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Help with Hba1c

pinkbeckyann

pinkbeckyann

Member
Messages
13
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Diabetes!, high sugar levels, low sugar levels, people who think they are diabetes experts when they have no clue!
I have been a really badly controlled type one for 17 years now (I'm now 25)but recently I have got my Hba1c from 13% down to 9.7% which I'm so pleased with! BUT I'm now stuck and feel i have hit a wall and cant get it down any more. My next blood test is due in January, and i want it to come down slowly and carefully and I'm aiming in the 8% range. Can anyone help with how to get it down please?
 
Do you keep a diary and regular readings. By regular readings meaning pre bed, morning, pre breakfast, pre lunch, pre tea and 2 hours after EVERY meal. by recording all your readings, amount of carbs eaten, and insulin doses really helps to determine how things are.

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I try and keep a diary but testing my blood is not my strong point although im making a big effort now. I tend to panic if its too high, but feel unsure of correction doses because then i hypo. I HATE hypos, so eat like crazzzzy then its high again. I cant seem to balance it! Diabetes is so frustrating and is really getting me down!
 
Keep with the diary, don't panic if you are a bit high, testing is very important in learning ratios. Important to have a good few days readings before adjusting ratios.
When you say you hypo after correcting a high do you think you are over correcting it by injecting too much. by keeping a diary you will learn weather to give yourself more/less with your meals and not having high/lows after

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Completely agree with Brett, testing and keeping a good record are really important. A really good book to help is 'Think Like a Pancreas' by Gary Scheiner it's been a huge help to me.
 
Thank you both sooo much! Im guna try extra hard to keep testing. Its nice to get advice from people who know what its like!

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Probably be worth you doing a DAFNE course if you can - it would give you much more confidence in correcting :)
 
As others have said a diary is a must. I'd recommend getting into a routine. For a couple of weeks eat the same amount of carbs for each meal on a day-to-day basis. For example, have 50g porridge for breakfast, have a sandwich and the same piece of fruit for lunch and for dinner have the same amount of pasta or rice with your evening meal. Note that it is important that you count the carbs in everything, not just the starch carbs like break, rice, pasta etc.

You'll soon figure out how much insulin you should have. One unit of fast acting insulin brings most people's levels down by 3mmol/l. So, if on day one before breakfast you start of at 7 mmol/l and 2 hours later you are at 13 mmol/l, then you know that the next day you will need to give yourself 2 extra units. Once you have got your insulin doses sorted, you can then figure out what your insulin:carb ratio is and start having a variety of meal sizes or carb portions.

Testing is a must, it's impossible to control diabetes well without testings. So test before and after ever meal and before bed. The before bed and before breakfast readings tell you if your basal insulin is correct. Before you start playing with your fast acting insulin, you MUST have your basal insulin correct. If it isn't, it's very difficult to figure out your fast acting insulin. To figure out your basal dose, don't eat or inject fast acting insulin around 4 hours before bed as this will influence your readings. Compare your before bed and before breakfast readings. If they change by more than 1.6 mmol/l then you will need to adjust your long acting insulin by 10%.

Finally, if you are afraid of hypos (and I am - I HATE them) then consider reducing the amount of carbohydrate you eat. If you are eating fewer amounts of carbs then you will inject smaller doses of insulin. If you are injecting smaller doses of insulin then any mistakes that you make in calculating your dose will be smaller. For example, if I eat a 100g carb meal, I'll need around 10 units for it. If I misjudge the amount of carbs by by 30% (and hence the amount of inculin by 30%), I'll have 3 extra units of insulin in me. So I'll end up hypo. If I eat a 30g carb meal and misjudge by 30% I'll only have 1 extra unit of insulin in me, so probably won't end up hypo and if I do, it won't be a bad one.

Sorry for the essay - hope it helps!!
 
Thanks everyone! I've got a new diary to start recording my blood results and I've already started injecting more already. You would think after 17 years of being type 1 diabetic i would know what im doing! Im just fed up of diabetes controlling my life instead of me controlling it!

Im going to try your idea SAMJB, and eat the same amount of carbs for each meal for a week or so and test test test and record so i can see where im going high and low.

I really appreciate all your help :)
 
Hi! I've been very similar to you in the past and seemed to hit a wall at 9.3% I have been on an insulin pump since April and have felt so much better! I've brought my hba1c down to 7.4% already, it fits in with my lifestyle so well. If you haven't thought about a pump it could be another option to consider. What ever you do, good luck :)
 
Hi I have been t1 for 18 yrs and not well controlled , but I have changed hospital and I have learnt more in diabetes and understanding since July than in the previous 18 years, I think people just thought I had it for so long that I knew how to manage it , but I learnt that the carbs in food is more relevant that the sugar , injection sites have been inspected and learnt that the sites have affected insulin absorb ion and the most important basic thing is to get the long acting right and then sort fast acting out once basal is stable, I was always happy to test but I never recorded what was going on so we could not find trends , my Hbac were 126% but with carb counting , reducing the amount of carbs I eat and writing everything down my Hbac is coming down last one was 112% good luck
 
Well done in getting your hba1c down. I'm 24 and mine us 13% so this has inspired me to keep pushing to get it down. I had an appt with my new consultant on Monday and finally feel like I'm getting the support I need. All your comments have given me a push further in the right direction.
 
I have had to be really honest with myself so we can all see what is happening , but I have also eating less carbs ,I eat jacket potatoes and cheese at every meal, always love veg and salad so the potato has gone so don t really eat other carbs but a slice of bread at b,fast, but have been told that reducing Hbac to quickly can be bad for eyes so be carefully if you have problems , I also treat hypos with more control , very rarely consumed the whole packets of biscuits and sweets, and I use to give to much insulin so I might have a ho so I could have a reason to eat the sweets ,


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Hi there,
I was stuck in the 9s for years and years until I took the Dafne (equivalent) course. I also found that I felt 'safe' at that number because I can go hypo at the drop of a hat.

However, since recollecting portion sizes for carbs, and not yo-yoing with hypos and then high blood sugars, I have really dropped down to the low 8s and sometimes 7s, which is a good number for me to maintain balance overall.

So i hope you can find some help with the issues that might contribute to high blood sugars and well done for dropping down from 13. :D
 
Hi Brett,
sorry for late reply, been very busy!

I'm doing well, thank you, Ive been testing loads, and now finding im hypo-ing abit more, so trying to find the balance now! Very frustrating!!
 
Hi everyone, thanks for all your posts, so nice to know im not alone!

I thought i would update you all, i got y hba1c back today and its.....8.6% YAYYYY!!!!! im so proud of myself!

How is everyone else getting on???
 
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