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First HbA1c since diagnosis results

noblehead said:
I also inject ahead, but injecting 30-45 mins before food would see me hypo, I inject no more than 20 mins before.

But much depends on the food, if the meal is high in fat then injecting ahead isn't always an option due to the fat slowing down the digestion of the carbs.
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Totally agree with you! It depends on what I am eating, how much I am eating, what exercise session I have completed that day...and many other variables. That's why I gave a window of 30-45 mins. No person is the same and it takes a considerable amount of trial and error if you want to do what I do.
 
sammyc123 said:
Totally agree with you! It depends on what I am eating, how much I am eating, what exercise session I have completed that day...and many other variables. That's why I gave a window of 30-45 mins. No person is the same and it takes a considerable amount of trial and error if you want to do what I do.
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Yes it's trial & error, we are all different and what works for one may not work for another.
 
Thanks everyone :)


According to my diaconnect app I should be down to 6.3 ish now :) ImageUploadedByDCUK Forum1422651413.919362.jpg
 
sammyc123 said:
Also meant to mention - it is important that you find exactly how long your fast acting insulin stays active in your body...I'm fortunate that I know that after 3 hours I'm clear.
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How do I find out how long insulin stays in my body?? I take novorapid with my meal.

Also if you wait 45mins don't you feel hypo symptoms? The most I've waited before breakfast is 23 minutes and I still had a spike!! Could my liver have kicked in or should I wait longer?
 
asyarlk said:
How do I find out how long insulin stays in my body?? I take novorapid with my meal.

Also if you wait 45mins don't you feel hypo symptoms? The most I've waited before breakfast is 23 minutes and I still had a spike!! Could my liver have kicked in or should I wait longer?
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First step I recommend is working out your carb:insulin ratio (depending on how active you are and your body composition this could be anywhere between 1unit:8-15g chb). On days when I have heavy/ more intense bike workouts I find my ratio to be slightly lower (I require more insulin) however, post heavy/intense/long bike ride days my ratio is much higher (require less insulin).

Once you have found the magic numbers then you can start experimenting with pushing your hypo threshold time. I started at taking insulin 15mins before meal (breakfast is a good time to test as there is no other food in the system). Each day add another minute...but make sure to keep all other variables the same (food, weight, time of meal, basal etc etc). Once you find your threshold time you have one of two options and these I cannot advise on as I'm not qualified...just my own experience. 1) you can stick with that time and take insulin number of minutes before each meal or 2) you can continue to try and build your threshold time by adding either 30seconds each day or 1 minute every other day. I understand that any health professional will advise against option 2 but for me it has worked and my results show it (hba1c of 4.0 and only diagnosed 30.4.14).

This is all assuming you have got the right basal set up...have you done this?

I cannot recommend exercise aiming 1-3 hours daily as a minimum (I understand this is difficult but try and build it into your life because it helps a lot!!)

Any more questions feel free to ask! I hope this has been of some help
 
Ps too find out how long insulin stays on your system involves making sure your basal is completely right. Once that is right then it involves eating a meal eg breakfast...and I may have went overboard but I literally tested bg every five minutes for four hours...you have to be pretty committed lol! It's a painful but very useful exercise. I repeat this approx once every 6-8 weeks to ensure that things haven't deviated too much.
 
I just don't see how you can have a 4.0 HbA1c without having some really scarey low numbers.
 
britincali said:
I just don't see how you can have a 4.0 HbA1c without having some really scarey low numbers.
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Control the spikes and I aim between 3.4-5.2 24/7. I do a lot of exercise which I find helps as well.

Also this is the thing that I find a lot - people are almost afraid of hypo's. By no means am I saying go hypo...but at the same time there is no need to be afraid of it happening as it's inevitable for all insulin dependant diabetics.
 
britincali said:
You can function in the 3s? I start shaking around 4.2 :(
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When I was first diagnosed I would shake in the 5's....but you can gradually lower your hypo symptom threshold level (I'm not advising this because you don't want to lose hypo awareness - but you can lower it). Eg I don't get symptoms until I am 2.9 or lower...but that's because I run a tight ship lol

And yeah I have no problems in the threes at all - for certain bike workouts I actually have better power output figures when I'm mid there's as oppose to higher.
 
Avoid the spikes is definitely the way to go for HbA1c. You don't have to have your basal that low, if you can just prevent the spikies.

Libre is very useful for that.
 
sammyc123 said:
Control the spikes and I aim between 3.4-5.2 24/7. I do a lot of exercise which I find helps as well.

Also this is the thing that I find a lot - people are almost afraid of hypo's. By no means am I saying go hypo...but at the same time there is no need to be afraid of it happening as it's inevitable for all insulin dependant diabetics.
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So even an hour after eating are you around 5.2 at a peak? Have you cut out carbs or are you eating a normal diet? I have been thinking about waiting a while before I eat as I tend to have a spike and a low so I'm guessing my food and insulin aren't working together. That's such a good hba1c score. Do you know what you were when you were diagnosed?
 
asyarlk said:
So even an hour after eating are you around 5.2 at a peak? Have you cut out carbs or are you eating a normal diet? I have been thinking about waiting a while before I eat as I tend to have a spike and a low so I'm guessing my food and insulin aren't working together. That's such a good hba1c score. Do you know what you were when you were diagnosed?
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Yes an hour after eating I am within the previously stated range. There are a few tricks that work for (not recommended by the professionals) and that is taking insulin longer pre meal and also if you split dose the insulin for the meal it can work well. A final thing I do sometimes is spread the meal and eat small amounts every 20mins or so...this prevents the peaks if done correctly. And I eat a normal diet.
 
Wow 5.2 1hr after eating is really good. Can you clarify splitting your dose? Sorry this is all new to me and post meal spikes are causing me problems!!
 
Because I am having some sort of crisis with insulin right now, this morning I took my basal and bolus and waited...... I did a test at 30 minutes and it was the same as before, then after an hour. It was only then it was starting to drop and even then had only dropped by 1.3 mmol. It seems Novo takes a long time to get going for me, certainly at breakfast time. I regularly take my insulin at least 30 mins before my meal without a hypo in sight. Interesting experiment to do but you have to be careful of course as we are all different.
 
asyarlk said:
Wow 5.2 1hr after eating is really good. Can you clarify splitting your dose? Sorry this is all new to me and post meal spikes are causing me problems!!
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Takes a bit of practice and experimenting...if you want good numbers post meal you just really gotta be willing to experiment. In terms of splitting dose....say you take 10 units to cover a meal, instead of injecting all 10 at once, try taking four units then immediately taking another 6 units (just different injection sites). This will allow more insulin into your system a little faster which should reduce post meal spikes however, I do recommend you experiment with caution...I also wouldn't mention it to your diabetic specialist nurses/consultants as you will stress them out...I almost had one of mine in tears because they were like 'you can't do this...it won't work...it's dangerous...blah blah blah'. My response was 'look at my hba1c and tell me whether it is working or not' lol.
 
Ali H said:
Because I am having some sort of crisis with insulin right now, this morning I took my basal and bolus and waited...... I did a test at 30 minutes and it was the same as before, then after an hour. It was only then it was starting to drop and even then had only dropped by 1.3 mmol. It seems Novo takes a long time to get going for me, certainly at breakfast time. I regularly take my insulin at least 30 mins before my meal without a hypo in sight. Interesting experiment to do but you have to be careful of course as we are all different.
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Do you do any exercise before breakfast? Try injecting in your leg and doing a 15-20 minute cycle on the bike (at a pace where you can maintain conversation - heart rate should be between 110-120bpm)...that'll definitely kick start your insulin for you!!
 
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