insulin dribbles into my system (from my fat) for a period of 5-6 hours, and that allows me to eat two smallish meals. What you seem to be doing with the fast-acting insulin is covering one large meal with one dose of insulin. Personally, I prefer to eat the way I'm eating (one serving of food an hour after injecting, and then a second serving a couple hours later).</p><p></p><p>Pianoman, a person who injects fast-acting insulin minutes before a meal would have to be injecting it into a vein (or perhaps muscle) in order to mimic the effect of the pancreas. Any insulin injected into fat will take hours to work its way into the system, no matter how it is formulated. So even if you are taking a fast-acting engineered insulin, you have to inject 30-40 minutes before the meal.</p><p></p><p>My experience with the dawn phenomenon is that when I keep my carbs to a good level (180 grams a day or lower), I wake up with numbers in the range of 115 to 135 (6.4 to 7.5), which is acceptable. However, when I'm slipping off my diet and eating 250 grams a day, I can wake up with much higher numbers. (I know that there are people on the board who probably think that 180 grams is a daily binge, but the average American is eating 250 to 350 every day. I don't know what your diet is like in England.)</p><p></p><p>I don't mean to hijack the discussion, but my problem with food is that I have favorite foods that I just can't stop eating. I adore sushi, and my local supermarket has a sushi chef come in every day to prepare it fresh. A small tray of that has 40-45 carbs. Then there is a local food company which makes the best soups I have ever tasted. Towards the end of the day, that same supermarket puts the cream soups on sale at half price, and I just can't resist getting a pint of clam chowder or corn chowder or lobster bisque. All the soups have potatoes and/or thickeners in them, and so that's another 40 carbs. Then I have to have my daily chocolate fix, and that's 30-60 carbs. Then I love iced coffee, and the packets of sweeteners I put into it have one gram each. It takes 8 packets to sweeten a large coffee, and the half & half brings it up to 12. (I'll drink 2 of those a day.) I'm also addicted to a gourmet brand of yogurts that have 20 grams each. I occasionally will make a low-carb meat-based dish to eat when I'm hungry, but even that has 10 carbs per serving. And then there are the impulse purchases. Yesterday I bought teriyaki wings on impulse, and they had about 50 carbs in them. I'm not eating such a bad diet for a non-diabetic, but I'm not a non-diabetic. It just goes on and on. I hate cooking, and there are very few prepared foods available that are low in carbs.</p><p></p><p>Oh, about that chart that you posted, Mark, it gives me a lot of hope that if I can't get my A1c below 6%, I'll still be all right. The fact that that's a commercial site, however, is very worrisome. The chart also explains why so many doctors are satisfied with an A1c of 7%, since it makes it look like a 7 isn't that bad.</p></blockquote><p></p>
[QUOTE="Caleb Murdock, post: 223352, member: 37907"] Grant, about regular vs. fast-acting, the regular insulin dribbles into my system (from my fat) for a period of 5-6 hours, and that allows me to eat two smallish meals. What you seem to be doing with the fast-acting insulin is covering one large meal with one dose of insulin. Personally, I prefer to eat the way I'm eating (one serving of food an hour after injecting, and then a second serving a couple hours later). Pianoman, a person who injects fast-acting insulin minutes before a meal would have to be injecting it into a vein (or perhaps muscle) in order to mimic the effect of the pancreas. Any insulin injected into fat will take hours to work its way into the system, no matter how it is formulated. So even if you are taking a fast-acting engineered insulin, you have to inject 30-40 minutes before the meal. My experience with the dawn phenomenon is that when I keep my carbs to a good level (180 grams a day or lower), I wake up with numbers in the range of 115 to 135 (6.4 to 7.5), which is acceptable. However, when I'm slipping off my diet and eating 250 grams a day, I can wake up with much higher numbers. (I know that there are people on the board who probably think that 180 grams is a daily binge, but the average American is eating 250 to 350 every day. I don't know what your diet is like in England.) I don't mean to hijack the discussion, but my problem with food is that I have favorite foods that I just can't stop eating. I adore sushi, and my local supermarket has a sushi chef come in every day to prepare it fresh. A small tray of that has 40-45 carbs. Then there is a local food company which makes the best soups I have ever tasted. Towards the end of the day, that same supermarket puts the cream soups on sale at half price, and I just can't resist getting a pint of clam chowder or corn chowder or lobster bisque. All the soups have potatoes and/or thickeners in them, and so that's another 40 carbs. Then I have to have my daily chocolate fix, and that's 30-60 carbs. Then I love iced coffee, and the packets of sweeteners I put into it have one gram each. It takes 8 packets to sweeten a large coffee, and the half & half brings it up to 12. (I'll drink 2 of those a day.) I'm also addicted to a gourmet brand of yogurts that have 20 grams each. I occasionally will make a low-carb meat-based dish to eat when I'm hungry, but even that has 10 carbs per serving. And then there are the impulse purchases. Yesterday I bought teriyaki wings on impulse, and they had about 50 carbs in them. I'm not eating such a bad diet for a non-diabetic, but I'm not a non-diabetic. It just goes on and on. I hate cooking, and there are very few prepared foods available that are low in carbs. Oh, about that chart that you posted, Mark, it gives me a lot of hope that if I can't get my A1c below 6%, I'll still be all right. The fact that that's a commercial site, however, is very worrisome. The chart also explains why so many doctors are satisfied with an A1c of 7%, since it makes it look like a 7 isn't that bad. [/QUOTE]
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