Type 1: What are your HbA1c test results?

[Marie 2]

@david4503 I had a c-peptide test years ago and I don't make any insulin of my own. I've been a type 1 for 19 years. Retirement, prebolusing timing, exercise, cgm and a pump have all played a part in that control. I sugar surf! I respond pretty quickly because of my CGM to trending lower or higher BG levels. And sure I can trend higher or lower, but my alerts are set pretty tight so I usually catch it before I leave my parameters. My alerts are set at 4.4 and 7.2 (80 and 130) I don't like to see numbers out of that range, although it depends on the circumstance how I react to it.

And yes, I have better control than most type 1's. Before retirement even with a cgm and pump I don't believe I could have had such good control. I didn't want to mess with tech at work, but looking back I should have. But I still did pretty good as I stayed with about a 44-46 (6.2-6.4) A1c.

 

[david4503]

To get that kind of tight control without any serious insulin reactions requires some dedicated tightrope walking. Very impressive.

 

[JLChamberlain]

Most recent was 6%, highest it’s ever been in my life is 6.4%

 

[michelle88]

Your A1c numbers are fantastic for a Type 1. And consistently fantastic, which is even harder to do. Congrats. There seems to be a lot of confusion here, in some cases at least, over whether a particular Type 1 or 2 diagnosis is correct or whether a patient still making some of their own insulin is actually an early Type 1. If you’re not making any or just a negligible amount, a “full-on” Type 1, it’s a remarkable job of taming this beast, covid or no covid.

Thanks so much for your kind words. Yes, it's almost like a full-time job to be in this A1c range. My last one unfortunately was completely out of that range, it was 7.7%! My specialist and I figured out it was my Libre 2 that was giving me these false low readings, but I have no idea why, I always stick it in the back of my upper arm, it wasn't in a muscle or anything like that. According to the Libre, my A1c should have been 5.9%! So now I've switched to a Dexcom 6 and I do like it a lot more. It is definitely more accurate.
As per my last C-peptide test over 3 years ago, I'm not making much insulin anymore

 

[curly]

Just got a lifetime best of 5.4% yesterday! So pleased. My CGM says 4% time spent low over last 90 days, so I’m reassured the result is not due to hypos. Mind you, I’ve now to convince my GP of this as she was gunning for me and my driving licence at the start of the year as I was registering 10% lows regularly. Told me my control was ‘too good’ and I should have a higher A1C. So she will have a fit when she sees 5.4% this time. Threat of no licence has really spurred me on to work on control.

This is also my first A1C since getting a CGM. Has brought me down from around 6.3% where I’ve been pretty consistently last 10 years or so. Has taken a lot of work and literal ups and downs but I now feel it’s been worth it

Might also be worth mentioning in these days of low carb diets that I’m a carb fiend and eat around 350g carbs per day! If low carb is the way for you then that’s great. But to reassure people who don’t wish to go that way that there are other options too.

 

[PaulAshby]

My last one a couple of weeks back was 4 so am pleased with this result obviously, I tend to run my BG low but do have a few massive spikes, generally at the weekend for some reason so my glucose monitor is always screaming at me, much to my wife's annoyance

 

[Antje77]

Mind you, I’ve now to convince my GP of this as she was gunning for me and my driving licence at the start of the year as I was registering 10% lows regularly. Told me my control was ‘too good’ and I should have a higher A1C. So she will have a fit when she sees 5.4% this time.

Have your CGM with the time in range info in your hand upon walking into her office, and make it the first thing she sees! If you initiate the conversation on that, it will be much harder to berate you for your hba1c after that.
Good luck!

 

[curly]

Have your CGM with the time in range info in your hand upon walking into her office, and make it the first thing she sees! If you initiate the conversation on that, it will be much harder to berate you for your hba1c after that.
Good luck!

Thanks! I decided to email screenshots of CGM time in range to the GP today in the end to try to get in first before the complaint comes my way fingers crossed

 

[RobertJ]

This thread has been an eye-opener. I've had Type 1 since I was 12 and I'm 32 now. My last hba1c was 59 and I thought that wasn't far off from good, but it seems it's quite bad. The big question I always have is, if your average day is readings around 5 and 6, how do you avoid going low all the time?

 

[Antje77]

My last hba1c was 59 and I thought that wasn't far off from good, but it seems it's quite bad

It's not quite bad, and it's fairly close to the official guidelines for T1's.

The big question I always have is, if your average day is readings around 5 and 6, how do you avoid going low all the time?

For me, it works to eat very little carbs to prevent rollercoasters.
I also couldn't do it without a libre sensor, which enables me to slightly nudge up my sugars before I go hypo instead of treating hypos. Well, most of the time, not always.

 

[RobertJ]

It's not quite bad, and it's fairly close to the official guidelines for T1's.

For me, it works to eat very little carbs to prevent rollercoasters.
I also couldn't do it without a libre sensor, which enables me to slightly nudge up my sugars before I go hypo instead of treating hypos. Well, most of the time, not always.

Yes, I have a Libre too and it's definitely given me the confidence to be bolder with doses but I've had it since 2016 and my hba1c is still not that good. I, too, catch hypos before they happen but it's annoying having to eat extra things all the time. I've heard from other type 1 people that simply eating less carbohydrate makes everything easier and I guess I do that sometimes. For a lot of my life, though, I've simply operated on the DAFNE ideology that you're supposed to eat whatever you want, and did so.

It's only in very recent times that I was diagnosed with background retinopathy that I've started to take my diabetes even more seriously than before. I am now questioning more food and drink is actually worth it when weighed against the chaos it could cause with my blood sugars.

The message of DAFNE (when I first did a course) was definitely to do whatever you like but I now think that message was too simplistic.

 

[Antje77]

I am now questioning more food and drink is actually worth it when weighed against the chaos it could cause with my blood sugars.

That's what I do all the time, most high carb foods are just not worth the hassle for me. Although I've learned to dose for some of them, like my beloved high carb Belgian beers, I can get away with that one by adjusting the speed of drinking to the line of my Libre.

I suppose a relevant difference between you and me is the time where we were diagnosed.
You've had to do with the occasional fingerprick most of your life, and have done quite well!
I was only diagnosed 6 years ago, and have used a sensor almost from the start, so I started out trying to reduce the peaks and troughs from the beginning, no relearning anything.

 

[Marie 2]

@RobertJ I eat what I want and I have really good control. For me it's a matter of timing of prebolusing part of my dose for any eating. I then take my second dose for what I actually ate. Retiring helped a lot in being able to respond more to a high. I eat mostly at home and can get on my exercise bike when needed after.

Make small changes and once you start knowing what helps, you can refine what you have learned. But if you are having to eat constantly to treat a low, it sounds like your basal rate isn't right. And if your basal rate isn't right, it's hard to have the right bolus ratios.

Prebolusing is a huge key. In my case a common meal at home I prebolus half 30 minutes before I eat and then my second dose is geared to what I actually ate. With some meals, timing could be different. Other people might take a third 15 minutes before eating. But prebolusing and activity have always been key factors in controlling my BG levels. If you are basically taking the right dose, it’s not increasing the dose, it’s the timing of the dosing. I truly believe most people can eat what they want, it just takes learning what works. And you have to be able to adjust, as we can change what we need depending on what life throws at us, from weather changes to stress, to a sleepless night.. I am 96% in Time in Range between 3.9 to 8.9.

For basal testing
https://www.mysugr.com/en/blog/basal-rate-testing/

 

[david4503]

Just got a lifetime best of 5.4% yesterday! So pleased. My CGM says 4% time spent low over last 90 days, so I’m reassured the result is not due to hypos. Mind you, I’ve now to convince my GP of this as she was gunning for me and my driving licence at the start of the year as I was registering 10% lows regularly. Told me my control was ‘too good’ and I should have a higher A1C. So she will have a fit when she sees 5.4% this time. Threat of no licence has really spurred me on to work on control.

This is also my first A1C since getting a CGM. Has brought me down from around 6.3% where I’ve been pretty consistently last 10 years or so. Has taken a lot of work and literal ups and downs but I now feel it’s been worth it

Might also be worth mentioning in these days of low carb diets that I’m a carb fiend and eat around 350g carbs per day! If low carb is the way for you then that’s great. But to reassure people who don’t wish to go that way that there are other options too.

Hate to say it but with an A1c of 5.4, she may be right to be concerned. If I could pick my A1c numbers, I would not want them to be that low. That’s apart from my not approving of doctors and bureaucrats having the kind of power over driving licenses that they do in the UK. I’ve mentioned a few times that I don’t agree with the UK’s system for approving driving licenses for people on insulin. Rigorous regulations should require a demonstrated need for them.

 

[RobertJ]

That's what I do all the time, most high carb foods are just not worth the hassle for me. Although I've learned to dose for some of them, like my beloved high carb Belgian beers, I can get away with that one by adjusting the speed of drinking to the line of my Libre.

I suppose a relevant difference between you and me is the time where we were diagnosed.
You've had to do with the occasional fingerprick most of your life, and have done quite well!
I was only diagnosed 6 years ago, and have used a sensor almost from the start, so I started out trying to reduce the peaks and troughs from the beginning, no relearning anything.

It's difficult, I think getting diagnosed at the age of 12 in 2003 meant I wasn't in charge of what I ate anyway. Plus, back then the advice was more about snacking all the time to avoid going low rather than eating smaller amounts of carbohydrate to make things easier, as crazy as that sounds. Back then the message was more: being low is the awful but being high is not the end of the world.

I also never met a single other person with Type 1 until well into adulthood and therefore simply did not know other people were being experimental in this way. Also, I wrongly thought it was no big deal to have levels around 9-13 for large parts of the day so high-carb meals were fine.

So now, at the age of 32 and with a slightly terrifying diagnoses if background retinopathy I feel like I'm restarting this whole diabetes thing and striving for the kind of standards I was meant to be striving for all along.

 

[Antje77]

and therefore simply did not know other people were being experimental in this way.

I think you'd like to read about Sugar Surfing. https://www.sugarsurfing.com/
I don't exactly follow it, but a lot of sugar surfing techniques seem to suit me naturally.

 

[Ipodlistener]

Diagnosed 11/21 with an A1C of 6.9 in 01/22
Had my latest at 5.7 or 38mmol.
After a few days my Libre2 clicked down to 5.6

 

[curly]

Hate to say it but with an A1c of 5.4, she may be right to be concerned. If I could pick my A1c numbers, I would not want them to be that low. That’s apart from my not approving of doctors and bureaucrats having the kind of power over driving licenses that they do in the UK. I’ve mentioned a few times that I don’t agree with the UK’s system for approving driving licenses for people on insulin. Rigorous regulations should require a demonstrated need for them.

Hi David - each to their own, of course, but here is my time in target for last 7 days. Personally I don’t think there’s much wrong with these numbers, but understand why people like to run on the slightly higher side if it’s a choice between slightly high or slightly low. Also takes a lot of work to sustain.

 

[Torres71]

Mine has come down to 55 mmol or 7.4 % - which has taken considerable effort & adjustment of both my insulin. Very pleased.

 

[Bernadettenuttall]

What are your H test results?

Mine is 7.1mmol

I'm really confused now. My last HbA1c was 59. I have never been given it as a percentage??