HbA1c high?

Emma_P23

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Messages
112
Type of diabetes
Type 1
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Pump
2 weeks ago I had my diabetic review at the hospital. My HbA1c came out at 7.2 which I was told was quite high. I just wondered how high it actually was?
I know I need to tighten up control of my blood sugars but I didn't think they were too bad. They generally run at about 6-10. However, they are mostly around 6-7.
 

xAoifex

Well-Known Member
Messages
199
Type of diabetes
Type 1
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7.2 is not that high, i think the target is somewhere around 6.5. Do you know how your blood glucose is overnight? We spend something like 1/3 of our time asleep, it could be that you're higher overnight than you thought?
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
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Tablets (oral)
as a T2 I think any time I see more than 8 on my meter, according to the science I'm doing myself harm. ...worse than that for a T1 is a bad hypo, so it needs to be balanced off
the target for tight control is 6% for insulin I think..6.5-7% is spoken about too
being a young woman emma, I would try for 6.5% to start with. as xaoifex also said, try to get some 5's in your 6-7's
 

pavlosn

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2,705
Type of diabetes
Type 2
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An a1c of 7,2 corresponds to an average glucose level of 8,9 mmol (160 mg/dl). As this is only an average it probably disguises periods (after meals) when you are running even higher.

While not terrible, it would be good to come down to at least the NICE recommended level for T2s of 6,5% if feasible.

Pavlos
 

CarbsRok

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4,688
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2 weeks ago I had my diabetic review at the hospital. My HbA1c came out at 7.2 which I was told was quite high. I just wondered how high it actually was?
I know I need to tighten up control of my blood sugars but I didn't think they were too bad. They generally run at about 6-10. However, they are mostly around 6-7.
Are you sure it was 7.2 and not 72? If it was 72 the your A1c is 8.7 which is high. So you need to find out which it is and then take the appropriate action to sort it out.
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
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Tablets (oral)
emma have you read "think like a pancreas" and Bernstein's "diabetic solution" I don't know what pump books are recommended.

have you heard about TAG, total available glucose, some people find that helps too, there are some pump groups on the net that talk about it

@noblehead has a good link for pump basal testing
 

pavlosn

Well-Known Member
Messages
2,705
Type of diabetes
Type 2
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Tablets (oral)
Do you test before and two hours after meals?

By concentrating on the latter and reducing the carb content of your next meal until your after meal count is within 2 mmol of your corresponding pre meal count, you should soon see all your counts dropping.

Any increase in physical activity, shedding of excess weight should also help.
 

Emma_P23

Well-Known Member
Messages
112
Type of diabetes
Type 1
Treatment type
Pump
Thanks for your replies. My hospital are very supportive in that they run a pump specific clinic for my 6 monthly checks.
My post meal testing is my worst ones of the day. Though not overly bad, it all depends on what I'm eating. I guess I need to kick myself into tighter control.
They mentioned my weight gain and that they will keep an eye on it. I have gained just over a stone in a year and a half. However, I am still a good weight for my height and my bmi is normal so there is no rush in looking at why I have gained weight.
Overall I just felt like I had failed a little bit when they told me it was high.
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
Treatment type
Tablets (oral)
you can't let your self esteem be based on a meter reading, there is more to you than that, as you have worked out, good BG today can be the opposite tomorrow and you still do the same things. sometimes there is no reason and we all just struggle on

now the weight I can help with...adjust your carbs, to adjust your weight, make sure you keep your protein in the normal RDA range ~50g

http://www.dietdoctor.com/lchf it’s a long page and a video
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm For me, the more carbs we eat the more carbs we want. they don’t give up easy.
http://lowcarbdiets.about.com/od/lowcarb101/a/firstweek.htm

http://www.lowcarbdietitian.com/blog/carbohydrate-restriction-an-option-for-diabetes-management



some ada stuff for your dietitian if she freeks

American diabetic association ( http://www.professional.diabetes.org/)
http://www.professional.diabetes.or...=DP&s_src=vanity&s_subsrc=nutritionguidelines

Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes;
therefore, goals should be individualized; fat quality appears to be far more important
than quantity.

In people with type 2 diabetes, a Mediterranean-style, MUFA-rich eating pattern may benefit
glycemic control and CVD risk factors and can therefore be recommended as an effective
alternative to a lower-fat, higher-carbohydrate eating pattern.

(LF Defined as total fat intake, <30% of total energy intake and saturated fat intake,<10%.)

Carbohydrates Evidence is inconclusive for an ideal amount of carbohydrate intake for people with diabetes.
Therefore, collaborative goals should be developed with the individual with diabetes.
The amount of carbohydrates and available insulin may be the most important factor influencing
glycemic response after eating and should be considered when developing the eating plan.
Monitoring carbohydrate intake, whether by carbohydrate counting or experience-based
estimation remains a key strategy in achieving glycemic control.
For good health, carbohydrate intake from vegetables, fruits, whole grains, legumes, and dairy
products should be advised over intake from other carbohydrate sources, especially those
that contain added fats, sugars, or sodium. [processed carbs]
Substituting low–glycemic load foods for higher–glycemic load foods may modestly improve
glycemic control.
Low carbohydrate Focuses on eating foods higher in protein (meat, poultry, fish, shellfish, eggs, cheese, nuts and seeds), fats (oils, butter, olives, avocado), and vegetables low in carbohydrate (salad greens, cucumbers, broccoli, summer squash).
The amount of carbohydrate allowed varies with most plans allowing fruit (e.g., berries) and higher carbohydrate
vegetables; however, sugar-containing foods and grain products such as pasta, rice, and bread are generally
avoided. There is no consistent definition of “low” carbohydrate. In research studies, definitions have ranged from
very low-carbohydrate diet (21–70 g/day of carbohydrates) to moderately low-carbohydrate diet (30 to ,40% of
calories from carbohydrates).
 

noblehead

Guru
Retired Moderator
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2 weeks ago I had my diabetic review at the hospital. My HbA1c came out at 7.2 which I was told was quite high. I just wondered how high it actually was?
I know I need to tighten up control of my blood sugars but I didn't think they were too bad. They generally run at about 6-10. However, they are mostly around 6-7.

Preferably it should be around 6.5% but 7.2 isn't a disaster by any means, especially so if your previous Hba1c's have been much higher.

Personally I would work much closer with your pump team and try and find out where you are running high, perhaps some tweaking of your pump settings might resolve a few highs, if your lucky they may loan you a CGM.

As for basal testing on a pump, the following might be worth having a look at:

http://integrateddiabetes.com/basal-testing/