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Told to raise HbA1c

Charlie Tudgay

Charlie Tudgay

Active Member
Messages
43
Type of diabetes
Type 1
Treatment type
Insulin
Got my HbA1c back the other day and it was 46 (6.4) which I am really happy with and would like to stay at this if not reduce it slightly, but the nurse has said to try and get it up to around 53. Is there a reason for this?
I've only been diagnosed about 13 months was 109 at diagnosis.

Thank you :)
 
We all aim for a lower a1c not higher, this is the first time I have heard this.
 
This is weird. All I hear is 'get it down'!! ;-)
 
Yes there is a reason, though it's not a great one.

They are assuming that your low HBa1c represents a risk that you are having too many hypos. And that you are at the point where the risk of the (presumed) hypos is more harmful than the benefit from the lower HBa1c.
 
I thought that might be the case. I only get hypos during the night after I've been dancing. Even if I eat a fair amount of carbs with no insulin (and no evening basal) I still have a hypo. This is twice a week at the moment as that's how often I'm teaching dance at the moment.
 
Ok well they may have a point then about asking you to raise your HBa1c. Or you could just interpret it as asking you to focus on reducing the hypos. Though it would have been good of them to put it in that way to you.
 
I get told the same, my hba1c is 5.8% and I always get told they would like it a bit higher so I'm not at risk of too many hypos.

I rarely have hypos though so I'm happy with my hba1c as it is.

Well done at a good result :)
 
Hi Charlie Tudgay
agree with spiker on this. -- although well done on the HbA1c too :)
I am always aiming for as low as possible but with you getting the hypos and no basal insulin it is worth considering their viewpoint.
knowing the pattern though you should be able to make a small adjustment by eating a slow acting snack before bed on dance nights ??
 
I was told after every appointment that i need to raise mine lol

I told them 'nope. I want mine in the normal range, and this is it. I am happy with things as they are"

As pointed out above they likely think that you are risking/having to many hypos or that you are putting to much work into your diabetes. Ya, to much work lol They want a balance of a decent HbA1c as well as not having to fight your numbers all day, so it really is a question of "Are you able to handle an A1c this low? and can you keep it up without having some kind of mental breakdown for the constant monitoring? "

If you can handle it, then great! if its easy, then don't slack, as throughout your life you are bound to have some higher numbers and you will happy you kept it low when you had the chance.
 
I'm always told to raise my hba1c. However, without the pump which has so improved my SD and longterm members will remember how I did have a driving incident....
I am hypo aware but it wasn't enough to save me from a **** time with DVLA.

With the pump my SD is much improved as is the qtys of hypo's.

Night time hypo's for me were very different too. I recognised them the vast majority of the time only when my dog climbed under the duvet or I sweated so much. Nowadays I don't unfortunately have my beloved girlie to climb under the duvet and I just wake up and treat without getting sweaty either.

I have just been for blood tests today and I have actually tried to raise them but keep my SD at a minimal level. However, it will be Tuesday before I know.

To me with the strength of the night time hypo's and my driving incident I do believe that my consultant is right.
 
Had my HbA1c a few weeks ago and mine was 53 (7%) and the hospital doctor said that is exactly where you want it to be. I though to myself it's not really as I would like it nearer 48 (6.5%).
I told him I try to manage my BG as tight as possible and tend to be a little obsessive about the numbers, to which he replied "most people with diabetes just get on with their lives". Do they??
 
I'm t2 but from reading here...can you set the alarm prior to hypo, to test and eat during the night that you exercise?
I think I would see my consultant about the hypos, you can't have 2 hypos a week like that forever, you may have grounds for a pump?

for now I would also go the the hard core sports forums and ask how the diabetes there control hypos after heavy exercise, as you would know there is a 12-24 hr hypo window afterwards.

you may need to do more stuff to prepare for the aftereffects. I don't know if there is anything here to help
http://www.joslin.org/info/why_is_my_blood_glucose_sometimes_low_after_physical_activity.html
 
birchy66 said:
Had my HbA1c a few weeks ago and mine was 53 (7%) and the hospital doctor said that is exactly where you want it to be. I though to myself it's not really as I would like it nearer 48 (6.5%).
I told him I try to manage my BG as tight as possible and tend to be a little obsessive about the numbers, to which he replied "most people with diabetes just get on with their lives". Do they??
Click to expand...

Yeah I want to be as close to the normal range as possible to make sure things look better for me in the long run.
I am the same I'm quite obsessive with keeping things controlled and get annoyed when they don't do what I expect and the doctors say I'm trying to control it too much!!
 
jack412 said:
I'm t2 but from reading here...can you set the alarm prior to hypo, to test and eat during the night that you exercise?
I think I would see my consultant about the hypos, you can't have 2 hypos a week like that forever, you may have grounds for a pump?

for now I would also go the the hard core sports forums and ask how the diabetes there control hypos after heavy exercise, as you would know there is a 12-24 hr hypo window afterwards.

you may need to do more stuff to prepare for the aftereffects. I don't know if there is anything here to help
http://www.joslin.org/info/why_is_my_blood_glucose_sometimes_low_after_physical_activity.html
Click to expand...

Yes the only thing with trying to set an alarm is that it happens randomly each time I never know if it will be around 12am or 6am or anywhere in between.
They have said I can apply for a pump but I'd much rather have a CGM and would find it a lot more useful. I have good control apart from these hypos on MDI.

Thank you for the link :)
 
birchy66 said:
Had my HbA1c a few weeks ago and mine was 53 (7%) and the hospital doctor said that is exactly where you want it to be. I though to myself it's not really as I would like it nearer 48 (6.5%).
I told him I try to manage my BG as tight as possible and tend to be a little obsessive about the numbers, to which he replied "most people with diabetes just get on with their lives". Do they??
Click to expand...
what an irritating pr**k of an answer that is -- i hope he got a firm rebuttal from you -- if not please do so next time --- grrrrr :blackeye:
 
birchy66 said:
Had my HbA1c a few weeks ago and mine was 53 (7%) and the hospital doctor said that is exactly where you want it to be. I though to myself it's not really as I would like it nearer 48 (6.5%).
I told him I try to manage my BG as tight as possible and tend to be a little obsessive about the numbers, to which he replied "most people with diabetes just get on with their lives". Do they??
Click to expand...

And for some ( following the poor or non existent " advice" they have been given, ) that life could potentially be brutal and short .

That comment annoys me intensely, because even to " get on with your life" it requires attention to detail that is beyond the ken of most non diabetics. Yup, we do get on with our lives, the alternative is errr, the opposite to life :rolleyes: , and that's what we are trying to preserve.

Signy
 
I have a copy of a letter sent from my consultant to my gp, where he says my HBA1c is excellent. It was 50 (6.7%). Err I don't think so. It may be good, but it's not good enough for me. I'm aiming for 42 (6%) which equals 7mmol/L. That would be an achievement in my little diabetic world. I can't help but wonder if the Consultant, DSNs and other health care officials were diabetic, what they would aim for...................I bet it would be lower than 50 and then they might stop patting us all on the head and telling us was good children we are. It's a constant struggle to keep our bg levels down to as near to normal as possible and as Heathenless says it requires meticulous attention to detail that non diabetics are totally unaware of. Right, I've had my rant and will now go find the duvet :)
 
Charlie Tudgay said:
Yes the only thing with trying to set an alarm is that it happens randomly each time I never know if it will be around 12am or 6am or anywhere in between.
They have said I can apply for a pump but I'd much rather have a CGM and would find it a lot more useful. I have good control apart from these hypos on MDI.

Thank you for the link :)
Click to expand...
you could go keto?
www.youtube.com/watch?v=n8BY4fyLvZ
upload_2015-4-18_6-48-3.png
 
I've had the same too! I guess it's protocol really...better to be safe than sorry from their behalf. I'm nowhere near experience enough but if you can get away with a low hba with minimum hypos then why not.

It's strange how a single number can alter your mood though, ha.
 
This must vary depending on who you speak to. My last test was 47, the consultant said that was great. Yet, when I had this level before the DSN was concerned that it may be too low.

I read that only 30% of diabetics have their BG controlled. My consultant was telling me other patients only remember to take insulin 3 times a week and can't resist a doughnut every day. If you consider this then for the majority a reading of under 50 could be a worry. For those on here, you take your diabetes serious but as a minority we get the hard time rather than the praise we should.

I have realised that it is all about managing the variance. Eating and treating in a way that prevents big swings in BG and therefore minimises hypo risk.
 
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