Hospital review today

[grant32]

12 months ago HbA1c was 9.1, today it was 7.1. I saw the diabetologist at hospital today who recommended not aiming for anything below that due to risk of too many hypos. I'm still determined to get it lower through more intensive monitoring, slowly reducing my carb intake, and increasing my exercise time. She seemed to think I had excellent control and didn't need to do anything else. When I asked about low carb diets, she said definitely not. I asked about exercise and was told not to do anything too strenuous, nothing more than walking!! That I find rather odd advice. 'm happy to research and make my own decisions, especially with the wealth of information on this forum. Apparently I was the most educated patient she had seen in weeks.

 

[charon]

Did she say why she recommended against them?


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[grant32]

Only that it would result in too many hypos.


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[grant32]

I so asked about cgm (I would self fund). She said only useful if you have poor control. Sigh.


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[Shell1]

My 9 year old hbca1 first result was 6.9 they said anything under 7 is brill a non diabetic should be 5 and diabetics anything from 6 to 7 is excellent? Also were on list for CGM machine but they only borrow them you for 6days it takes your bloods up to 300 times a day and then they give you your data even if you have good blood sugar levels it can only be of use to help you understand your diabetes better i would push to just hire it for the week to see if it does help you.low carbing they said is only if your sugars are not well controlled but exercise helps you use your insulin more efficiently ,not sure what she ment but exercise lowers Chloe's blood if she high and its good for everyone x


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[ElyDave]

your diabetologist seems pretty much out of step with current good practice and recommendations. Exercise is recommended for both T1 adn T2 unless there are underlying additional risk factors or diabetic complications, where it may be either contra-indicated or recommended under close supervision.

My diabetologist and specialist nurse/dietician have just supported me in an attempted ultramarathon and are working with me to help me maintain my previous levels of exercise. It's all a matter of working out a strategy to support your activity, manage your insulin in my case and understand exactly how the exercise affects your condition.

I've given a fairly detailed account of my most recent learnings in my blog. Please take a look adn if you have any questions I'd be happy to give you my personal take on it.

When I'm back home I can also give you a couple of helpful references.

 

[grant32]

Another disappointing consultation today. HbA1c 7.0% down from 7.1. I said my target was 6.5 and was strongly advised against it. I was told that the lower the HbA1c I achieve, the more likelihood that my hypo-awareness would diminish. I challenged this for a while but in the end I just accepted that it was a one-size-fits-all approach and just nodded and agreed. Seems everyone I see can't give decent responses to advice that I challenge.

 

[noblehead]

An Hba1c of 7 is still pretty good and is a small reduction on the last time, HCP's do stress about us losing our hypo awareness symptoms with lower levels and I do understand their concerns, but provided you keep the hypo's to a minimum when lowering your levels further it should be impossible to hit the 6.5 target without losing your awareness.