Better control but higher HBA1C

Ouch. What a nightmare choice to have to make? It would be an easy one if your hypo warnings had not returned, but since they have and I know you've posted problems with unawareness before, you have to weigh up the pros and cons of each scenario, and only you can do this. Part of it will depend on what your control has been like since diagnosis, do you have any other complications, or first indications of same?

It MIGHT be worth running a higher HbA1c level to keep hypo awareness, but only you can make this decision. How you arrive at your HbA1c level is probably significant too, is it composed of a narrow band of bg control or are there more extremes - some studies suggest that it is the extreme peaks and troughs of blood glucose control that actually do more damage.

EDIT: Just thought of something else, you could try a different insulin and see if you can retain hypo symptoms AND achieve better HbA1c? Works for some, and I've recently done this to try and get some awareness back...?

Good advice from Keg.

What you also need to remember is that HbA1c is an indicator of the previous trends for the last three months. Not an indicator of what is happening now. Maybe you shouldn't 'beat yourself up' over this, see what the NEXT one says in another 3 months time.

If you are now well controlled and have got that awareness back I am sure the next result will be much better. Everything will take a little time to filter through.

Ken

Hi,

I thought I would add my two pennies worth to your post........

Since very recently, seeing my consultant regarding my problems with losing my awareness, I showed him a whole years worth of BG data for the year of 2008.

He immediatley ssaid that I had lost my awareness BUT stated it wasnot my fault.

He went by saying, some health care nurses & consultants try to aim for the NHS HBA1C blood test readings, which is/was 5%, & he has seen my case scenario in so many T1 Diabetics.

He mentions the continous whipsawing of going low & then high, then stabilising at my target range, then only to drop into the hypo zone. Alot of my reading were in the right zone.
My average readings for the whole of the years was 7.2 mmol/l!
He stated by going by this 5% target, I am running right on the border line of hypos all the time.
I did express my concerns to him that I had mentioned this to my previous consultant/nurses (when i was living in London), but all they suggested was adjust my dosage & have more snacks. Well regarding the snacks, I was eating like a horse & was reducing my dosages as well.

Now that I am on Animal insulin, my BG is better, more constant but as I am under alot of stress at the mo, it is quite hard to control.
From this, he has sdvised me to run my Blood sugars high & aim for a HBA1C reading of around 8 to 9% for 6 months or so, till my domestic issues improve & gain better control & hopefully get my awareness back!

I hope this helps.

Steve