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disappointed with hba1c...only down by 0.1%

claire_786

claire_786

Well-Known Member
Messages
71
Location
birmingham
Type of diabetes
Type 1
Treatment type
Insulin
ok so i just got my hba1c results today and on the 12th of march it was 8.2% and 4 weeks later its 8.1%... ive been trying soo hard with walking a lot, eating the right food with no extras and no sweets and my overall blood glucose was good... i have another appointment in another 4 weeks time... just feeling a bit gutted and dunno what else to do..plus i have to come every month until it goes to 7% so i can have my treatment done
 
Hi Claire

As I understand this test,reflects last 10 -12 weeks? So your fab efforts of last 4 weeks will be averaged out within last 10 -12 weeks, so it might shoot down more than this next time.

All the best

D
 
What are your daily BG readings,Claire ?

Because you are having HbA1c every four weeks, the results can be a bit skewed because it measures glucose attachments to red blood cells over a three month period normally. This is because three months is more or less the time it takes for the cells to be renewed. So having it tested after 4 weeks is not a good indicator of where you are in relation to your last test, as its a mix of new and old RBC's with differing glucose attachments . So the results will not show a dramatic change .

What is your daily diet like ?

Signy
 
Daffodils1 said:
Hi Claire

As I understand this test,reflects last 10 -12 weeks? So your fab efforts of last 4 weeks will be averaged out within last 10 -12 weeks, so it might shoot down more than this next time.

All the best

D
Click to expand...
Yeah I was thinking it might be lower when I test next month ...It was 9.2 in November 8.8 in January then 8.2 in march
 
Heathenlass said:
What are your daily BG readings,Claire ?

Because you are having HbA1c every four weeks, the results can be a bit skewed because it measures glucose attachments to red blood cells over a three month period normally. This is because three months is more or less the time it takes for the cells to be renewed. So having it tested after 4 weeks is not a good indicator of where you are in relation to your last test, as its a mix of new and old RBC's with differing glucose attachments . So the results will not show a dramatic change .

What is your daily diet like ?

Signy
Click to expand...
I have porridge in the mornings an egg sandwich with brown bread or brown pasta for lunch and a home made curry which will be chick peas. Kidney beans or vegetables with a jappati (flat bread) for dinner and I don't eat extras and lots of water ..maybe cause I'm testing every 4 weeks it maybe it will be lower next month and my blood sugars can be max 10...
 
Well, the key to lowering your HbA1c is to get those daily readings lower. Currently if you are having readings of 10mmol/l upwards, then your Hb will be about 8 . Have a look at this converter here :
http://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

It looks to me that your daily carb amount is on the high side, which will be contributing to your higher numbers. Perhaps you could look at making some substitutions to getting the carb count down ? There are some great threads on the forum on low carb eating. I'm not suggesting that you go the whole way with low carbing ( unless you wish to !) but the threads may give you some ideas on alternatives to the pasta, porridge, bread and chappati which are all very high in carbs.

I know that the starchy carbs are what is recommended that you eat, and that theoretically you can eat all of those things and match it with a bolus, but in reality that doesn't always happen, and the result is higher BG and HbA1c numbers. Small tweaks can make all the difference .

Signy
 
From November its a 1.1 reduction so your heading the right direction Claire, but understand you want to get to 7 so you can start your treament.

Looking at your previous posts I seen you started on a LCHF diet back in March, how did you get on? I wonder if your DSN or Consultant has ever mentioned an insulin pump, this might help somewhat if your struggling on MDI, ask about a pump when you next speak with them.
 
noblehead said:
From November its a 1.1 reduction so your heading the right direction Claire, but understand you want to get to 7 so you can start your treament.

Looking at your previous posts I seen you started on a LCHF diet back in March, how did you get on? I wonder if your DSN or Consultant has ever mentioned an insulin pump, this might help somewhat if your struggling on MDI, ask about a pump when you next speak with them.
Click to expand...
I did ask for a pump and had the interview for it... but then I cancelled cause it looked too much for me... but the nurse did say they might wanna put me on a pump when I do get pregnant and a 5 day constant glucose reading but at the moment I'm happy with just the injections and I can't really find any low carb ideas
 
I reckon that when you have done LCHF for a couple of months more you will find BG control a lot easier, ironing out any large swings. Like the others have said it's going in the right direction:)
 
claire_786 said:
I did ask for a pump and had the interview for it... but then I cancelled cause it looked too much for me... but the nurse did say they might wanna put me on a pump when I do get pregnant and a 5 day constant glucose reading but at the moment I'm happy with just the injections and I can't really find any low carb ideas
Click to expand...

Pumps take some time to get use to and it involves pre-training and a lot of learning, I would have thought it would have been better to go a pump before becoming pregnant so that your confident enough to adjust your insulin as your body changes, but if your happy on injections then there's no reason to change Claire, just keep working away at things and hopefully your next Hba1c will be much lower.

For low-carb food idea's have a look in the low-carb section of the forum.
 
Claire, the internet is full of low carb recipes, join Pinterest for free and type in low carb....... also do a search for a page called "typeonegrit". They must have hundreds of recipes categorised into meal times. Yes you have to work hard at low carbing and, if you want variety, it does involve restocking your store cupboard with stuff like almond flour, flax meal, seeds, nuts, coconut oil, psyllium husks etc but these are all available in large supermarkets or on the net.

My A1C is now 6.1 and will be in the 5s next time. I keep my readings in a reasonably tight range most of the time. It is a myth when we are told we can eat slow release carbs like brown bread, brown rice, spaghetti etc etc, they ALL spike without question.

Here's an easy one for you, google low carb fathead pizza. It is dead easy to make, totally delicious and it won't cause a spike as the carbs are minimal. Then cauliflower rice, cauliflower hash browns, spicy zucchini cakes, courgette spaghetti......... the list goes on and on and I promise you they are not hard to make. I do swedish low carb buns, cheddar scones which are low carb. I live with and care for my parents, I switched out rice for cauli rice and they were flabbergasted at how yummy it is!

Ali
 
Ali H said:
Claire, the internet is full of low carb recipes, join Pinterest for free and type in low carb....... also do a search for a page called "typeonegrit". They must have hundreds of recipes categorised into meal times. Yes you have to work hard at low carbing and, if you want variety, it does involve restocking your store cupboard with stuff like almond flour, flax meal, seeds, nuts, coconut oil, psyllium husks etc but these are all available in large supermarkets or on the net.

My A1C is now 6.1 and will be in the 5s next time. I keep my readings in a reasonably tight range most of the time. It is a myth when we are told we can eat slow release carbs like brown bread, brown rice, spaghetti etc etc, they ALL spike without question.

Here's an easy one for you, google low carb fathead pizza. It is dead easy to make, totally delicious and it won't cause a spike as the carbs are minimal. Then cauliflower rice, cauliflower hash browns, spicy zucchini cakes, courgette spaghetti......... the list goes on and on and I promise you they are not hard to make. I do swedish low carb buns, cheddar scones which are low carb. I live with and care for my parents, I switched out rice for cauli rice and they were flabbergasted at how yummy it is!

Ali
Click to expand...
so when I do go for this low carb diet how do I know how much insulin I need to take.. I'm using novorapid with 10g carbs to 1 click on the pen
 
claire_786 said:
I have porridge in the mornings an egg sandwich with brown bread or brown pasta for lunch and a home made curry which will be chick peas. Kidney beans or vegetables with a jappati (flat bread) for dinner and I don't eat extras and lots of water ..maybe cause I'm testing every 4 weeks it maybe it will be lower next month and my blood sugars can be max 10...
Click to expand...

I am guessing the treatment you can start when your HbA1c is lower might relate to your desire to become pregnant? If that's the case, it might be useful to start a thread to open dialogue with others who have faced similar challenges, and find out how they got over the hurdles. They might also have some exciting insights.

I do agree about the probable need to manage your carbs more tightly, but wouldn't like to suggest any more, as I have little knowledge of pregnancy;diabetic or otherwise.

I hope it all goes well for you.
 
Clare

Lowering carbs may be good for you.

At the end of the day though upu say that basicly you are happy on injections.. However, your blood readings must still be swinging after your meals or you are pretty much runnning higher levels consistently all the time.

To be honest, if you are wanting treatment and you will end up on a pump pretty much then anyway.. Why not stop this faffing around now and just go for the pump now and get a greatly improved hba1c sooner rather than later?

Have you been on a course or been told how to adjust your doses for food and reduce your levels?

Finally, do you test before every meala and 2 hours after each meal and write your results down and make changes.

Low carbing is good for a T1. I've done it pretty much all my 30 yrs of T1. I just eat real food..nothing that is processed. I'm always told off for my hba1c being too low!!

However, you should not lower your carbs if you are unsure how to work out changes with basal and bolus.

I think you should be asking your care team to learn how to adjust your insulins

There are good instructions on line... Hopefully @jack412 can post up some links and details for you. (I'm still too thick).

Your food is heavily laden with carbs. The carbs should be reduced but you need to know what you are doing first.

Are your pens 1 unit ones or1/2 unit ones?
 
donnellysdogs said:
Clare

Lowering carbs may be good for you.

At the end of the day though upu say that basicly you are happy on injections.. However, your blood readings must still be swinging after your meals or you are pretty much runnning higher levels consistently all the time.

To be honest, if you are wanting treatment and you will end up on a pump pretty much then anyway.. Why not stop this faffing around now and just go for the pump now and get a greatly improved hba1c sooner rather than later?

Have you been on a course or been told how to adjust your doses for food and reduce your levels?

Finally, do you test before every meala and 2 hours after each meal and write your results down and make changes.

Low carbing is good for a T1. I've done it pretty much all my 30 yrs of T1. I just eat real food..nothing that is processed. I'm always told off for my hba1c being too low!!

However, you should not lower your carbs if you are unsure how to work out changes with basal and bolus.

I think you should be asking your care team to learn how to adjust your insulins

There are good instructions on line... Hopefully @jack412 can post up some links and details for you. (I'm still too thick).

Your food is heavily laden with carbs. The carbs should be reduced but you need to know what you are doing first.

Are your pens 1 unit ones or1/2 unit ones?
Click to expand...
My pen is 1 units but I have a spare pen with half units
 
Are you happy with calculating bolus's including a correction if need be at time of eating etc?
 
It may seem obvious, but look at each 24hr day - if you can ensure you go to bed at a nice 'normal' reading (say 6) and you haven't eaten for 3+ hours from the time you went to bed, with a good basal rate, you should wake up around 5.5-6.

This is ~8hours of every day. That 1/3 weighs heavily on your overall HbA1c.

So lets say, over night you stay at 5.5mmol/L for 8 hours, and the other 16 hours you run at 9mmol/L all day long. That averages out to to a 7.8mmol/L over that 24 hour period. Thats a good number.

Whatever you do, make sure you are going to bed at a nice 'normal' reading, every night. It will really help with HbA1c readings
 
Diamattic said:
It may seem obvious, but look at each 24hr day - if you can ensure you go to bed at a nice 'normal' reading (say 6) and you haven't eaten for 3+ hours from the time you went to bed, with a good basal rate, you should wake up around 5.5-6.

This is ~8hours of every day. That 1/3 weighs heavily on your overall HbA1c.

So lets say, over night you stay at 5.5mmol/L for 8 hours, and the other 16 hours you run at 9mmol/L all day long. That averages out to to a 7.8mmol/L over that 24 hour period. Thats a good number.

Whatever you do, make sure you are going to bed at a nice 'normal' reading, every night. It will really help with HbA1c readings
Click to expand...
Hi Diamattic, what do you do to ensure your bedtime BG is around 6mmol/L I do achieve this sometimes but often it is between 7 and 9 mmol/L. My HbA1c is 7% (53) but I would like it to be lower.
 
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