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hba1c results

Discussion in 'Type 1 Diabetes' started by miszu, Jun 11, 2017.

  1. miszu

    miszu Type 1 · Well-Known Member

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    Good eve,
    so i was diagnosed in december, its been half a year now and since im out of hospital this is my first hba1c result. I know it should be every 3 months but anyway better late than never. 6 months ago my hba1c was 86,4 mmol/mol and now its 46,0 mmol/mol. I dont have much to compare to so i dont know if i should be excited about the results, but its almost half of my previous hba1c so im glad.
    I had one hard time when my BG was sky high for 3 weeks and didnt know what to do but that was maybe in.. april? so its all fine now. I was able to reduce total 3 units insulin in the past few months. In the hospital I started with
    morning - 8 units, thats now 6 units.
    lunch - 6 units, thats still the same.
    dinner - 7 units, now 6.
    I reduced the morning 8 units to 7 close to when i got out of hospital, coz i felt like thats a bit too much. Needed some time to get use to the -1 unit but i ate better carbs and my body was happy with the 7 units then. The other -2 units were not long ago, one is a morning -1 unit making it 6 units morning insulin. I started working around that time, my daily routine was to wake up at 6-7AM, bfast then getting ready and then next reading at 9AM at work. I noticed my after meal BGs were very low then since i started working, readings between 3-4,5. I always had to eat some snacks right after i got to work. So i decided to lower my morning BG to 6 units. My after bfast BGs are between 5-6 now. Once i got a 2,8 2hrs after lunch, i freaked out then and had 40gr of sugar (juice, choco cookies and something else), my BG after this amount was 6. I try to have smt extra for lunch now like a few apple slices. I didnt lower my insulin for lunch coz that change with food seemed to work well and i like having some more energy there, i def need it at work! But sleeping early, it can be annoying getting a low reading after brushing teeth and all ready to sleep... i kept getting 4,somethings after dinner. dinner at 8PM, bed at 10PM so yea i didnt enjoy the extra food that late. So i reduced insulin by 1 unit for dinner. Now its better, still sometimes need a little snack but not as often. I eat the same amount of carbs now as before when i started carb counting at the hospital, i do keep a more strict eye on what i eat, i try to have only good carbs but probably the biggest change is that im more active now. I mean for 4 years i didnt move around much, was staying home with other issues that time, now i go out every day, go to work, do sports again. I dont get long acting insulin, dont need it yet my doctor said. My morning BG is usually between 5,5-6,5. Before meal BGs usually between 4-5,5. After meal it stays under 8, when im at work my after meal BGs are around 6, when im being lazy it can be close to 8. My goal is to always keep my BG under 6,5. Tho i still try out new foods, test them if i can have it or not in the future and that can do bad to my BG sometimes, but it always goes back to the usual by next reading. So overall, i dont know if this 46 mmol/mol is good average or what but i feel like im learning more and im able to control my diabetes well.
    Thanks for reading, good day/night for all and hope everyones doing great ! (:)
     
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  2. Diakat

    Diakat Type 1 · Expert
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    Hi @miszu
    46 is great - firstly because you lowered it so much and secondly because it is less than 48 which means you have a significantly lower chance of diabetic complications.
    Well done.
     
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  3. miszu

    miszu Type 1 · Well-Known Member

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    thanks, i had a look at type 1 hba1c results thread and now i feel like theres a lot more to go. I see people with 6%+ say they want to lower it more so thats my goal too now !
     
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  4. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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    Sounds like you're got the situation under excellent control. To be honest, I hadn't done an A1C on myself for probably 8 years until recently (doctors are the worst patients, right?). And guess what: it was 6.2, the same as it's always been. What I look at are the average 14 and 30 days BS readings on my home meter. If they are between 4.7 and 6.0 I'm fine with that, and my A1C will be fine too. I know, many around here follow their "spikes" and the CGM thing and graphs and trends and that's fine, but I tend to KISS when it comes to my diabetes and have done pretty well that way. The problem with running A1C's in the low 5's is you get a lot of lows. That has to happen. Lows are bad news, I should know. My motto in the old days was: "the best way to know you're not high is to be low". Bad motto!
     
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  5. DiabeticDadUK

    DiabeticDadUK Type 1 · Well-Known Member

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    Well done on reducing your A1c. I would love anything near that in the next few weeks :)
     
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  6. Snapsy

    Snapsy Type 1 · Well-Known Member

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    This really resonates with me, @TheBigNewt . In my first couple of years with diabetes my paediatrician kept on and on and on about my HbA1c needing to be lower - so much so that I started secretly injecting more insulin so as to keep him happy.

    This is when I was 11 and 12. It still shocks me today that I did that. But even today (I'm 42) I have big big issues about not ever wanting to be over 7mmol/l every single time I test my blood sugar.

    :banghead:
     
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  7. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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    There was a big randomized study of Type 2 diabetics (different than us, I know that) and one group was going for tight control the other stayed on their usual regimen and their A1C's were like 7.7 and the other group's goal was <6.0. They obviously were on more drugs (some oral of course) and they stopped the study early because the tight control group had more deaths. I realize that Type 2's are different but still they couldn't show tight control helped (in fact it came out worse).
     
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  8. Kristin251

    Kristin251 LADA · Expert

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    My A1C has been 5.1 for 1.5 years. Coming up in aug will be my 4th since DX. According to my meter it should be lower.

    I have very tight control and rarely hypo under 70 or go over 100. I eat small very low carb and higher fat meals 4 times a day with a few small snacks in between. I take very small doses of insulin so not much room to hypo. I do seem to need a small dose every three hours or I rise. This is ok as I prefer grazing rather than larger meals, though dinner is larger.

    That bring said, if I didn't eat small and inject small I can see where it would be trouble. I couldn't find a way to dose insulin while eating carbs without hypos or spiking. I love fat!! Good thing
     
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  9. pleinster

    pleinster Type 2 · Well-Known Member

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    The fact that Type 2 diabetics have varying levels of pancreatic function, that some respond better than others to different approaches, the fact that some are on one type of meds for diabetes and others are on entirely different ones, some use insulin, some don't some rely purely on diet of varying kinds), some eat no carbs, others eat some, some are on meds and diets, some are on a pile of different meds for different conditions (pre-exisiting and/or as a consequence of diabetes)..the fact that soem say they stick to a diet strictly but don't, the fact that "usual regimens" means nothing without detail, age, sex, genes, steroids etc etc etc...completely negates the validity of any findings in such vague studies. Speaking personally, having been on meds and off meds, having adhered to a strict low carb diet and a more relaxed diet - it is entirely bonkers to say that there is evidence that tight control did not help! Just saying.
     
  10. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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  11. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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    FYI this ACCORD study 2011, was the lead article in the NEJM, and involved 10,000 Type 2 diabetics using multiple academic medical centers, so it is hardly a "vague" study. It was a tightly controlled, randomized, huge study designed to answer their primary question. And they stopped it early due to excess (cardiovascular) mortality in the tight control group. Oral agents are different from insulin.
     
  12. pleinster

    pleinster Type 2 · Well-Known Member

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    I get that. I am not trying to be awkward; I just don't accept studies (and there have been a number of them) which make claims based on certain kinds of data that do not appear to take into account all the potential factors. That doesn't just apply to medical or scientific surveys. Simply being included in the NEJM does not make it gospel fact - otherwise every single conclusion reached by medical academia would have stood the test of time. Theory is not fact...and I am sure there will be other academic opinions as there always are. Historically, many conclusions have been drawn following what was supposedly a tightly controlled all-encompassing survey - until later data and evidence have suggested otherwise. This has been particularly true of the medical community at an academic level over the decades. I would also add that while stopping the survey early due to higher mortality rate in one group may be used to indicate probable outcomes, it is more accurately inconclusive as it has been stopped early (whatever that may indicate). It stops short of strict empirical evidence. I am only saying...evidence can be used to represent opinion quite effectively but the bulk of us don't actually get to analyse all the data and all the potential reasons at a sophisticated level. All surveys are open to debate - always.

    I also know full well that oral agents are different from insulin - obviously.

    No offence intended. I was simply expressing a view. I choose to govern my own blood sugar levels through a less than entirely strict low carb diet (avoiding meds as I am on plenty for other medical issues), ignoring the largely financially motivated NHS advice that I don't need to test myself and that I should stick to a nice "healthy" balanced diet. Each to their own. Medical PhD students can get published over my sorry remains.
     
  13. TheBigNewt

    TheBigNewt Type 1 · Well-Known Member

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    The study was stopped after 3.7 years, so it's not like it didn't go on for awhile. The point is the premise going in was that the outcome would be better in the intensively treated group (avg A1C=6.6) vs the "standard" group (A1C=7.7). The A1C was 8.3 in both groups at the start. These people all had diabetes for at least 10 years and weighed about 93kg, so they were a higher risk group for sure. Fewer heart attacks but more cardiovascular deaths in the intensive group, who took more diabetes drugs on the average. Not what they expected at all. Their LDL cholesterol was around 90 in both groups and didn't change, so I'm sure most were on statins.
     
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  14. pleinster

    pleinster Type 2 · Well-Known Member

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    I get that, and appreciate your efforts to clarify the details of the survey. I'm sure I can be a bit closed to surveys and stats at times (and this is due to an academic background)...and we should take on board every bit of info we have available to us. I just don't generally trust no grey area conclusions. Still, heart attacks don't just happen due to diabetes. Why not include people who haven't had diabetes as long and who don't have weight issues at all? I'm not really saying it doesn't paint a reasonable picture of things under certain circumstances...just that it's not a wide enough survey in terms of its parameters to conclude on how approaches impact on all diabetics. I was born with a kidney disease and past surveys have led to very poor practise in that area (particularly in terms of diet in relation to transplants and rejection). Things have improved dramatically, but in many areas of medicine, the con sequences of changes due to such surveys have hindered as much as they have helped. That does not mean that I think they should be stopped. Thanks for getting back with more detail.
     
  15. Shazzle80

    Shazzle80 · Well-Known Member

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    Are you not carb counting?? I don't have regimented insulin amounts, I just work out how many units I need from the amount of carbs I'm eating at any given time.

    My Hba1c is currently 7.6 which I'm happy with, I had a period of highs from the middle of Dec to Feb which freaked me out, it was still only 7.8 then thankfully. I'm pretty new to it too, diagnosed Christmas Eve 2013 after gestational diabetes xx
     
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