3rd three month / Hba1c reading of 53 mmol.

banjobongo said:

hi guys.
I recently had my 3rd three month / Hba1c reading , which was 53 mmol.
(I was diagnosed with Type 1 diabetes last June 2016 as a 53 year old man)
The consultant thinks that 53 is a good reading and says its my target, and that he thinks Im coming to the end of a “honeymoon” period as my levels of insulin I injected are gradually increasing.
So my consultant/specialist is happy with my progress, but Im a bit dissapointed with my 3 month reading of 53 mmol, as my previous reading was 49 mmol, in April 2017, so to me it looks like Im getting worse....am I being unrealistic in my reaction?

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53mmol/mol is a good HbA1c, you should be pleased as many T1's will simply never see a value that low.

If you are coming to the end of your honeymoon period as your doctor suggested, then your doses and ratios may well be up in the air. So to only have a 4mmol/mol increase is very impressive, given the variability and unpredictability of a honeymooning T1's BGL's and insulin requirements/production. And not forgetting potential error margins from the actual HbA1c blood test.

See your latest result of 53mmol/mol as a positive thing, and aim to improve on it. We can ALL improve on our numbers - no-one is exempt from that. Don't beat yourself up just because you're numbers aren't super low; they are good and you're only a year in! You have already demonstrated an element of control that most T1's will never see.

Although these figures are specific to Scotland and outdated - they will give you an idea of how well you've done in having an HbA1c of 53mmol/mol

https://www.diabetes.org.uk/In_Your_Area/Scotland/Diabetes_in_your_area_Scotland/Grampian/

Very similar to me. I was diagnosed at 54 just over 3 years ago. My results in Nov 49mmol/mol and In May 53mmol/mol. I too was having a lot more bolus. Interspersed with this were periods of lows as my pancreas kept throwing out insulin. Changing my basal to accommodate this is an ongoing nightmare. My honeymoon period is quite frankly going on far too long and becoming a pain. I wish my pancreas would just put up a white flag.
I too was disappointed and beating myself up, but the specialist said I was still doing very well and as I had come to diabetes later in life the outcomes for me would be more positive.
Keep plugging away and good luck with your next result.

Diabetes is a work in progress; and all of our results will fluctuate. However, I very much agree with @GrantGam's point about us all trying to improve our levels.

It's very difficult to get a clear causative view on what is causing blood sugar fluctuations as there are so many plates in the air (hopefully not eatwell plates though...) but if you keep your eye on it and keep making small changes that improve your control you can do really well.

It's hard but always try and cut yourself some slack in this; it's a tricky bloody disease and perfection is not the approach to take but rather aim at constant gentle improvement.

My go to control strategies would be eating to your meter (i.e. don't eat stuff that spikes you) and carefully monitor your bloods so if possible get a Freestyle Libre to understand what your bloods are doing continuously over the course of a couple of weeks. The information is incredibly useful unfortunately the cost of the kit (which isn't available on the NHS) is high.

https://www.freestylelibre.co.uk/libre/

This is a really good resource; Blood Sugars 101 http://www.phlaunt.com/diabetes/

To understand the targets we are set this is information on the trial (the Diabeties Control & Complications Trial) that informs those targets https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000390

Essentially, the closer to non-diabetic blood levels we can get the better. Although mileages will vary; some people seem to handle higher levels very well for a long time.

Best

Dillinger