• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Great HbA1c result but got told off for it...

LooperCat

Expert
Messages
5,222
Type of diabetes
Type 1
Treatment type
Other
Rant alert

I had a raft of blood tests last Friday to investigate why I’ve been getting blood pressure drops when I stand up, and the nurse asked if I’d like her to take an HbA1c while she was at it - I jumped at it because my last one covered one month of no Libre and lots of carbs (and Christmas) plus two with Libre and keto, so didn’t really give me an accurate picture of how things have improved since I got it.

Phone rang this afternoon, it was the practice nurse. She just said that they’d got my results and my HbA1c was 43. And then silence. I assumed it was to give me time to gush, and I said how thrilled I was with such a good result. More silence.

They want me to drop my insulin and get it back up to 50.

I said no way, that 43 comes under “excellent control” on the chart they have on their wall, and that I was delighted. Cue a lecture about hypos, and I tried to explain that I don’t really have any, maybe one mild one a week (never at night), and that I never drop below 3mmol. She actually said she didn’t believe me! And wants me to come in so I can have hypos explained to me. I explained that having had T1 for 20 years, I was very experienced at having hypos, but I’m now managing it in such a way with my Libre as to make sure I don’t get them, and explained the “sugar surfing” methods of a glucose tab here, half a unit there to nudge my sugars into range if they’re drifting off. Apparently I must be having night hypos! I’m going to have to go in armed with printouts of my Libre traces to prove that I’m not - I haven’t had a night hypo since flippin’ January! We had the driving conversation and I explained that I run my sugars a little higher (6-7mmol) to drive, and she said I should be aiming for TEN

So that’s rather taken the shine off a result I’ve been working so hard to accomplish.



I also got cholesterol numbers, but I’m not quite sure how to interpret them, can the hive mind help? She didn’t seem too happy about those either.

Total 6.2; HDL 4.2; LDL 3.7; Trigs 1.2

Anyway, I’m seeing my GP at the end of the month to discuss it all, looks like I’ll have to go armed with my lever arch file of results and dig out the battle handbag again

/rant
 
I've given you a winner for your post as you are clearly going about your management the right way. Please don't be deterred by the conversation you've had - you have solid evidence to the contrary of what the practice nurse was suggesting.
 
I'm just wishing I had a line like that!

Well done for not blowing your top with her, a hba1c that's great and you're being told off?

 

Fab result Mel! Just goes to show the power of immediate feedback and sensible actions.

For your cholesterol, you might find this little tool helpful in getting a bit of an insight: http://www.hughcalc.org/chol-si.php
 

You could just see the doctor and ignore the DN. I never see mine. I'm type 2 btw. Is the HDL figure of 4.2 correct?
 
Brilliant results well done feel free to rant away you'll only get support here.

Re the cholesterol numbers. If , as I do, you follow the belief that the important ratio is trigs/HDL and it should be below 0.87 yours is 0.285 which is completely amazing.
 
Mel dCP said:
Total 6.2; HDL 4.2; LDL 3.7; Trigs 1.2
Click to expand...

There is something wrong with those figures.

The Total cholesterol is made up of LDL + HDL + 46% of the trigs
Your figures don't add up.

4.2 + 3.7 = 7.9 all on its own, without adding in the 46% of trigs.

I suggest you check the numbers on-line or on a print out.

I have seen many other threads on here where T1s have been told off for low HbA1cs. They seem paranoid about hypos. Your 43 (excellent by the way) equates to an average of 7.1mmol/l. I can see nothing wrong with that. I would try to put what she said out of your head - and next time you see her do take along your Libre prints.

All I can say is well done and congratulations.
 
Ah, ok, thanks for that heads up - I’ll call in the morning and ask about the cholesterol numbers. We don’t have online results in Wales!
 
Mel dCP said:
Ah, ok, thanks for that heads up - I’ll call in the morning and ask about the cholesterol numbers. We don’t have online results in Wales!
Click to expand...

But you are entitled to print outs. When you ring tomorrow, ask for them. This needs sorting, and the written lab report is better than anything verbal.
 
Mel dCP said:
looks like I’ll have to go armed with my lever arch file of results and dig out the battle handbag again
Click to expand...

Great, I'd love to be a fly on the wall when you confront her with cold hard numbers from the Libre. I'm also intrigued by the idea of a Battle Handbag! I'm picturing something in Woodland Camo, don't let me down on this.
 
I am type 1 and doing keto too (except last weekend when hangover sent me back to carbs!) so yours is a great inspirational story to me and getting pretty nromal bgs all the time is awesome. I too have a nip of lucosade if needed but generally find that my bgs are smoother because I am not eating a huge pile carbs then taking lots of insulin and getting timing/dosage wrong!
I do not know any other type 1s who get great HBA1c results without coping with rollercoaster blood sugars (the libre is also a good tool for showing that rather than just the mean average of your bgs you are spending lots of time 'in range' ) when they eat the standard high carb diet.
Your hdl and trigs are great if correct (you are looking for a ratio of TRIGS1:1hdl or lower. LDL is deemed to be less relevant when you are eating a low carb diet so I'd focus on the trigs/hdl thing when you get the right numbers out of the surgery!
 
AdamJames said:
Great, I'd love to be a fly on the wall when you confront her with cold hard numbers from the Libre. I'm also intrigued by the idea of a Battle Handbag! I'm picturing something in Woodland Camo, don't let me down on this.
Click to expand...
It’s hard leather with very sharp corners. Very business like, also works well at funerals.

I had a camo handbag once, but I lost it in a field.
 
Let's think up some new slogans for diabetes specialists I'LL GO FIRST.

"Defining a new low point in the quality of medical practice"
"Making all other fields of medicine feel better about themselves"
"Toying with the already-fragile psychology of really sick people"
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…