Type 1 Hba1c

Nadia19

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I have been diagnosed 3 years this October. My hbA1c is high at 87. It was 97 when diagnosed. I need help on how to lower this and how strict do I need to be with my diet. I am really worried, and very upset as I have a 1 year old daughter and I’m only 21 myself. I need advice on where to go from here. Thanks
 

Antje77

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My hbA1c is high at 87. It was 97 when diagnosed. I need help on how to lower this
How do you decide how much insulin to take? Are you on fixed doses per meal or do you adjust for the amount of carbs you eat?
Have you looked into following the DAFNE course?
 

searley

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I have been diagnosed 3 years this October. My hbA1c is high at 87. It was 97 when diagnosed. I need help on how to lower this and how strict do I need to be with my diet. I am really worried, and very upset as I have a 1 year old daughter and I’m only 21 myself. I need advice on where to go from here. Thanks

Well as a type1 how strict you are with food depends on how good your control is…. Plus the fact that if you eat too much you’ll gain weight…. So I don’t need to be super strict as I have reasonable control.. so long as I watch my weight

Your care team should be able to advise you on how better to manage your insulin and offer advice on adjusting your long acting insulin so you are more stable between meals then you can work on getting the right meal time dose

Dafne or even the Bertie online course will give some assistance in this area as you care team about them

But ultimately it’s comes down to getting the right amount of insulin for you…. And even that will change over time
 

EllieM

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Well, firstly my congratulations on getting through a T1 pregnancy so soon after diagnosis. Plus I imagine that having a new baby to look after hasn't given you a lot of time and energy left over to look after your diabetes.

Your team should be helping you to improve your levels but if they've left you stranded with instructions to lower your levels but no help as to how we can make some suggestions.
First question, what kind of insulin regime are you on? Basal/bolus, pump or fixed doses?
 
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Nadia19

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114
How do you decide how much insulin to take? Are you on fixed doses per meal or do you adjust for the amount of carbs you eat?
Have you looked into following the DAFNE course?

So I used to count carbs and weigh and I was really on top. Then when I had my baby I just seemed to think that I didn’t need to look after myself. So currently I just adjust every meal I eat and I guess how much insulin to take. I haven’t looked into that, but I probably should.
 

Nadia19

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114
Well, firstly my congratulations on getting through a T1 pregnancy so soon after diagnosis. Plus I imagine that having a new baby to look after hasn't given you a lot of time and energy left over to look after your diabetes.

Your team should be helping you to improve your levels but if they've left you stranded with instructions to lower your levels but no help as to how we can make some suggestions.
First question, what kind of insulin regime are you on? Basal/bolus, pump or fixed doses?

Yes it was very hard but all worth it in the end.

I do feel quite restricted to time for eating in the morning I will just snack, I have been to the clinic recently thats why I know my hbA1c is so high. I’ve to go back for review in 6 months. So basal insulin I take 2 injections one in the morning at 12 units. Then night time 8 units. Bolus insulin I take just when I eat and I normally just guess, I find I eat alot of sweet foods and sweet breads, or spreads with toast. I want to be able to have these things as they do mean alot to me and before I was diagnosed this is what I was used to. I need to make some changes and find substitutes for the things that I enjoy, and have the real treats as a one off. Thanks for the replies I needed advice from someone who has T1 instead of a doctor who doesn’t have it. Makes a difference.
 

Nadia19

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114
Well as a type1 how strict you are with food depends on how good your control is…. Plus the fact that if you eat too much you’ll gain weight…. So I don’t need to be super strict as I have reasonable control.. so long as I watch my weight

Your care team should be able to advise you on how better to manage your insulin and offer advice on adjusting your long acting insulin so you are more stable between meals then you can work on getting the right meal time dose

Dafne or even the Bertie online course will give some assistance in this area as you care team about them

But ultimately it’s comes down to getting the right amount of insulin for you…. And even that will change over time

When I was diagnosed I was strict I was scared to even eat 1 square of chocolate. I need to get my diet correct and find meals that I like so I’m not eating things that will raise blood sugars. Is there anything you recommend me trying? Snacks, lunches?
When I was pregnant carb ratio was 1:1 . So even anything I ate I was taking alot alot of insulin. Thanks for your reply I enjoy to read back from other T1s
 

EllieM

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When I was pregnant carb ratio was 1:1 . So even anything I ate I was taking alot alot of insulin.

That must have been very difficult.

As regards your current levels, the first thing to ensure is whether your basal amounts are right. In theory, if your basal is right, you should not need to inject at all apart from when you are eating. In practice, you'll probably need to inject a few correction doses as well.

So, in theory, if your basal is right, you'd go to bed at one level and wake up at roughly the same, assuming
a) that your bolus insulin is out of your system by the time you go to bed
b) that your carbs from your evening meal are out of your system by the time you go to bed.

Once your basal is right you can work out whether your carb ratio is right. In theory, as a T1 you can inject for your carbs, though if, like me, you are quite insulin resistant and prone to weight gain (in my case, thanks T2 dad) you may want to keep your carbs down. But plenty of T1s do eat high carb diets, it just depends on your own personal metabolism. Do you have any idea as to your current carb ratio? (Be aware that basal doses and carb ratios can vary with exercise, stress, illness, time of year, and, according to some, what colour socks you are wearing.:))

The other question is how often are you testing? I personally found that my control went to <insert favourite word for bad places here> whenever I didn't test much, and improved whenever I tested more, but that may or may not be the case for you. And now that cgms are available it's possible that your clinic will help you out if more testing will help you get control.

scared to even eat 1 square of chocolate.
You can get 95% or 99% chocolate which has almost zero carbs and is hard to eat in large quantities.:).

Do you like things like tuna, ham, eggs, salad? Avocadoes? Plenty of low carb snacks if you google keto snacks.....
 

Nadia19

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Messages
114
That must have been very difficult.

As regards your current levels, the first thing to ensure is whether your basal amounts are right. In theory, if your basal is right, you should not need to inject at all apart from when you are eating. In practice, you'll probably need to inject a few correction doses as well.

So, in theory, if your basal is right, you'd go to bed at one level and wake up at roughly the same, assuming
a) that your bolus insulin is out of your system by the time you go to bed
b) that your carbs from your evening meal are out of your system by the time you go to bed.

Once your basal is right you can work out whether your carb ratio is right. In theory, as a T1 you can inject for your carbs, though if, like me, you are quite insulin resistant and prone to weight gain (in my case, thanks T2 dad) you may want to keep your carbs down. But plenty of T1s do eat high carb diets, it just depends on your own personal metabolism. Do you have any idea as to your current carb ratio? (Be aware that basal doses and carb ratios can vary with exercise, stress, illness, time of year, and, according to some, what colour socks you are wearing.:))

The other question is how often are you testing? I personally found that my control went to <insert favourite word for bad places here> whenever I didn't test much, and improved whenever I tested more, but that may or may not be the case for you. And now that cgms are available it's possible that your clinic will help you out if more testing will help you get control.


You can get 95% or 99% chocolate which has almost zero carbs and is hard to eat in large quantities.:).

Do you like things like tuna, ham, eggs, salad? Avocadoes? Plenty of low carb snacks if you google keto snacks.....

I love meat, cheese. Things that have no carbs. I test before every meal. I feel if i tested after too it would help my control. How many times do you test a day?
 
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Nadia19

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I love meat, cheese. Things that have no carbs. I test before every meal. I feel if i tested after too it would help my control. How many times do you test a day?

My mum and dad, brother are all not diabetic . Does it run in generations? Or was I born with it and something has triggered it, I’ve always wanted to know lol
 

searley

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When I was diagnosed I was strict I was scared to even eat 1 square of chocolate. I need to get my diet correct and find meals that I like so I’m not eating things that will raise blood sugars. Is there anything you recommend me trying? Snacks, lunches?
When I was pregnant carb ratio was 1:1 . So even anything I ate I was taking alot alot of insulin. Thanks for your reply I enjoy to read back from other T1s

I’m on a pump… never been pregnant:)

A lot of non diabetics get gestational diabetes which ‘I think’ is similar to t2.. ie insulin resistance…

So I assume that a t1 can get the same issue.. ie become more insulin resistant.. when pregnant.

I don’t know where you stand with your care team.. but mine after a few chats sent me away to decide my own insulin doses…. So the first thing I do is basal testing to get the basal right…. Then when I know that’s right I work on my bolus…. Ensuring after a period of not eating with very stable bg I eat something with a known amount of carbs. Normally about 30g.. I monitor my bg for the 2-3 hours after eating this will tell me if there was enough insulin or not..

Another important note is how long you have your insulin before your meal can have a significant effect too… for me about 8 minute before is correct. If I have it much closer to the meal I will go quite high before I start to drop.. more than 10 minutes before and I risk a hypo

Fatty foods like pizza will probably need different handling

My current dose during the day is 1u to 9g carbs except my evening meal where I’m more 1for 8

Now I have my dose right I can almost eat that I want.. I do a lot of ‘batch cooking’ and freeze it saves time but I know how much insulin per meal is needed

However technically speaking it’s possible to have both t1 and t2 together but it’s classed as t1 with insulin resistance. If your an insulin resistant t1 diet becomes more important or you’ll need ever increasing amounts of insulin.

Has you care team suggested you need to tweak your doses yourself if do they want you to do it through them?
 

searley

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Messages
1,888
Type of diabetes
Type 1
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Diabetes, not having Jaffa Cake
My mum and dad, brother are all not diabetic . Does it run in generations? Or was I born with it and something has triggered it, I’ve always wanted to know lol

From what I’ve been told no child is born diabetic something triggers it…. If the knew what they would be closer to finding a cure :). Don’t know if this is true though