Lowering a1c

[Charisma_1630]

hi all,

I don't use the forum much I just occasionally come on when I'm in need of advice! So here's my issue.

A year ago I did a carb counting course as my a1c was around 8.5. I've had major (and I mean major) anxiety over the past year about my diabetes. About going low about complication about what's gonna happen in my future if I'm gonna see my daughter grow up have more kids etc. ive sort of dedicated the last year to fixing my sugars I keep a detailed diary and see my nurse once a month. I've slowly been making changes in the right direction food wise and with routine and my last a1c was 6.8. Now my nurse was really pleased with this and doesn't want me to lower it anymore but as its my health/life that's at risk I feel I can lower it further I'm just not sure how!! I've been put forward for an assessment on the pump because of my anxiety but I don't think Theyll give me one. So in the mean time can anyone give me any advice on little habits that help you daily with keeping your sugars down?

i don't know any other diabetics so I'm curious how a well controlled diabetic lives their life!

I've also been looking into local help and support as I get none at all from family or friends but there's nothing out there. I feel really alone and scared with it all!

 

[noblehead]

Well done on the changes you have made so far, that reduction in Hba1c is impressive

Do you have a figure in mind in which you want to aim for, 6.8% is pretty good and and I wouldn't want to be lowering it any further if you already have anxiety problems about hypo's, I would just do what your doing now and try and get on top of your anxiety issues, are you getting any help from your gp ?

 

[Charisma_1630]

Hi thank you for replying!

My issue is before I had my daughter I never took care of myself I got into a bad way with my sugars ignoring them and I got a bad pain in my left hard and really blurred vision. Whilst pregnant I got my a1c to 6.1 continuously for 9 months and the pain and blurred vision disappeared completely. (As well as my background retinopathy) after pregnancy I stupidly went back to ignoring my sugars and around 18 months later the pain and blurred vision came back. That was about a year ago, same time as my anxiety came so I guess it's due to that. Anyway my a1c at 6.8 and I'm still getting these problems. I believe if I can get it back to maybe 6.5 or under then they will go away again and I can go back to living a semi-normal happy life again!

With regards to my anxiety maybe someone can give me advice on that. I've been in a really bad way recently. I'm a single parent so no partner. I've tried reaching out to family but they don't seem to care. Same with friends. I started seeing a counsellor via my gp but he didn't really get it so I stopped after about 4 sessions. I've spoken to my nurse and consultant about courses to learn more or something but they don't know of anything. I went to a support group near my house but literally every person there was type 2 and in their 60's ish. (Plus I kept getting evil looks as I had to take my daughter and she's Young so wouldn't sit quietly :-( ) tbh the only thing I found helpful is I've found people on Facebook who have been diabetic along time and live happy normal lives! I'm so surprised there isn't more help or information out there for support!

 

[Charisma_1630]

Btw when I say about 6.1 during pregnancy I tested every single hour and treated for hypo every other hour as told by the consultant at the time. Its not something that's possible for every day life

 

[noblehead]

Understand your reasons for wanting to go lower, perhaps by taking up the offer of a pump would go a long way in giving you stable control without increased hypo's and hyper's, over the last year there's been numerous members changed over from MDI to pump therapy with great success, if you read round the Insulin Pump section of the forum you should find them.

Sorry, can't help with the anxiety issue, all I would suggest is you ask for help from your HCP's.

 

[Charisma_1630]

Thank you I do appreciate your reply! I have pushed my nurse the other day as waiting for my pump assessment seems to be taking a while! I think I saw in another post that youve been offered a pump! I bet you're nervous. Can I ask what kind of a1c's you get? I don't think I've ever heard anyone say they didn't like the pump more than pens!

 

[yingtong]

Hi,I have been diabetic for over 50 years and have 4 grown up children.Congratulations on your a1c and like noblehead Said I wouldn't want to take it lower,as for your anxiety I think you need some professional help,so chase your GP up.I am about to go on pump therapy early next year and I think you should investigate this some more.As you can see I have been diabetic for a long while,with only a couple of minor problems,so life can be good.I wish you all the best and don't give up and keep fighting this bloody disease.

 

[noblehead]

Hi,I have been diabetic for over 50 years and have 4 grown up children.Congratulations on your a1c and like noblehead Said I wouldn't want to take it lower,as for your anxiety I think you need some professional help,so chase your GP up.I am about to go on pump therapy early next year and I think you should investigate this some more.As you can see I have been diabetic for a long while,with only a couple of minor problems,so life can be good.I wish you all the best and don't give up and keep fighting this bloody disease.

Not nervous as such, just a little apprehensive as anyone would be, but change can be a good thing and I am looking forward to it just the same, starting reading the book Pumping Insulin last night and can now see why everyone praises pump therapy.

My last Hba1c was 6.4% and I'm due another soon, it may well be a little higher as I've been experiencing a few injection site problems over the last few months, but as long as it's not too high I won't be too concerned, I've had retinopathy problems in the past so need to keep stable bg control and not swing from high to low as I did pre-diabetic retinopathy.

 

[Charisma_1630]

Hi,I have been diabetic for over 50 years and have 4 grown up children.Congratulations on your a1c and like noblehead Said I wouldn't want to take it lower,as for your anxiety I think you need some professional help,so chase your GP up.I am about to go on pump therapy early next year and I think you should investigate this some more.As you can see I have been diabetic for a long while,with only a couple of minor problems,so life can be good.I wish you all the best and don't give up and keep fighting this bloody disease.

Wow 50 years and no big problems! It's speaking with people like you that inspire me to be better at it! can I ask what sort of diet you stick to?? And what sort of a1c's you manage? Everywhere you go the complications are pushed in your face, you don't really see the people that are living well with it enough!

I think you're right I will see my gp again. It's hard though as its all related to my diabetes. I feel that once the penny drops and I can grasp what it takes to get the better a1c's then I'll feel more relaxed in life. I'm also looking at trying meditation to try and relax my mind about it!

 

[yingtong]

Like you noblehead,I to am a little apprehensive but I am using my time waiting to read as much as possible about insulin pumping so when February comes I'll be as ready as I can.

 

[yingtong]

Hi my last a1c was 6.0% as long as I am between 6 and 6.5 I am more than happy but in my younger days I must admit to abusing my diabetes for about 6 years but thank god I came to my senses on started to manage my diabetes.My diet, I eat 150 gems of carbo a day, but do go out for meals and have to do some corrections after the meal.I do admit weighing out my food but this is a relic of my early days of being diabetic,as I was told I had to weigh all my food.Please keep your head up I am sure you wil WIN.By the way I intend to celebrate being diabetic for 75 years but a while to go yet.

 

[Charisma_1630]

You've just made my day saying you have 150 grams a day. As I tend to eat around that amount too!! I know a lot of people swear by a very low carb diet but I don't think that's for everyone. It's nice to k ow good sugars can be achieved by eating carbs. Since doing my carb course I'm a little obsessed with weighing food and making sure im matching insulin. If I eat out I panic a little as not very good at judging just by looking. I usually go high after when I guess. Can I ask what sort of meals you eat? I tend to be sticking to the same and getting really bored :-(

 

[yingtong]

I eat almost every thing but smaller portions because I am very strict on counting my carbs.You must allow yourself a treat every now and again,this will not cause you any problems as you appear proficient at being able use correction doses.The reason i am going on a pump is because I no longer recognise hypo's,my consultant says this is because I have been on insulin for so long,but I am sure I will manage itA little thing I always remember is I rule the diabetes and the diabetes does not rule me.

 

[Charisma_1630]

Thanks you've both certainly given me something to think about. I'm guessing to have an a1c of 6.0 you must run your sugars pretty low which also contributes to losing hypo awareness so I hear. One last question, how does the pump help with loss of hypo awareness?

 

[yingtong]

It allow better control which allows less chance of hypo's.Buy the way I have tried running my blood/ sugars at around 10 for 5 months but not return of hypo awareness,it just made me feel ill so I just test my blood/glucose every couple of hours,as I have always tested regularly not to much of a cross to bare.

 

[PSS]

Hi Chrisma

I have recently had a spell of anxiety. In my case I came across a CBT (cognitive behaviour therapy) course online. Here is the link to the site https://moodgym.anu.edu.au/welcome . My GP wanted me to try out anti depressant but I wasn't very keen on that.

I am much better and have find mediation techniques really useful.

Although I have recently joined but I find the forums on this site very supportive and useful.

Goof luck with your anxiety problems, I am sure you will beat it

 

[Charisma_1630]

Hi thank you I shall take a look into that link. When I was refered to the counsellor before I was hoping it was cbt but he just went over the same things every session and I didn't get anything from it. He also have the advice that I don't need to carry my blood sugar kit around with me on short journeys. COuldnt believe he would give me such stupid advice!

I did start using this forum a while ago but saw so much about complications I stopped coming as it was making me more anxious. At that time I thought if it could happen it was!

 

[yingtong]

Providing you look after your diabetes,which I believe you are,so my advice would be get on and live your life and start enjoying life.Good luck.

 

[Diamattic]

Just to reinforce your first post, I really like the idea of keeping a food journal, it's something I do and find that after while when I do go out to a restaurant I can look back on the last time I had that meal and what my sugars were and how much insulin I took and how it worked out 2 or 4 hours later, and adjust this time accordingly.
It's a great idea, and works well if you keep the book on you and at least write down the meals!

My daily goals are just to have the lowest sugars possible every time I check, shooting for 5-7, and if I keep that in mind then the A1c will work itself out later.

From what I have read going low has no long term adverse effects, but going high does. Going low only present that immediate danger if you go too low, so going down to 3 might make you feel weird it's not a long term danger. The more lows you have the less better the body adapts to them and they begin to feel less and less strange.

Try not to be afraid you'll be okay

 

[lizdeluz]

Hi thank you I shall take a look into that link. When I was refered to the counsellor before I was hoping it was cbt but he just went over the same things every session and I didn't get anything from it. He also have the advice that I don't need to carry my blood sugar kit around with me on short journeys. COuldnt believe he would give me such stupid advice!

I did start using this forum a while ago but saw so much about complications I stopped coming as it was making me more anxious. At that time I thought if it could happen it was!

I took my anxiety to my GP and was recommended mood gym, and I did find it beneficial. I also had about 10 sessions of cbt with a trained counsellor attached to the practice. This was really effective and taught me to recognise why I was anxious. Though pills were prescribed, I decided not to go down that route. One-to-one counselling and discussion may help you best, but, of course, it's quite likely that the counsellor will know much less about diabetes than you do, (as you have already discovered!). So I'm thinking that maybe you could make a point of explaining your anxiety to your diabetes consultant and/or DSN who may be able to refer you on to someone with the skills needed to help you cope. Perhaps your diabetes team just don't realise you are really struggling with anxiety?
You said that your team are assessing you for a pump because of your anxiety? Seems to me they'd assess you for a pump because they recognise you are already achieving good control?