Operation

[homer190376]

Hi,

I'm due to go into hospital for an operation on my foot in 3 weeks, how can i reduce my HbA1c from 82 to under 69 in this period of time.

Any help would be appreciated.

thankyou

 

[Fairygodmother]

Hi,

I'm due to go into hospital for an operation on my foot in 3 weeks, how can i reduce my HbA1c from 82 to under 69 in this period of time.

Any help would be appreciated.

thankyou

The HbA1c is a measure of the amount of glucose that has joined with red blood cells. Red blood cells have a life of 8-12 weeks before they are replaced by fresh ones. The HbA1c therefore measures the average amount of glucose in your blood over a period of two to three months.
It's therefore unlikely that you'll be able to reduce it dramatically within the space of three weeks without either a blood transfusion or three-weeks' worth of life-threatening hypoglaecemia.
Don't despair!
I don't know what insulin you are using or how you judge the amount of carbohydrate you eat so I can't give any advice there, but maybe your DSN can.
Hope the operation goes well!

 

[Juicyj]

Hi @homer190376 Can you give us some more information about your insulin regime and your self management ? Although a useful guide the HbA1c is only an indicator of your management as mentioned above, what's really important during your operation and recovery is to maintain good control to limit the risk of infections and any potential complications. Please tell us more about your control ?

 

[homer190376]

Hi, i've always been around the 8-14 in daily tests since diagnosed 18 years ago. I'm on novorapid 3 times a day and take tresiba as long acting. various medication for high blood pressure.

 

[catapillar]

A hba1c of 82 is equivalent to an average blood sugar of 12.6.

The targets for type 1s is to have their blood sugar:

• 5.5-7.5 before breakfast
• 4.5-7.5 before other meals
• 6.5-8.0 before bed

Have you ever been on any structured diabetes education, like a DAFNE course? Have you ever read up on how to manage diabetes, like the book "think like a pancreas"?

How do you decide on your novorapid dose? Do you carb count? Do you ever correct for highs with a bolus?

I don't think it is possible to reduce a hba1c by 16% in 3 weeks because a hba1c measures over a 12 week period, so it will only show 3 weeks at the attempt at reduction and the other 9 weeks will remain the same. Have you been told the operation won't be performed unless you achieve this target? Have you got any support from a diabetic specialist nurse or an endocrinologist?

 

[Juicyj]

Hi @homer190376 Catapillar has mentioned targets above, this is where you need to focus your efforts, forget the HbA1c target for now, with your impending operation you have to think about these targets before meal times as your guide.

If your on novorapid 3 times a day are you doing any correction doses if you test and are running high ? Also are you carb counting ?

Also can you tell us what your operation is for ?

 

[TheBigNewt]

3 weeks ain't enough time.

 

[homer190376]

thank you all for your responses, it been taken on board. I broke my foot in March this year, didn't realise this until April when i saw my diabetic team who immediately decided it was chacot foot, month or so later they ruled that out and said the foot was broken, however was in a boot for 4 months as it just didn't want to heal, in June i was told that it started to heal, only to be told again in July it hadn't and the only option was to operate, it is the navicular bone which is broke and apparently difficult to heal, there idea is to remove the broken bit, replace with donor bone (with my stem cells) patch together with a metal plate. a nerve also runs down the side of this that is also effected, and causing a lot of numbness in my toes. think thats about it, they have estimated a 4-6 month complete recovery. yes have done the DAFNE course, just not that good at it! the pre-assessment team has only said if my sugar level is to high on the day, they may cancel.