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98mmol and counting...getting HbA1c under control..Advice?
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<blockquote data-quote="Scott-C" data-source="post: 1408254" data-attributes="member: 374531"><p>Hi, [USER=385428]@BathO[/USER] , remember that old line, "look after the pennies, and the pounds will look after themselves"? </p><p></p><p>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.</p><p></p><p>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.</p><p></p><p> 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. </p><p></p><p>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.</p><p></p><p> 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.</p><p></p><p> 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. </p><p></p><p>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. </p><p></p><p>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.</p><p></p><p>Best of luck!</p></blockquote><p></p>
[QUOTE="Scott-C, post: 1408254, member: 374531"] Hi, [USER=385428]@BathO[/USER] , 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! [/QUOTE]
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