Great HbA1c result but got told off for it...

rab5

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Sure divide trigs number by HDL result . You want the answer to be be 0.87 or lower.
There's a long and involved explanation about the benefits of triglyceride levels being low and HDL being high and it can be used as a proxy for "better" cholesterol levels. Do you want me to dig out some bits on it for you?
I believe you... no need to go grabbing stuff. many thanks mate. Dont want to hijack this very succesful post. well done Med dCp
 

LooperCat

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Since I started on the Insulin pump mine has been around 45 (2 years and a bit on the pump) and 2 weeks back at my reveiw I was told I am now eligible for the Libre on prescription but my DSN wants me to have a CGM for a week or so to make sure my HbA1c is not through having hidden hypo's. I maybe having hypo's during the night as I was when I was using the Libre for 4 month at the end of last year, but I thought I had addressed the matter but hey ho. Maybe you should ask for the Libre trail OR a CGM trail for 5 days or so?

Good luck and keep us informed

I’ve been using the Libre for four months now, that’s part of the reason I’ve had such a good result - I can actually see what’s happening - it’s been a complete game changer for me. I honestly don’t have any hypos at night, and I can prove that to them if they continue to insist that I do. The last one I had was in January!
 

ringi

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Thank you! I’m just overweight, with a BMI of 25.5, but that’s coming down, so I’ll be back in the green on that front soon!

You may lose weight quicker if you use a little less inslin, this is a common issue with type2 on inslin, hence the advice in type2 not to go below A1c of 53 when a type2 is on inslin. (Personly I think 53 is too low if someone is using lots of inslin, but you are not on 200 units a day.)
 

Nondipoo

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:mad: Rant alert :mad:

I had a raft of blood tests last Friday to investigate why I’ve been getting blood pressure drops when I stand up, and the nurse asked if I’d like her to take an HbA1c while she was at it - I jumped at it because my last one covered one month of no Libre and lots of carbs (and Christmas) plus two with Libre and keto, so didn’t really give me an accurate picture of how things have improved since I got it.

Phone rang this afternoon, it was the practice nurse. She just said that they’d got my results and my HbA1c was 43. And then silence. I assumed it was to give me time to gush, and I said how thrilled I was with such a good result. More silence.

They want me to drop my insulin and get it back up to 50.

I said no way, that 43 comes under “excellent control” on the chart they have on their wall, and that I was delighted. Cue a lecture about hypos, and I tried to explain that I don’t really have any, maybe one mild one a week (never at night), and that I never drop below 3mmol. She actually said she didn’t believe me! And wants me to come in so I can have hypos explained to me. I explained that having had T1 for 20 years, I was very experienced at having hypos, but I’m now managing it in such a way with my Libre as to make sure I don’t get them, and explained the “sugar surfing” methods of a glucose tab here, half a unit there to nudge my sugars into range if they’re drifting off. Apparently I must be having night hypos! I’m going to have to go in armed with printouts of my Libre traces to prove that I’m not - I haven’t had a night hypo since flippin’ January! We had the driving conversation and I explained that I run my sugars a little higher (6-7mmol) to drive, and she said I should be aiming for TEN :mad:

So that’s rather taken the shine off a result I’ve been working so hard to accomplish.

:banghead::banghead::banghead:

I also got cholesterol numbers, but I’m not quite sure how to interpret them, can the hive mind help? She didn’t seem too happy about those either.

Total 6.2; HDL 4.2; LDL 3.7; Trigs 1.2

Anyway, I’m seeing my GP at the end of the month to discuss it all, looks like I’ll have to go armed with my lever arch file of results and dig out the battle handbag again :)

/rant
How stupid of the nurse. She obviously doesn’t understand the need to keep hbA1c at the lower level for your future health. It really makes me wonder what they are teaching them now.
 

Juicyj

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@Mel dCP Well done :)

Don’t let the inexperience of one person steal your thunder, I always think when faced with similar situations that it’s my duty to educate the ill-informed.

Also just to thank you as your post reminded me i’ve got my blood test in the morning ! :arghh:
 
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ringi

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How stupid of the nurse. She obviously doesn’t understand the need to keep hbA1c at the lower level for your future health. It really makes me wonder what they are teaching them now.

Be careful, as some study have shown that the people who lived longest with type1 used the least inslin, rather then have the lowest A1c, but these people have clearly lived most of their life's without CGM and are mostly not on low carb diets. (Even BG meters were not in use for most of their lifes!)
 

LooperCat

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@ringi I’m type one and I use very little insulin these days. 16-18 units of Tresiba a day, and less than 8 units of Novorapid. I’ve had to drop it by about two thirds since cutting carbs - I used to take 18 units of Lantus twice a day and 8-10 of Novorapid with each meal before. As for weight, I’ve lost 11lbs in three months. I’m quite happy with that rate of loss :)
 

EllieM

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How low is your low carbs? (Am thinking about going that way, currently on about 80 per day).
 

ringi

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@Mel dCP you are very different to most people a nurses will be dealing with, hence I think you A1c is great. But I expect I know a lot more about you then the nurse did.

Keto diets are rewriting the rule book......
 
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novorapidboi26

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:mad: Rant alert :mad:

I had a raft of blood tests last Friday to investigate why I’ve been getting blood pressure drops when I stand up, and the nurse asked if I’d like her to take an HbA1c while she was at it - I jumped at it because my last one covered one month of no Libre and lots of carbs (and Christmas) plus two with Libre and keto, so didn’t really give me an accurate picture of how things have improved since I got it.

Phone rang this afternoon, it was the practice nurse. She just said that they’d got my results and my HbA1c was 43. And then silence. I assumed it was to give me time to gush, and I said how thrilled I was with such a good result. More silence.

They want me to drop my insulin and get it back up to 50.

I said no way, that 43 comes under “excellent control” on the chart they have on their wall, and that I was delighted. Cue a lecture about hypos, and I tried to explain that I don’t really have any, maybe one mild one a week (never at night), and that I never drop below 3mmol. She actually said she didn’t believe me! And wants me to come in so I can have hypos explained to me. I explained that having had T1 for 20 years, I was very experienced at having hypos, but I’m now managing it in such a way with my Libre as to make sure I don’t get them, and explained the “sugar surfing” methods of a glucose tab here, half a unit there to nudge my sugars into range if they’re drifting off. Apparently I must be having night hypos! I’m going to have to go in armed with printouts of my Libre traces to prove that I’m not - I haven’t had a night hypo since flippin’ January! We had the driving conversation and I explained that I run my sugars a little higher (6-7mmol) to drive, and she said I should be aiming for TEN :mad:

So that’s rather taken the shine off a result I’ve been working so hard to accomplish.

:banghead::banghead::banghead:

I also got cholesterol numbers, but I’m not quite sure how to interpret them, can the hive mind help? She didn’t seem too happy about those either.

Total 6.2; HDL 4.2; LDL 3.7; Trigs 1.2

Anyway, I’m seeing my GP at the end of the month to discuss it all, looks like I’ll have to go armed with my lever arch file of results and dig out the battle handbag again :)

/rant
Good job.....I think once you show them the data they should back off...
 
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Lisbonlion67

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Hi,I keep getting emails inviting me to join the "Forum",when i do i cant find where to ask or when i find somewhere i am told (in other words i dont have permission or it is not relevant)
Anyway,I do not want to hear other peoples problems,i have enough myself,how is listening to other peoples illness going to help me.
Please,Do Not Send me Anymore emails or Anything else,I will deal with this by myself.Thanks.
 

Bertyboy

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215
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I have had a similar experience, except I've also had contradiction. I was diagnosed last November when my HbA1C was 153 mmol/mol. I was immediately put on insulin and I adjusted as required to get my FBG levels into the 5s and cut out the carbs. By January my HbA1C was 40. The endo consultant at the hospital was very pleased with this but the diabetic nurse at my surgery had a bit of a go at me and told me to adjust my diet/insulin to get it back over 50. I told her I had had no hypos but I don't think she believed me.
 
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bulkbiker

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Hi,I keep getting emails inviting me to join the "Forum",when i do i cant find where to ask or when i find somewhere i am told (in other words i dont have permission or it is not relevant)
Anyway,I do not want to hear other peoples problems,i have enough myself,how is listening to other peoples illness going to help me.
Please,Do Not Send me Anymore emails or Anything else,I will deal with this by myself.Thanks.

Well hello and welcome to you too... don't want any help from people who have been in your position? You never know it might help.
 
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Brunneria

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Hi,I keep getting emails inviting me to join the "Forum",when i do i cant find where to ask or when i find somewhere i am told (in other words i dont have permission or it is not relevant)
Anyway,I do not want to hear other peoples problems,i have enough myself,how is listening to other peoples illness going to help me.
Please,Do Not Send me Anymore emails or Anything else,I will deal with this by myself.Thanks.

Hi @Lisbonlion67
Welcome to the forum :)

rather than derail this thread with your queries, I will send you a Private Message, explaining how to change your profile settings to stop recieving emails.
When the Private Message arrives, it will appear as a green envelope in the top right hand corner of your screen.
Just click on it, and you will see the title of the message appear in a drop down box.
Click on that to read the message.
 

dbr10

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I have had a similar experience, except I've also had contradiction. I was diagnosed last November when my HbA1C was 153 mmol/mol. I was immediately put on insulin and I adjusted as required to get my FBG levels into the 5s and cut out the carbs. By January my HbA1C was 40. The endo consultant at the hospital was very pleased with this but the diabetic nurse at my surgery had a bit of a go at me and told me to adjust my diet/insulin to get it back over 50. I told her I had had no hypos but I don't think she believed me.

Seems to be a theme here. You've got things moving in the right direction. Brilliant. So why the obsession with 50?
 
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LooperCat

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Seems to be a theme here. You've got things moving in the right direction. Brilliant. So why the obsession with 50?
I don’t know, it’s obviously the target figure they have in mind - I’m wondering if it’s a funding target? But looking at the conversion chart, an HbA1c of 50 is equivalent to an average blood glucose reading of 8.1mmol - whereas 43 is equivalent to 7.1, still a good 50% over a non diabetic’s levels. Surely we should be aiming for lower than 50?
 
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dbr10

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I don’t know, it’s obviously the target figure they have in mind - I’m wondering if it’s a funding target? But looking at the conversion chart, an HbA1c of 50 is equivalent to an average blood glucose reading of 8.1mmol - whereas 43 is equivalent to 7.1, still a good 50% over a non diabetic’s levels. Surely we should be aiming for lower than 50?
I would have thought so.