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4.4 hb1ac

Discussion in 'Type 1 Diabetes' started by Curleous, Apr 7, 2010.

  1. Curleous

    Curleous · Well-Known Member

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    hi all

    last hb1ac in today and 4.4 ?

    what should i be doing now.?

    Cheers
    Curleous
     
  2. cugila

    cugila · Master

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    Celebrating I should think..........well done !!! :D :D :D

    Ken
     
  3. Dillinger

    Dillinger Type 1 · Well-Known Member

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    You should be dancing!

    Excellent result!!
     
  4. timo2

    timo2 · Well-Known Member

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    I believe that it's customary on such occasions to run around shouting, "And that, ladies and gentlemen, is how we do that!"

    Very well done, Curleous.
     
  5. hanadr

    hanadr · Expert

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    "Perfick!"
    Hana
     
  6. noblehead

    noblehead Type 1 · Guru
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    Could you not have done better than 4.4?.................................................... :lol:

    Very well done Curleous! :D

    Nigel
     
  7. Curleous

    Curleous · Well-Known Member

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    Thanks all but am concerned that this too low as in my post with changing from lantus and not feeling brill..

    Thanks again.

    Cheers

    Curleous
     
  8. phoenix

    phoenix Type 1 · Expert

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    Ok Curleous, I wrote a reply then cut it because I didn't want to appear a killjoy
    However I did save it!

    Sorry, amongst all the jubilation I'll add a note of caution.
    You did ask what to do!
    Did you expect it? You put a question mark, so I'm not sure.
    If you did expect it go to the bottom of the post
    Quite coincidently the equivalent of 4.4 % Hb A1C is 4.4 mmol/l estimated average blood glucose.
    I'd be looking to see if this truly reflected my smg levels, If it was a long way from my average I'd begin to wonder why. (several posssible reasons )

    If my average really was near to 4.4mmol. I would be taking a close look at the range of my readings. Was it from 4mmol- 4,8mmol ; if so fine.... or was it wider ie the higher levels were balanced by levels below 4mmol.

    My personal experience of having an HbA1c (higher than yours) of 4.9% with an eAG of 5.2mmol was that I was losing my hypo symptoms. Running a bit higher now means I have them back in the 3s.

    If all is well then join the dance!
     
  9. Curleous

    Curleous · Well-Known Member

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    Hi there

    yes that is what i am concerner about..my guess is that if it is 4.4 then half the time it is going to be under 4.4 which meand a good amount of time it will be sub 4 . I on average get a reading of sub 4 once or twice a week but very rarely experience a reading of over 8.I have experineced a reading of 3.4 and 3.2 with very little or no warning but most of the time i do feel flaky when getting low. Is it usual to do this as some days i fell hypo and test and find level about 6... i have also reduced lantus from 17 to 14 over the last few weeks and will be reducing to 12 over the next few days. I have increased exercise as now swimming a lot more. My lantus dose does not seem to make any diiference to my morning readings. I could take 18 units tonight and will still wake up at about 6.5 to 7 or i could take 14 and still be the same..
    Its a funny old game this diabetes

    thanks
    Curleous
     
  10. noblehead

    noblehead Type 1 · Guru
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    Curleous, provided that you are quite sure that you are not going hypo on a regular bases, 4.4 is a excellent result. I know some consultants may frown on such a low hba1c, as they will believe that you are having hypo's without realising it, but if you test regulary and are sure this isn't the case, then all is well. As I said in my other post to you, best to see your gp if you are feeling unwell, some things are not always diabetes related.

    Nigel
     
  11. Debloubed

    Debloubed Type 1 · Well-Known Member

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    Are you sure your unwell feelings are not hypo feelings? Hypo's come in many different guises and sometimes, it's hard to recognise them.....like you say, it's a funny old game......but congrats all the same, not going over 8 is an achievement in itself when you are type 1 :D :wink:
     
  12. lilibet

    lilibet · Well-Known Member

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    Firstly , well done. :mrgreen:

    To echo the others though - my last one was at 5.5 which I was v suprised at as I didnt think meter averages were that good, and had some hellish numbers for no reason in there, so was pleasantly surprised

    However, am now going to start testing during the night as Endo thinks nocturnal hypos are a prob. Now I dont, but am going to check anyway cause I dont want to be having them if they are, and want my hard work bloody well recognised!!.

    Still to get the hba1c, I do reckon you need to be extraordinarily well controlled or sailing close to the wind but to be fair maybe insulin just works well on you and stops spikes above 8.
    d Couple with your own physiology (ie not being a high 'glycator') and a bit of honeymoon period, and maybe you just manage it therein. I did read some blood probs like haemolytic anemia can cause low hba1c but presumably there would be other symptoms picked up by medics.

    Still worth checking at random times for hypos.

    Or maybe just order a big pizza cause If my insulin worked that well (or my pancreas which is clearly DEPLETE of anything) Id chance it. As it is, bit of ryvita will have me taking sumo wrestler sized ratios!!
     
  13. bohemianbri

    bohemianbri · Member

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    I was diagnosed Type I about 16 months ago, aged 56. I control with novomix30. At my first review my Hb1AC was 5.3. I had been very strict with my diet (less so with drinking habits but avoiding sugar) and monitored blood sugar at least twice a day. I used the one touch software to analyse my results and trends over 3 months and they were pretty much in-line with the Hb1AC result. I would recommend using this software to anyone that doesn't...

    ...now to my point. My consultant was of the opinion that that result was a liitle low. Her advice, "Less than 5, don't drive". She advised me to be a little less stringent in my diet control and aim to be around 6.0.

    Hope this is not too confusing or contradictory.
     
  14. cugila

    cugila · Master

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    Well, I am a bit confused here.......is your Consultant really telling you that you shouldn't drive if your HbA1c is less than 5% ??? Seems an odd thing to say to me. That figure is an average over 3 months and is not really relevant to daily numbers. So in effect you would have to wait another 3 months perhaps until the HbA1c went higher before you could drive again ?? Very strange.

    Is the Law in your State something to do with this......as this is a UK site things may be totally different where you are. We certainly don't have a rule like that.

    If the comment had been about being less than 5 mmol/l when your Bg level was checked during normal testing then I could go along with that.......anything less than 4 mmol/l is considered hypo territory, not recommended. I know you use mg/dl where you are which would be less than 72 mg/dl.

    Ken
     
  15. bohemianbri

    bohemianbri · Member

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    Hi Ken,

    You're correct, she was suggesting that a meter reading of <5 mmol/lt was getting into the caution levels for driving etc. Her reasoning was that under stress your bg level can fall and before a disabling hypo occurs concentration, awareness, judgement and decision making can be impaired. Her analysis was, based on the graphical results and trends that i provided (coutesy of the aforementioned one touch software), that my Hb1AC 3 monthly average indicated that i might well be below 5mmol/lt much of the time. BTW the software recorded 223 readings with one potential hypo (<3.5) average bg 6.0 standard deviation 1.4

    There is no law regarding Bg level and driving in the UK but there are laws regarding diasbling hypos, deteriorating hypo awareness etc. You should be able to google them if you so desire.

    Her advice may have been specific to me and not generic. I use novomix30 twice daily in small dosage. 20 + 16. She observed that i seemed to have a very efficient insulin usage characteristic.

    Guess the best bet is always to ask your diabetes consultant / specialist for specific advice but beware of generic advice; ther is no one condition that defines diabetes.
     
  16. CarbsRok

    CarbsRok Type 1 · Well-Known Member

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  17. bohemianbri

    bohemianbri · Member

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    Further to my last comment i just looked up what this web site says about Hb1AC...

    How does HBA1c return an accurate average measurement?
    Due to the fact that red blood cells survive for 8-12 weeks before renewal, by measuring HbA1c an average blood glucose reading can be returned. For non-diabetics, the usual reading is 3.5-5.5%. For people with diabetes, an HbA1c level of 6.5% is considered good control, although some prefer numbers closer to non-diabetic.

    Maybe the consultants advice of 6.0% was a good compromise between the normal upper limit for non diabetics and the "considered good control" value for diabetics?
     
  18. cugila

    cugila · Master

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    Not sure where that information has come from ? Do you have a link to it ?

    I have again checked the latest Feb 2010 DVLA Medical standards guide for Practitioners and Motorists. This is the current information which also incorporates the March 2010 amendments here:

    HYPOGLYCAEMIA
    The risk of hypoglycaemia (low blood sugar) is the main hazard to safe driving and can occur with diabetes treated with insulin or tablets or both. This may endanger your own life as well as that of other road users. Many of the accidents caused by hypoglycaemia are because drivers continue to drive even though they are experiencing warning signs of hypoglycaemia. If you experience warning signs of hypoglycaemia while driving you must always stop as soon as safely possible – do not ignore the warning signs.

    Then this:
    Drivers with insulin treated diabetes are advised to take the following precautions:
    • Do not drive if you feel hypoglycaemic or if your blood glucose is less than 4.0 mmol/l.
    • If hypoglycaemia develops while driving stop the vehicle as soon as possible in a safe location, switch off the engine, remove the keys from the ignition and move from the drivers seat.
    • Do not resume driving until 45 minutes after blood glucose has returned to normal. It takes up to 45 minutes for the brain to fully recover.
    • Always keep an emergency supply of fast-acting carbohydrate such as glucose tablets or sweets within easy reach in the vehicle.
    • Carry your glucose meter and blood glucose strips with you. Check blood glucose before driving (even on short journeys) and test regularly (every 2 hours) on long journeys. If blood glucose is 5.0mmol/l or less, take a snack before driving.• Carry personal identification indicating that you have diabetes in case of injury in a road traffic accident.
    • Particular care should be taken during changes of insulin regimens, changes of lifestyle, exercise, travel and pregnancy.
    • Take regular meals, snacks and rest periods on long journeys. Always avoid alcohol.


    Some of the information on the YouGov website is inaccurate and you should always check the DVLA site as the information sometimes changes frequently. This is the current rules in the UK.

    Ken
     
  19. cugila

    cugila · Master

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    Hi Brian.
    Thanks for the response. :D As for Google.....nah. I prefer to use the DVLA site for this sort of information. That, and my own experience.

    Whilst there is no specific Law relating to Bg levels and Driving there are the Guidelines which are quoted in my post above and also on the DVLA website. There is also the information regarding disabling hypo's and hypo awareness, again no specific Laws, just guidelines which have to be adhered to.

    If there were to be an Accident and the guidelines had not been adhered to then that would be grounds for a Prosecution for Driving without Due Care/Careless Driving etc. An Offence punishable with a hefty fine/Licence ban and or imprisonment.

    I have in the past prosecuted drivers for such offences and they were dealt with quite severely.

    Ken
     
  20. noblehead

    noblehead Type 1 · Guru
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    Some great and useful information going on here!

    From a personal perspective, I always ensure that my bg is around 5.5 or above before driving a car, as a type 1, I am all to aware how bg levels can change in a very short period of time. I make sure that I test before, less than 1 hour after into my journey, and every hour until I reach my destination. As I value my own life and those around me, I would not drive unless I was 100% confident that I was safe to do so.

    Nigel
     
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