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5% CLUB

My hospital consultant was very clear that he would only advise DVLA to remove someone's licence based on two actual severe hypos (or one behind the wheel). Or actual hypo unawareness. Not on any prospective basis or risk basis that the person might have severe hypos or might develop hypo unawareness. He also made it clear he wasn't in the business of providing the DVLA with any information other than his own medical view on whether the patient was safe to drive.

If you are worried that your consultant or GP will not take the same strict view with DVLA, see if my hospital will do the report for you.

If you actually have severe hypos or actually lose hypo awareness then that's a different matter. But there is no need to lose your licence over "risk of" those things based on a generalisation about HBa1c - however accurate that generalisation might be about the overall insulin using diabetic population.

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I'm very happy keeping a Hba1c in the 5's, if I was to do a cut with very little carbs I'm sure I could hit a Hba1c in the 4's. That being said I have a very well controlled and regimented diet and blood sugars that very rarely fluctuate. The difference between levels in the low 4's and high 3's are night and day for me when it comes to hypo awareness, though obviously I can't say the same for other people.

It worries me a little to see people have such a negative disposition toward Hba1c but in the end you have to do all your own research and education and come up with what works for you and not worry about others.
 
Thundercat said:
I really detest the word normal. Doctors seem to love it..
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Except when it comes to what used to be called "educationally sub-normal", when they tie themselves in knots trying to avoid the word "normal" by substituting "typically developing", "mainstream", "less cognitively challenged" and such euphemisms. I really don't like euphemisms.

I'm not a T1 because my insulin failure is inborn, not auto-immune, and has been slowly deteriorating since birth rather than being lost all at once. But I'm with @James12 in aiming for what Dr Bernstein defines as "normal" blood sugar. My latest Hb1Ac was 5.2 (I think: 33 in new money), and I aim for 4.6.

I don't know what I'll do about driving when I have to go back on insulin (low carbing enabled me to come off it, but the point will come when my insulin production drops too low). Just keep my fingers crossed I have a sensible doctor such as @Spiker's, I suppose. Putting into my system the carbs that I know used to damage it is not an option.

Kate
 
Hi there 5% club, just curious... Are you all pumping or do you achieve this with MDI?

I have to say I have no idea how you do it! I low carb (<50g per day), I test before each meal, 2 hours after each meal, before bed and at 3am every morning. I swim 3 times a week and walk 3 times a week, I'm on MDI and wondering whether a pump would help me get it lower. I'd like to be around 6%

My A1c is 7.0 now :( Not that it's really terrible, but my God, how much effort do you have to put in to get in the 5% club?!
 
James12 said:
I don't believe there are any studies on diabetic patients who have near perfect control over their blood sugars (because theres not enough of us). I would say its dangerous if you are unskilled at maintaining normal blood sugars. Blood sugar normalisation takes a lot of work but when done properly its very safe.
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James, if you read my post you'd notice that it was a warning against losing hypo awareness. It isn't dangerous to have abnormal sugar levels. As mentioned in my original post, an HbA1c of around 6.5% means your risk of complications is at unity with the non diabetic population. With an Hba1c of 6.5%, your BGs are abnormal, compared to a non diabetic. It's dangerous to have an HbA1c higher than around 6.5%.

Many people report a loss of hypo symptoms when they run their BGs in the 4s for an extended period, which is what you will need to do to achieve an HbA1c so low. You are free to flippantly ignore this advice, but to assert that it isn't dangerous to potentially lose your hypo awareness, is incorrect.
 
petsnponies said:
Hi there 5% club, just curious... Are you all pumping or do you achieve this with MDI?

I have to say I have no idea how you do it! I low carb (<50g per day), I test before each meal, 2 hours after each meal, before bed and at 3am every morning. I swim 3 times a week and walk 3 times a week, I'm on MDI and wondering whether a pump would help me get it lower. I'd like to be around 6%

My A1c is 7.0 now :( Not that it's really terrible, but my God, how much effort do you have to put in to get in the 5% club?!
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Hi - I'm only just in the 5% club I suppose (at 5.9) but I'm on MDI and I low carb <30g/day. I don't find it too difficult to keep levels down now - I've been low carbing since September last year. Took a little while to work out how much bolus to take for meals but I think I have it sussed now.
 
SamJB said:
James,
Studies have shown that the frequency of complications approaches unity with the non-diabetic population at an HbA1c of around 6.5%. Look up the DCCT trial. Another study has shown that Type 1 diabetics with an HbA1c < 6% have a higher mortality rate.

I'd argue that its dangerous to aim for an HbA1c in the 4s as you will likely lose your hypo symptoms. It only takes a single hypo to kill you.
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I'm on insulin and my last two A1Cs were 4.9. I test all the time and on 3units Humolog( 75/25 ) in the morning and 0 to 3 in the evening. I exercise - running and weights.

I purposely tend to run a higher fasting BG level, but really control my post meal spikes. When I first was diagnosed I was A1C of 13.6 and looking back I was sick for years. My initial insulin was about 37units and antibodies for both type 1 and type 2. Obviously, I was insulin resistant. Now if I suspend all insulin and exercise - keeping with the diet my BG creeps back up relentlessly.

I had issues with my eyes, burning numb feet, unable to stand quickly without fainting and both classic hip and back pain that was worse in the evenings. These after almost a year have surprisingly cleared up - I'm lucky I know especially no kidney damage

As for the hypos, it is tricky. The better physical shape and stronger core muscles I have the less severity of the hypos or so it seems.

I've not had a terrible hypo on this insulin that I am aware of. I do get classic symptoms sweating on the back of the neck and shoulders but BG I usually in the 90s, I just eat some raisins or glucose tabs.

The more seriousness or low hypos are that when running my thigh muscles feel wobbly and if I am out and about I can become overly irritated with people. These are rare, and occur if I've missed a meal and are corrected with raisins or glucose.

As for the studies Jenny Rhu has looked at many and disagrees with the methodology and conclusions http://www.bloodsugar101.com ( sorry a framed site so can't give you the exact URL ). These studies are older as are here reviews 2006 to 2008. But are pertinent as my GP is always quoting them.

I of course am biased and I think very highly of Dr. Bernstein and his book 'The Diabetic Solution' which I thought at first was rubbish.

I also, believe one strong therapeutic measure that is not used and that is pushing I self with high intensity exercise - based upon ones fitness level.

There was a study of older patients with heart failure and one group did high intensity exercise vs the other which did normal physical therapy - when the study ended the HIE group had increased their oxygen uptake by 26% which dramatically enhanced their lives.

Dr. Bernstein believes this too, and he writes that he believes that doing high intensity exercise for over 30-minutes pushing one above their theoretical max heart rate is an important factor in controlling heart disease. He goes as far as increasing patients max heart rates as slow as 1-extra beat a month until reaching their goal.


Sent from Runner2009 Burt
 
petsnponies said:
Hi there 5% club, just curious... Are you all pumping or do you achieve this with MDI?

I have to say I have no idea how you do it! I low carb (<50g per day), I test before each meal, 2 hours after each meal, before bed and at 3am every morning. I swim 3 times a week and walk 3 times a week, I'm on MDI and wondering whether a pump would help me get it lower. I'd like to be around 6%

My A1c is 7.0 now :( Not that it's really terrible, but my God, how much effort do you have to put in to get in the 5% club?!
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I would say normalising blood sugars requires a considerable amount of effort to begin with, but think of it like riding a bike; once you know how to, you never forget and it becomes almost second nature. You will need to read:

1. Dr Bernstein's Diabetes Solution: A Complete Guide To Achieving Normal Blood Sugars, 4th Edition by Dr Richard K. Bernstein

2. Gary Scheiner - Think Like a Pancreas, 2nd edition

Interestingly, Dr. Bernstein advises against the use of a pump.
 
Hey guys, just got my Hba1c done yesterday and it came back with a 5.0 which is a 0.1% "improvement" over my last result from August last year. However last year I achieved my Hba1c with low carb 50-100g a day and my sugars literally never deviated from 4-5.9mmol. This year I've been eating around 200g of carbs a day and I'm afraid my Hba1c has been a result of many lows and highs.

So my question is: Is there anyone here who has achieved a 5% Hba1c on high carb without fluctuating blood sugars and lows?
 
Omar101 said:
Hey guys, just got my Hba1c done yesterday and it came back with a 5.0 which is a 0.1% "improvement" over my last result from August last year. However last year I achieved my Hba1c with low carb 50-100g a day and my sugars literally never deviated from 4-5.9mmol. This year I've been eating around 200g of carbs a day and I'm afraid my Hba1c has been a result of many lows and highs.

So my question is: Is there anyone here who has achieved a 5% Hba1c on high carb without fluctuating blood sugars and lows?
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I'm on 75/25 Humolog insulin and my last two H1acs have been 4.9. I am on an extremely low carb diet basically 2-servings of carbs a meal. These carbs are 95% leafy, stalky vegetables, no legumes except for edamame or soybeans. Major calories come from nuts and olives fish cream and a little meats No breads, cereals, grains, pastas or sweet fruits except for a few berries avacados, eggplants and cucumbers.

If I eat any refined carbs or raisins, or lentils or grains my BG starts to sky to raise amazingly quickly. I would not be able to be this low without lots of exercise, insulin and basically no carbs. I've turned into a Dr. Bernstein


Sent from Runner2009 Burt
 
Spiker said:
Both of you are amazing. :-)

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Thx you Spiker. It is not amazing its cheating lol.

That is why when people say 'oh you have great control over your sugars when will you be off insulin?' I want to tell them you have no idea what that means.

I'm constantly focused on it. Lucky my gf is a physician otherwise I'd be by myself.

I did what you said you were doing, out of Hospital I took 6-months to focus on gaining my health back.

Little by little I became a Dr. Bernstein clone. I read as much as I could and tested and tested until I found what works for me. Plus I started running and lifting again ( not at first ).

I'm motivated by wanting to live a long life free as can be of diabetic complications.

I think of myself as an alcoholic but with carbs and it is one day at a time.

Its not easy, but it is worth it.

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Omar101 said:
I usually don't need as much as many others on the forum, In a day I'll have 15 Novo and 18 Levemir. Though I did need a bit more until I cleaned up my diet.


Aw shucks spiker thanks .:p
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I don't get when people say they have fixed amount of fast acting insulin per a day because almost everything we eat is going to raise our blood sugars (even fats and proteins) and then theres correction doses. Sleep patterns, physical activity, weight, % body fat, age etc. change our insulin to carb ratio and long acting insulin requirements. Its a constant balancing act

200g carbs sounds like it would require 'industrial' amounts of insulin so I'm not suprised your experiencing swings. I think if your looking to gain weight its a necessary evil but if your careful with insulin timing/dosage you can minimise risks of hypo or hyper.

I think someone needs start a Read Dr. Bernstein campaign on this website.
 
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