98mmol and counting...getting HbA1c under control..Advice?

[BathO]

Hi everyone,

So I have only just joined this community page today and am normally very private about my diabetes control...however I'm struggling and so I'm hoping that others could offer advice as to how they managed to get their HbA1c back under control. My work life has become increasingly more stressful the past while along with moving overseas a few years ago has made things a bit hectic at times. My diabetes has really fallen by the waist side.

I'm only 25 and my HbA1c is 98! If there is any advice from others who have struggled and how they got back on track it would be extremely encouraging to hear from you.

Cheers,

Orla

 

[azure]

Welcome @BathO

Type 1 isn't easy at the best of times, but when you're busy it can be a real,strain living life and keeping the diabetes under control.

I recommend assessing where you're going high and making a plan of action. For example, are you carb counting and adjusting your insulin as you should? Have you done a basal test recently? Have you then checked your meal time ratios? Are you getting spikes - advance bolusing can reduce those enormously.

Don't try to do everything at once. Go slowly and aim to improve things gradually. If you don't already I have it, I recommend the book Think Like A Pancreas, as it's brilliant for Type 1

 

[Juicyj]

Welcome to the forum @BathO

Can you give us an idea of what your daily diabetes routine looks like and what insulins you take ? So include stuff like time tested - result, food eaten and bolus calculation and time basal taken etc.

It's like anything in life really, put in a little bit of effort and you can reap the rewards and i'm sure with a few tweaks you can easily start to make some progress

 

[Nicksu]

Hi everyone,

So I have only just joined this community page today and am normally very private about my diabetes control...however I'm struggling and so I'm hoping that others could offer advice as to how they managed to get their HbA1c back under control. My work life has become increasingly more stressful the past while along with moving overseas a few years ago has made things a bit hectic at times. My diabetes has really fallen by the waist side.

I'm only 25 and my HbA1c is 98! If there is any advice from others who have struggled and how they got back on track it would be extremely encouraging to hear from you.

Cheers,

Orla

Mine was 102 at diagnosis! I know its an old chestnut but can I say exercise? I know its difficult - but it will also help with your stress levels - half an hours walk at the beginning or the end of the day will really make a difference.

 

[Kazza63]

I would also recommend the book Think like a Pancreas it has helped me understand things better

 

[1abRat]

+1 for Think Like a Pancreas

If you can get hold of a Freestyle Libre sensor and have a compatible Android phone you could try out this system for a one-off cost of £50.

Providing you scan at least every 8 hours you'll be able to chart your blood sugars every few minutes for the whole 24 hours for 14 days. This will really help you get an overview of your current control and let you see if you're especially high at certain times of day or if you're swinging from lows to extreme highs.

 

[Scott-C]

Hi, @BathO , remember that old line, "look after the pennies, and the pounds will look after themselves"?

Hba1c is the big picture, the 3 month average, the pounds. I don't think about it all on a daily/weekly/monthly basis. That's because, at the end of the day, I know there's no particular one big thing I can do to produce a good a1c. I can't just snap my fingers.

Instead, I know that that big picture result each checkup will be down to the accumulation of all the little things I've done the last three months. Each one is small, like pennies, but they all add up and hopefully make a good a1c at the end of it without me having had to focus too much on the a1c itself.

Other posters have already mentioned them - getting basal right, carb-counting, ratio adjustment, exercise, pre-bolusing, a small 1 or 2 u correction dose here or nudge up with 5 or 10 gms there.

Sure, I see what you're saying about stress at work, but the plain fact is that while T1s are kind people (as evidenced by people on this site!), each of us does also need to be selfish to a certain extent as a matter of ensuring long term health.

I don't mean selfish in a nasty way: I mean selfish in the sense of making sure we take the time to do the stuff that builds up the little pennies.

I don't expect any allowances to be made for me at work, and nor would I ever use T1D as a get-out or excuse, but if I'm having to deal with a slight hypo, I'm going to tell them to get back to me in twenty. I'm not going to delay going off for lunch if I've pre-bolused for it. I am never shy about testing or injecting where and when I want. Be selfish when you need to be. Make time for yourself to do these things.

I've found the libre to be astonishingly useful. On stressful days, instead of getting a few blood test snapshots, you get to see the whole movie and it just makes it so much easier to make adjustments on the fly, and figure out all that other stuff like ratios, basal etc.

If you just get into the habit of scanning regularly, or more testing, and making adjustments so that you're in range more than you're not, instead of just now and then, hba1c will almost inevitably fall.

Best of luck!

 

[isjoberg]

@BathO taking small steps is a fantastic way to regain control! One thing that really helped me get over continual chaotic control was not setting myself really strict targets (I'd have one good day then a week of rollercoaster bgs) as well as viewing each day by itself. Recording what is happening can seem a little overwhelming but even if you do it for a few days you get to see patterns and figure where to start. I used to get really upset about highs and not really want to test if I knew i was high but by accepting that some times it happens and it's just another thing to learn from really helped me. My control is nowhere near ideal but I have a healthier attitude to how to approach diabetes!

 

[BathO]

Thank you for all your comments and help everyone. They are really great!