Hbac1

[TINAB]

hi, just had my three monthly Hbac1 blood results back today, and they have gone from 10.7 to 4.8, and my doctor and diabetic nurse were not happy with me, they think that i am not eating enough, and i have been told that i have got to get my blood sugar levels up to about 7 or 8, I am finding this hard, and i know perhaps i dont eat enough but i am scared to let them go up. I have only been diagnosed since January, and i think i have taken it all too serious, i have lost nearly two stone in weight, and i know that they are worried. anybody else like me,or can anyone put my mind at rest that it doesnt matter to go a bit higher thanks

 

[phoenix]

anybody else like me,or can anyone put my mind at rest that it doesnt matter to go a bit higher thanks

I looked back at your profile and think that you are a bit like me, ie getting type 1 at an older age.

Like you, from the start doctors have told me my Hb A1c was too low, it was always below 5.3% and was at one time below 5%. Most problems have been to do with avoiding hypos rather than hypers. With an Hb A1c of 4.8% your average level is 5mmol, presumably it rises after meals so there must equally be some periods when it falls to hypo levels. The danger of this is it can lead to hypo unawareness and its a very insidious thing as you don't realise it's happening.
If this isn't happening and you have a flat profile, then I would think that the main concrn is the weight loss.

I have deliberately raised my levels because of this, the last one was 5.6% but personally I would not like, nor consider it sensible to raise it to 7%.I think that I'm regaining awareness though to be honest it is variable. I now have a pump and that helps.
MY premeal targets now are 4-5.5mmol , 2 hours post meal I don't like to go above 7.5mmol but don't get too upset if its a little higher from time to time, some meals take longer to absorb and digest than others . I try to avoid going below 3.8mmol... these are the targets that resulted in the 5.6% )
I think the main reason its not too difficult to keep fairly low levels is that quite frequently the loss of beta cell function is gradual.This is particularly true in people who develop type 1 at an older age. Even young people and children often go through a 'honeymoon period' when after injected insulin is started the beta cells are able to give a bit of 'help' to the injected insuin. With young people this honeymood period is usually quite short.With luck, if you are older it can last a relatively long time.
For you it is only 3 months after diagnosis and even young people can often have honeymoons longer than that.
If you think that your doctors are right and you aren't eating enough, then you could try eating just a little more and seeing what differences it makes to your levels. Obviously you will need to keep an eye on your insulin and adjust if necessary. (I can't help there as you're on a mixed insulin which I don't know much about)

 

[hanadr]

Tina
Ask them what their own HbA1cs are. 4.8% is brilliant and a non-diabetic number. There's no sensible reason for you to go higher.
I cannot see why The medics want to keep diabetics diabetic. Non-diabetic numbers are GOOD
Hana

 

[angelONE]

Hi everyone My Hbac1 after 7 moths as a diabetic is 5.5, it started at 10.5 and 6.9 in April. I find it quite easy to control my levels as Humalog is an excellent insulin. I pretty much eat everything just as I used to My doctor said the same about my 5.5 that I get hypos...but I dont...
I never eat junk food anyway and always have had a balance diet..here and there naturally some snack maybe too often, but I am not too bothered...Enjoy your life, but calculate carbs and you wont have a problem...that's my strategy

 

[fergus]

I think you've done spectacularly well to make such a difference to your HbA1c in such a short time TINAB. 4.8% would be fairly typical for a healthy non-diabetic and, let's face it, we all share that ambition don't we! The one certainty in raising your level is that the risk of complications rises significantly.
Surely you don't mean that your doctor asked you to raise HbA1c to 7 or 8? If he did, it's time for a new doctor. If he meant your average blood sugar, that's also poor advice. Again, a non-diabetic will average around 5mmol/l.
You don't say whether or not your weight is in the right range for your height? Type 1's always start out slim (due to the chronic lack of insulin) so it doesn't necessarily mean you're not eating enough if you are slim.
To my mind, the important issues are these: Are you undernourished, hungry or lethargic? If yes, eat more, if no, you're doing fine. Are you suffering regular hypo's? If yes either eat more or reduce your insulin a little, if no you're doing fine. Are your blood glucose levels stable and predictable? If yes, you've cracked this diabetes lark in record time!

All the best,

fergus

 

[TINAB]

thanks for all the feedback,i have decided to keep my blood sugar levels asthey are, I have never had a hypo, so cant see what the problem is,the doctor just wanted me to raise my blood sugar levels f or a little while, buti think that defeats the whole object. I intend to maybe eat a little more, but i feel really healthy at the moment so am just carrying on as normal, thanks again everyone

 

[lilibet]

Tina
My 2nd Hba1c was 5.1 and I got the same lecture. Like you I had lost weight and was probably eating low carb and low fat -hence the weight loss. Like you I could tell my clinic thought I was keep weight and bg artificially low by not eating -which was not the case. Its ironic though because they then tell you that your good results are
a) its probably because you are in honeymoon -bloody cheek, I WORK HARD at it
b) you are having lots of hypos, will lose hypo awarness, crash your car and die (em no hypos, sorry)

My next Hba1c was 5.7 and weight has gone up too (cream in your coffee anyone? )
They still think this is too low and to be honest they dont know me so cant tell that im generally quite fastidious, so choose to believe I have probably got psychological problems :lol:

However

I really couldnt give a ****@@@@@ what they think because I am the diabetic in that relationship and If I choose to reduce carbs and have a good a1c and reduce my chance of complications, then so be it. I dont think it helped mind when I said Id rather have a hypo than a heart attack.......

You are prob a bit in honeymoon (mines now ending sadly- bye bye pancreas :roll: ) but relish your good a1c.Eat a bit more if you are hungry and dont limit yourself too much cause it will make you miserable. your Hba1c will likely go up a wee bit , but dont worry, keeping it as low as possible gives you the best chance of a long-ish and health life

 

[Jen&Khaleb]

I had a conversation with a family who's father died of a heart attack in his 40's. He was diabetic and was keeping very low levels and this was apparently what caused the heart attack. It was explained that the low levels starved his organs and he would of been better off keeping them a bit higher. I have done no research into this but it would be reasonable that the human body needs to maintain glucose in tissues and organs.

Maybe you can't win being high or low and just have to try and find that middle ground as much as possible.

Anyway, I'm sure people who have been living with diabetes a lot longer than me would know more about this. It would seem that people are so worried about higher levels but with children we are told to prevent hypos because of the damage they do to the body.

Jen