A serious Question

[ickihun]

It seems to me that so much hangs on the A1c test results. But maybe that's because I'm having one tomorrow.

Are you expecting it lower?

 

[woodywhippet61]

Are you expecting it lower?

Thank you asking. I've just written and deleted a reply because it was just so whingy whiney. So I've pulled myself together now and YES I am hoping it will be lower.

My bottom line is that I don't want to take meds. The DN has said that I won't be able to manage my type 2 without taking meds and I was sneered at for asking what level I had to get down to in order not to have to take them. I don't want another appointment like that one.

All things being equal my A1c should be lower but as we all know things aren't always equal.

 

[caroline_92]

That is such a bad generalisation for the DN to say you need meds to manage type 2! I am having an on-going bet with my GP to prove him wrong that is also has to be a degenerative condition. If I ate what they told me to eat on diagnosis, it would have got worse no doubt, but adopting the low carb approach has stabilised it for me. Good luck tomorrow

 

[Resurgam]

Thank you asking. I've just written and deleted a reply because it was just so whingy whiney. So I've pulled myself together now and YES I am hoping it will be lower.

My bottom line is that I don't want to take meds. The DN has said that I won't be able to manage my type 2 without taking meds and I was sneered at for asking what level I had to get down to in order not to have to take them. I don't want another appointment like that one.

All things being equal my A1c should be lower but as we all know things aren't always equal.

I have had a lot of sneering from HCPs in the past - it is great to see them baffled.
I just had to stop taking the tablets as I was so bad with them, and have had to justify not taking them - but for diabetes, I just eat low carb and have no symptoms - not that I had anything much amiss before diagnosis, I just feel a lot better now.
I don't see any reason if you are a lucky type two and willing to eat a lot of salads why medication should be required. I mean - what for?
I like to tell doctors about the time there was a big revolt against statins in France, people stopped taking them, and the death rate reduced significantly. If they are being really insistent I enquire how they explain it.

 

[Daphne917]

Good morning after a year of FBG testing every morning and studying the results it appears to me that my FBG results ate not in line with my 4 x 3 monthly HbA1c results and I am contemplating easing up on them(not stopping them),my last HbA1c result was 40/5.8 as I eat exactly the same food all the time with no variation at all I would like some advice from you all,thank you

@wiseowl_123 I don’t bother to test every day anymore. I know what I can eat but test occasionally to check that my reaction to food has stayed the same. However I will start testing regularly soon as I haven’t had an hba1c test for 14 months as there are no DN appts on the horizon. When I tried to make one I was told that there were none before Dec and to ring again in 2-3 weeks when the diaries for next year would be showing on the screen so I will be using my test kit to keep an eye on my BS!

 

[lovinglife]

I very rarely test my fasting bg, only if I feel ropey or a bit off. I'm of the opinion there is nothing I can do about the number so no point in stressing

 

[Grateful]

.... I was sneered at for asking what level I had to get down to in order not to have to take them.

With the caveat that we are all different and that advice could differ from one patient to another: Upon diagnosis my HbA1C was 8.3% (67). My doctor asked me to go on a low-carb diet and increase exercise. He said that if my number did not fall enough after the first few months of diet/exercise, he would put me on meds. His definition was: I needed to achieve HbA1C of 7% (53) or lower.

When it fell to 5.5% two months after diagnosis, he scribbled "Excellent job!" on the test report. Six months after diagnosis it was 4.9% and he scribbled, "Wow!" He has made similarly encouraging comments during our face-to-face consultations. He is not a diabetes specialist, he's just my primary-care physician.

There is no justification for being "sneered at" by a health-care professional. That is outrageous. I was a relatively heavy drinker at the time of diagnosis, and I was open with my doctor about it, and he did not make any judgmental comments although it must sometimes be tempting for doctors to do just that! He just said cutting back would help deal with the T2.

My bottom line is that I don't want to take meds.

I hope you will find some medical professionals who will help you try to achieve that, if at all possible. My thoughts are with you.

 

[Biggles2]

I don't see any reason if you are a lucky type two and willing to eat a lot of salads why medication should be required. I mean - what for?
I like to tell doctors about the time there was a big revolt against statins in France, people stopped taking them, and the death rate reduced significantly. If they are being really insistent I enquire how they explain it.

Interesting point @Resurgam! I did a little research after reading your post and found the following gem published in the World Journal of Cardiology (2105):
Cholesterol confusion and statin controversy
A snippet from the abstract:
“The role of blood cholesterol levels in coronary heart disease (CHD) and the true effect of cholesterol-lowering statin drugs are debatable. In particular, whether statins actually decrease cardiac mortality and increase life expectancy is controversial. Concurrently, the Mediterranean diet model has been shown to prolong life and reduce the risk of diabetes, cancer, and CHD. We herein review current data related to both statins and the Mediterranean diet. We conclude that the expectation that CHD could be prevented or eliminated by simply reducing cholesterol appears unfounded. On the contrary, we should acknowledge the inconsistencies of the cholesterol theory and recognize the proven benefits of a healthy lifestyle incorporating a Mediterranean diet to prevent CHD.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513492/pdf/WJC-7-404.pdf

 

[Hiitsme]

Hi @wiseowl_123
I do still measure fasting bloods but not sure they tell me anything other than warn me when they are high to look for a reason, such as stress illness, bad night's sleep etc. I also try (most days but not always) to test before and after my main meal of the day. I normally test one and a half hours after a meal, If for any reason that is high I then test again at 2 hours. I don't always eat the same things and do feel I need to try some different foods and see what I can manage now. A lot more than at the start of my journey. This is my way of working but it is important that you do what you are comfortable with. You have done really well and made such good progress. My only concern for you is that you wouldn't want to go back into the diabetic levels so at least an occasional test would keep you on track and alert you to take action. All the best whatever you decide.

 

[CherryAA]

Good morning after a year of FBG testing every morning and studying the results it appears to me that my FBG results ate not in line with my 4 x 3 monthly HbA1c results and I am contemplating easing up on them(not stopping them),my last HbA1c result was 40/5.8 as I eat exactly the same food all the time with no variation at all I would like some advice from you all,thank you

Fasting blood sugar, is generally a few points lower than the average for the day which will include the effects of your meals.
In the end I guess one should test what feel sright for you. if you eat same thing every time then why not just test the meals for a couple of days, reassure yourself you are not spiking badly and after that, it jsut keep an eye on the FBG occasionally ?

 

[pollensa]

FBG or any instantaneous reading has absolutely nothing to do with your Hba1c and there is no point getting depressed if they don't line up, they were never meant to.

The Hba1c is often described as an average of blood sugar over the last (up to) three months but even that is not quite true since it measures glycated blood cells. There is a connection between how much sugar is in the blood and how much sticks to a cell but it is not a direct connection.

Also to get a three monthly average using the finger prick method would take an infinite number of tests that carried on day and night for the whole three months. That's never going to happen so you don't have an accurate average to compare with anything.

Finally, instantaneous blood sugar levels and Hba1c are measured on different scales and although there is a conversion chart on this site

http://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

you should treat it as the interesting tool it is rather than an accurate comparison.

How right you are about Hba1C not quite true. The Medicals think its god and gold......but you hit it right on the head infact, as I understand, the red blood cells that the candy sticks to, a diabetic red cells live for aprox 81 days, a non diabetic cells live for as much as 141 days, so what happens, the results can give incorrect reading, as sugar has stayed on the non diabetic cells for LONGER, but that does not mean they have more Sugar, but the A1C test probably will show higher. This indicates that the system of A1C is not accurate and is false to think that everyones blood cells are the same. I dont trust the results of A1C at all for this sole reason. At one state the Who World Health put on their website, they did not recommend the A1C as a reliable marker and also due to variations lab tests. Australia wont cover it under national health, they use it as a tool, alongside first and foremost finger testing.

Mallorca.

 

[Bluetit1802]

I have loads of links to articles about the unreliability of the HbA1c test, in addition to my own very detailed records. Either I have very wonky red blood cells (not shown to be so in my blood tests) or they live a hell of a long time, far longer than the normal average of 120 days. My HbA1c is always at least 4 above where it should be, possibly more. I have given up on my HbA1c results completely. I still go for the tests because I want my other markers.

 

[Oldvatr]

Good morning after a year of FBG testing every morning and studying the results it appears to me that my FBG results ate not in line with my 4 x 3 monthly HbA1c results and I am contemplating easing up on them(not stopping them),my last HbA1c result was 40/5.8 as I eat exactly the same food all the time with no variation at all I would like some advice from you all,thank you

I used to do FBG levels since my GP wanted them, but I soon found that my pre-meal readings gave me a better value and avoided any Dawn Phenomenon effect. My am readings tend to waver all over the place, but my pre-meals in the evening seem quite steady.

I generally only have a 'standard ' breakfast that I repeat, and then an evening meal with no snacking in between.
Result is that I only do 3 readings a day instead of the 4 with FBG, and with 2 meters to feed this reduces the need to change test site so often.

 

[Robbity]

In a nutshell:

I work on the basis that my pre and post meal tests are the most important ones for me as they're the ones that help me manage my diabetes via my diet. I look after them and my fasting /wake up levels have tended to "manage" themselves and follow the other two's downward trends. Eating few enough carbs for long enough has enabled my body to make the appropriate chemical changes to re-learn how to use (stored) fat as fuel as well as any available carbs/glucose. And since we have much greater resources to store fats, this means I can keep going far longer without my liver always needing to keep topping me up with extra glucose every morning.

My HbA1c I only really take heed of as this is the result the doctor or nurse will work with...

@wiseowl_123 I actually eat a lot of different foods at different times and intervals, but I have learned what's OK and what to avoid so I could cut down on my testing. However, it's not only my food that affects me - illness, pain, stress, a bad fall have all upset nice stable levels so most of the time I try to "Keep Calm and Carry On Testing!". And I like the feeling of power it gives me over my diabetes. But as @Bluetit1802 said - if you're not learning anything new from continued testing, there's no real point in continuing if you don't feel the need - instead just do a little "quality control" now and again. It's your diabetes, and it should be your choice whether or when you feel you should be testing.

Robbity

 

[Anthony1738]

My doctor told me that he is not concerned at all with Fasting BG tests, he is more interested in after meal tests and what Ive eaten, and then a 3 monthly Hb1Ac. I think hes using me to write a book about, fasting and low carb diet and excersise plan hehe.

 

[pavlosn]

I completely agree.
I am always concerned to see newcomers and not so newcomers stressing over their FBG. When I was new I joined in the morning fasting thread, but didn't like all the competition going on.(among other trivial things). Newcomers were getting stressed because they weren't seeing numbers as low as other folk. That was in 2014 sometime, and it is still happening. There is far too much emphasis on it. I try to tell new people to forget FBG and concentrate on their pre and post meal levels, and that the pre-evening meal one is the best indication of how they are doing in general.

It is silly for diabetics to compare themselves with others, especially in terms of fasting blood sugars or even Hba1c. We are different, our diabetes may be at different stages, we are different sexes and ages, have different other medical conditions to take into consideration. Finally our lifestyles may be very different, a pensioner, office worker and someone involved in work with intense physical activity have very different lifestyles affecting their diabetes differently.

We should seek inspiration from each other, learn from what has worked for others but cot compete with others

Also because of the dawn phenomenon fbg is the least reliable and representative measure of glucose control.

I post to the thread you are referring to but only to the "with chat" thread and in truth mostly about the chat and comradeship.

Posting just my glucose level or reading just others posts of their glucose levels would not interest me. After all we are more than a medical condition and definetely more than a glucose meter reading.

 

[carty]

My fasting bloods are always about 2 points higher than other tests so I just don't test in the morning !!
CAROL

 

[bulkbiker]

Good morning after a year of FBG testing every morning and studying the results it appears to me that my FBG results ate not in line with my 4 x 3 monthly HbA1c results and I am contemplating easing up on them(not stopping them),my last HbA1c result was 40/5.8 as I eat exactly the same food all the time with no variation at all I would like some advice from you all,thank you

I'm not really clear on what you are asking. Maybe I'm being thick... don't all jump in at once!
Are you asking whether its a good idea to measure FBG, whether you should publish them in your signature, or join in on the FBG threads? I would say yes for testing but just for yourself.. sometimes my FBG is the only thing I remember to test so it's my only reference for the day is part of my getting up routine. It's also nice to see it reducing over time (although it took my body ages to do that).

 

[Biggles2]

The DN has said that I won't be able to manage my type 2 without taking meds and I was sneered at for asking what level I had to get down to in order not to have to take them. I don't want another appointment like that one.

Well, she is wrong. Many of us are successfully managing our Type 2 without medications!

What really upsets me about your experience, is the lack of support from your DN and the way she made you feel as someone who is trying to be proactive about your health. Full disclosure: I am a nurse, and it saddens me to hear of experiences like yours! The nursing profession exists for the sole purpose of helping people manage their health conditions. @woodywhippet61, if I were your DN I would do a happy dance if you were my patient! Proactive individuals like you make it all worthwhile in my book!

 

[KathyCP]

Personally, I worry about my bs spikes and hardly ever measure fasting levels. And my HbA1c has been 37/38 for 6 years now, down from 63 when diagnosed...

How often and when after eating do you measure your bs spikes?