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Diagnosed in Feb - Type 1. 1st HBA1C result -help?!

Paulaah

Paulaah

Well-Known Member
Messages
92
Hi,

I'm 39 and female, and diagnosed in February with Type 1. HBA1c was 12.3 and I had the antibody test which was positive. I was put on to Novomix 30 to get me initially "safe" as I had strong keytones etc. After an initial period of high readings and lows - loads of hypos which were terrifying, I was changed to basal / bolus - Apidra and Lantus, and I seem to have got myself on to an even keel, finally. I've been really committed to doing all the right things, and trying my best to get to grips with my new lifestyle.

By the way, the NHS have been totally marvellous. As too has this forum. I've only just plucked up courage to join and ask a question, but over the last 3 months listening to everyone elses problems and advice has been invaluable - so, thanks!!

So my question is this - First HBA1c since treatment back at 8.1. How does this sound? My nurse says she thinks it's good because within that reading there will be some honeymoon values of high unexpected readings. Just wondered if anyone had a minute to let me know their thoughts. It would be much appreciated.
 
Hi Paulaah,

Your doing very well to keep dropping your HbA1c - you've dropped it by 35% since diagnosis.

NICE currently suggest that diabetics should aim for HbA1c targets of less than 7.5% for the prevention of microvascular disease and less than or equal to 6.5% for those at increased risk of arterial disease.

However, for every percentage point drop in HbA1c blood test results (from 8.0 percent to 7.0 percent, for example), the risk of diabetic eye, nerve, and kidney disease is greatly reduced.

A recent study suggests that the average non-diabetic HbA1c is about 5.2%

I think therefore as Type 1's that's the target. Easier said than done (I've not got there yet). But I would keep on doing what you're doing and keep pushing to get as close to that figure as you can. Perhaps aim for below 7% and then below 6.5% and then try for the much sought after 5% club.

A lot of people don't manage to get those sort of levels, but I don't think that should stop us from trying.

Best

Dillinger
 
Hi Paulaah and welcome to the forum :) Your new HbA1c result of 8.1 is a great improvement. Well done and keep it up!

To help you to get even better control of your diabetes, here is some information written by Ken and Sue, former Monitors, for new members which I think you will find helpful. Ask as many questions as you like as there is always someone here to help you.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.
Click to expand...
 
I was just composing a reply saying pretty much the same as Dillinger. You're making great progress, and things may take months or longer to settle down. I went from 13.9% in November to 5.2% in May, but frankly I don't think I could sustain what I had to do to get there for the rest of my life and think my control has been too tight. I intend to take a slightly gentler path in future. Certainly though my HbA1c wouldn't have been that good after 2-3 months, it took a good five months to get it down to that sort of level.

Every bit of reduction helps and what works for one may not work for another. I say keep it up and let us know how you're going.
 
That's a good result for your first since dignosis.....when going on to a pump (still type 1 but different regime) it is preferred to see a gradul reduction in hba's because of possible retinopathy occuring if done too quickly....

By coming down on a gradual basis it also allows the body to adjust to the changes that you are making without rebeling, as it may with a huge difference in changing diets, portions etc.....

Well done...I hope that as a new type 1 on insulin that you are not experiencing too many hypo's etc...well done...
 
Hello again,

Thank you all so much for your words of encouragement. It's so good to get some context around things by hearing about different experiences etc.

I'm sure I've got lots more to ask as learning all the time, but taking each day at a time!!!

Thanks again,

Paula
 
Hi , you're doing very well, and being proactive is probably the most important thing.
You should find it easier to control your levels now you've moved to a basal/bolus regime in any case, though as an earlier poster said you should do it gradually.

However, for every percentage point drop in HbA1c blood test results (from 8.0 percent to 7.0 percent, for example), the risk of diabetic eye, nerve, and kidney disease is greatly reduced
Click to expand...
It is true that you can reduce your risk of developing complications greatly by reducing your HbA1c
to below 7%,but an HbA1c in the 5s, paticularly the low 5s doesn't confer much less risk than one in the 6s. If you can get there without too many hypos then fine; but the lower the HbA1c the greater the risk of frequent hypos and a loss of hypo awareness.

Bob Krause, recently mentioned in the press for being the longest surviving person in the US on insulin,(85 years) normally has HbA1c levels (since they were tested) between 6.4% and 6.7%, though up to 7% .
 
Hi Phoenix,

Thanks for your comments. It's funny you should mention about the higher risk of hypos, as I saw my nurse last week and she said she wanted me to try and push my readings down to within the 4 to 7 mark before meals. I'd been hovering around the 7.2 mark and she thought this was towards the top end of where I should be. This was a bit of a step change as we'd previously aimed for under 10 to keep me safe and assist in a slower overall drop of BG.

So I took up the "challenge" and have been a bit bolder with my Apidra clicks, leaving me lower before mealtimes. However, within 1 week I've had 3 near-hypos, where I know I've been uncomfortable and heading towards the shakes at say 4.1 to 4.7.

Agree a happy medium needs to be struck - it's just a case of finding it.

Your comments have definitely given me food for thought.
 
However, within 1 week I've had 3 near-hypos, where I know I've been uncomfortable and heading towards the shakes at say 4.1 to 4.7.
Click to expand...

I think that feeling hypos at that level when you've been higher is normal. That will change and you may not be aware of them until you're a bit lower . They also may become more subtle signs.
I think you're Nurse is right to aim for the lower levels pre meal (well that's what I do anyway so I would say that!) Two hours after meals is a finer balanc, if you aim too low 2 hours after meals your rapid (Apidra) is still working for another couple of hours . The risk is that you will have a hypo later on.
I have had a HBa1c as low as 4.9% and sometimes I wasn't sensing hypos until I was down to 1.8mmol. Mine is at about 5.7% now and I'm OK for me, though to be honest my doc would still prefer it a bit higher. I know from reading on these forums that for some people this would be impossible to achieve without serious lows.
As it is I put mine down entirely to exercise, yes that sends me low, but I know about it and correct immediately. When I run my overnight levels also stay stable and in the 4-5s, again other people find this impossible to do and these levels would be too low for them overnight. Conversley, when I don't run (or go for long walks) they rise overnight so I start the day from a higher level.
 
Paulaah

I am so jealous! lol (just kidding). Well done with the hba1c. Ive been a type 1 for 15 years now and I have never gone below 8.1. I think the lowest I've got so far is 9.1. It is a real balancing act to be sure so just keep doing what you're doing and let us know how you get on!

Best wishes, Yingal! X
 
Your first hba1c was good for a new t1 who was above 12 on diagnsosis.

One of the first things to remember is that your body needs time to adjust to it's new regimes and changes that are occuring to it. At a reasonable pace of doing this your body stands to accept it more than rejecting it!!

Yes, ideally it would be great to get levels between 5 and 7. This is tough going, especially when first diagnosed. Please remember that you are not advised to drive or operate machinery under a level of 5.

You are doing great. Take things gently and find out what happens to you when you eat certain foods, how these affect you etc, because it is this sort of thing that will get you better control long term. Don't give everything up to the point of an extreme, as this is when your body can give you huge problems of accepting the changes....everything i moderation...and you will get those levels down on a gradual basis without any kick backs by your body....well done...
 
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