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Complications Range

A

azizdhl

Well-Known Member
Messages
64
Hi guys ..
I was so obsessed with my BG range, I was told that anything more than 140 would cause me many complications in along terms


1. Is there any way to prevent all the complications like any normal person?
2. What is the range that I must flow in order to not have any complications?
3. Is it possible to be within 80-140 all the time all that's just a fantasy?
 
Diabeticretinopathy.org.uk quote "As each percentage point (10mmol/l) of HbA1c translates into a massive 37% difference in progression rate", so in this case at least, any improvement will help. This site has guidance on blood sugar levels recommended by NICE for type 1 and 2, and see also "Lower HbA1c linked with dramatically reduced risk of diabetes complications". You don't say if you are a type 1 or 2 diabetic, but for type 2, with a good diet, the NICE guidelines should be achievable by most of us and some of us are more ambitious, keeping as close to the normal range for non-diabetics as possible. The evidence suggests that any reduction in blood sugar by people with diabetes will help them, especially long-term, so don't give up if you can't reach the ideal.
 
So I think you can definitely be in range most of the time as a type 2 but the research suggests that there is a big difference between having blood sugars in range because you are taking many medications has a very different health outcome from having blood sugars in range because you are following the right diet and exercise pattern to achieve that! Jason Fung's book The Diabetes Code explains all of that very clearly based on the research quoted above.
As a type 1 having to control my insulin, glucagon and food mechanically, I do feel I am being sold a line when told that I can achieve normal blood sugars! As a type 2 though is possible to take your body back to a metabolic state where you can as you'll see from all the Success stories posted here.
 

1. We don't know for certain, remember that non-diabetics can also have heart attacks, strokes, eye problems, etc.
2. The recommended levels in the UK are here, but again it will be no 100% guarantee that you will have no complications
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
3. 80-140 mg/dL is 4.4-7.8 mmol/L
https://www.diabetes.co.uk/blood-sugar-converter.html

That is a very tight range. Remember non-diabetics will also go above and below that range often.

I would say it is certainly possible for a T1 to achieve that range, but it depends how much time, effort and limitation (in terms of diet and lifestyle) you are willing to put into it. You'd have to be very, very committed, and very likely on a very low carb diet.

I reckon I am in that range 85-90% of the time. But to get towards 100% (actually 100% may never be possible due to illness, etc and the sometimes randomness of T1!), so say 95% I would have to put in even more effort in my management of T1, go low carb, etc.

For the small gain in extra time in that range, the extra effort / limitation I would not feel is worth it, for me.
 

For your question 1, if you can keep non-diabetic bs level, you don't have to worry about complications. I believe it's possible to maintain non -diabetic bs level by adopting a low carb diet.
 

I agree it is a very tight range. I wear a Libre off and on and keeping it in that range is interesting. You can be doing so well, then something happens- illnesss/Adrenalin/DP/weather. For those who are Type 1 it is practically impossible to stay in that range 100% of the time. You just need to accept it, treat and move on. Tomorrow is another day!
 
It’s hard work to stay in a healthy range, but I don’t feel that’s a reason not to try. I feel I deserve non-diabetic levels.

Some days I can achieve my 3.8-7mmol (68-126mg/dl) range 100% - some days, like yesterday, when I was at a wedding it was just 50%! Today hasn’t been spectacular either. Most non-wedding (!) days I’m over 90% within my target zone.

My record has been a solid 78 hours in the green; just over three days. That got ruined by a night out
 

Just curious, do you have any problems with hypo unawareness when you keep your bgs so low? I have issues once my hba1c goes below about 6.9, so would have to move to an alarmed cgm to make it work for me. (Which probably means a dexcom, since libre no longer works for me.)
 
Not really, I still get most of the symptoms with one notable exception. Because I eat a ketgenic diet, and my brain now runs on ketones instead of glucose, I don’t get the panic and loss of control that I used to experience, ecause although my body’s glucose level is lower than it should be, my brain isn’t starving. So I can still think very clearly, work out how many dextrose tabs to take to get me back to my target level of 5, and not feel the need to eat the kitchen. I still get the tingly lips, sweats, slurry speech and shakes if I drop below 3, because that’s a physiological response, but that doesn’t happen often because my diet means very small amounts of bolus insulin. I’ve done a fair bit of testing to get my basal rate right, and it’ll keep me flat level at around 5 all day, even if I’m busy and fasting. I hope that makes sense!

I mainly only have hypos if I’m drinking, and the day after (like yesterday ).
 
Last edited:
Mel dCP said:
My record has been a solid 78 hours in the green; just over three days. That got ruined by a night out
Click to expand...
Haha, it's you who commented on my facebook message! I made it to 62 hours with the range set between 3.9 and 7. Dipped to 3.6 yesterday. But I'll try again and my new goal is 79 hours of course

(sorry for going off-topic)

edit: And now I have been lurking too, of course, and I absolutely love you photographs!
 
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Game on! I sent you a friend request on fb, hope you don’t mind x
 
80-140....... WISH! LOL! No, I don't think you can stay in that very tight range forever. Today, I went up above 300 b/c I got distracted. What I've been told is that you can avoid complications by staying under an A1C of 7, which is 152. Some "experts" say it's more important to stay in range than relying on your A1C and, if you have a CGM, seeing a straight line most of the time.
 
An HbA1c of 7% is an average on your home meter of 8.6mmol - that equates to pretty much double a healthy person’s levels. That’s too high for me.
 
Hi @azizdhl. It’s healthy to want to stay as close to the ideal range as possible, but, in my humble opinion, it becomes a mental health threat if you begin to be constantly plagued by the spectre of complications every time your blood glucose strays outside it.
Hypos can be life threatening so having a quick fix with you at all times, eg jelly babies and glucotabs, will help to keep them at bay and carrying your rapid acting insulin with you when you’re out will help you correct a higher than desired reading, but you no doubt know all of this already.
Some of us have been T1 for a long time, 45+ years, and have no signs of complications despite the difficulty of maintaining good levels in the pre-portable blood sugar test years.
You don’t say how recently you were diagnosed, or how old you are. I think that the health professionals are pushing really hard to put the fear of complications high on a list of early Diabetes education some T2 and a few T1 people have ended up them.
It’s certainly worth avoiding them.
 
TL;DR - rant about converting HbA1c to average BGs
I work in pharma, and in a branch called pharmacokinetics, which looks at the effects of a person's exposure to drugs (or anything else, including glucose). It's very difficult to say an average BG equals a certain HbA1c, because they're completely different things. HbA1c is a measure of the exposure to glucose, often abbreviated to AUC or Area Under the Curve, as it's the area under a graph of BG on the y axis and time on the x axis.

Technology like the Libre or a CGM would be able to give you an accurate AUC, and therefore calculate a predicted HbA1c, but averaging a poorly sampled 6 blood tests a day (or whatever you test), will not.

Answer to question...
Anyway, here's some very simple rules about complications risk:
  • An HbA1c in the 50s mmol/mol (7% in old money) will put you at a moderate risk of complications
  • An HbA1c in the 40s mmol/mol (6%) will put you in a low risk of complications
  • To get an HbA1c in the 50s, you need to be in single figures (<10 mmol/l for most of the day)
  • To get an HbA1c in the 40s, you need to go a few days in single figures
If you were to stay at 140 (7.8) for a few days, you will be at a low risk of complications.
 
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