How I knocked 0.7% off my HbA1c by doing almost nothing

SamJB said:

I had an HbA1c done last Thursday and it was 7.0%, down from 7.7% last time. I'm really chuffed as that's the lowest its been in years. My HbA1c's have always been higher than expected as I keep a record of before and after every meal and before and after exercise, so know my sugars have been fairly decent. So I decided to do some hunting for the hidden highs. I found that my sugar levels were going up by 7 mmol/l an hour after eating, but then returning to pre meal levels two hours after eating (which was when I normally did my post meal test).

I decided to switch to low GI carbs. Morrison's wholewheat muesli (had quick cook porridge before which has a really high GI by the look of it), Hovis seeded wholemeal bread (before I switched between white & brown bread) and brown pasta/rice (before I always had "white" rice/pasta). Eating these carbs causes a maximum of 1-2 mmol/l rise 1 hour after. I also inject 20 mins before eating. Doing this one small change reduced my HbA1c by 0.7%. Easy!

I know I'm probably a bit stupid only having figured this out (8 years of T1), but I also find it staggering as a diabetic that no-one has ever discussed my diet with me!

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Well done Sam, alittle goes a long way, doesn't it ? I'm still learning new and different things after 23 yrs . I am cutting down carbs by a little, not for weight issues, just because I would like to No one has ever discussed diet with me either :shock: :shock: when I see my hospital DSN in 2 weeks time I will bring it up. A lot od Diabetes care could do with a big shake up :thumbup:

Well done Sam :thumbup:

Just think what you'll be like after another 8 year

Well done Sam :clap:

Initially testing 1 hour after eating until you find which foods spike and those that don't is very worthwhile.....as you have found out! I try also to stick to lower gi foods wherever possible and do inject upfront or after eating depending on the food on my plate and of course bg readings, it takes time and patience to find out what works for us but it's worth the effort when you finally get there.

Good stuff Sam. Also worth considering is the GL (glycaemic load) of a food product. This is considered just as important (if not more so) as its glycaemic index. Glycaemic load is defined as the grams of available carbohydrate in the food multiplied by the food's GI.

Great news and thanks for sharing, ths is going to come in handy for a lot of people.

GL = the average glycemic glcose equivalent weight.

So Lizi's Granola contains 24.3g of carbs but only has a GL of 6g so I would take 1 unit of Novorapid rather than 2 or 3

I saw a hospital dietician three times - stopped going as most of the food recommended was Medium to High GI. There are some very good books on low GI and low GI load available. Patrick Holford springs to mind. Most libraries will be happy to advise.

On a recent carb counting course with the top diabetic nurses in the country and a diabetic specialist consultant, I was told 'you can eat anything as long as you carb count. ' I found this information both ridiculous and dangerous. I've been type 1 for 38yrs but there were plenty of newly diagnosed on ths course with me. This is completely the wrong message for them ' eat what you like, it's fine!' It's the last time I'll listen to 'specialists'

Brownie said:

On a recent carb counting course with the top diabetic nurses in the country and a diabetic specialist consultant, I was told 'you can eat anything as long as you carb count. ' I found this information both ridiculous and dangerous. I've been type 1 for 38yrs but there were plenty of newly diagnosed on ths course with me. This is completely the wrong message for them ' eat what you like, it's fine!' It's the last time I'll listen to 'specialists'

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Hi there,
It has always appeared to me that dieticians don't really have a clue..... I have been type 1 for almost 58yrs and was always taught to eat a normal healthy diet ... education on what is now called "Healthy" seems to be very limited! dj :?

Research has shown that BG reaches its highest approximately 75 minutes after a meal commences. [check David Mendosa'a website for info on this]
I Have wondered for years why the 2 hour figure is recommended. It doesn't make sense to me to check it when it's already on its way down. To lull people into a fasle sense f security perhaps? :twisted:
Hana

I am on levimere and novorapid and find that there isosoften a surge in sugar level in the evenings that I cannot account for . discovering this has enabled me to take my hba1c from 8 to 5.9 , I now swear by the extra blood testing I carry out regularly

I have type 2 Diabetes, and the whole HbA1c thing does my head in, as despite using a tracking system on my tablet computer which shows an average of 6.5% having calculated my daily blood tests to obtain same, when I visited the consultant I am told not to worry with readings of 8.1%/8.2%/7.7%/9.8%/10.76%/9.0%/8.4% going back to 2010. Indeed recently although not available in UK I spoke to my Diabetec Nurse about the USA HbA1c Test kit, and was told again not to worry as my daily checks were within an acceptable level, and yet my nuropothy within my feet/lower legs says different. Its really all very confusing, in fact its at the stage I am sick of seeing food although this is partly caused by 2 x 10mg Daily Byetta injections, so I tend to be good Monday to Friday and have a blow out with a Korma Curry and Spiced Onions sometimes at weekend which don't seem to effect anything. I think its all trial and error and down to you as an individual how you take control, although it can all be very depressing and give you mood swings which if you have a partner is not easy :thumbup:

hanadr said:

....
I Have wondered for years why the 2 hour figure is recommended. It doesn't make sense to me to check it when it's already on its way down. To lull people into a fasle sense f security perhaps? :twisted:
Hana

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The idea, I think, is to check how well your body processes the increased glucose in your blood. If it goes down at all without medication, that means that your pancreas is doing something, even if not enough. What I'd like to know is why my insulin production isn;t tested, along with HbA1c. After all, gliclazide is supposed to give my pancreas a boost, but if I'm producing enough insulin, then why bother with gliclazide? The problem would then seem to be mainly insulin resistance, not insulin production.

pete

apologies folks, I came to this forum via an email alert and didn't spot that it was a T1D forum, and as I'm T2D please ignore my previous post.

pete

I'm T1 and have been for 2 years ( diagnosed at 36). I went on the DAFNE course last year and was also clearly told doesn't matter, so long as you carb count. Ive gleaned from forums and once a nurse mentioned about checking levels after 2 hours, something along the lines of "should be 10" ..... Any links to more info on this?

hanadr said:

Research has shown that BG reaches its highest approximately 75 minutes after a meal commences. [check David Mendosa'a website for info on this]
I Have wondered for years why the 2 hour figure is recommended. It doesn't make sense to me to check it when it's already on its way down. To lull people into a fasle sense f security perhaps? :twisted:
Hana

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I think the two hour figure is recommended because most rapid insulins have used the majority of their action at the 2 hour mark.. i.e. most rapid insulins are giving you the most effect at the 1:15 - 2:00 post injection.. thus if you are still high at 2 hours post meal then you can choose to further correct; this may differ slightly in some people who are more or less sensitive but in general is the case..

Now most of the meals that you eat are going to peak you at around the 1:15 mark, some slightly faster some high fat or protein meals maybe not until the 2:00 - 3:00 mark... thus is we were to all time our insulin injections to hit a peak efficiency at peak carbohydrate intake (like the body does) then we would be playing a bit of a guessing game and running the risk of hypo's before the carbohydrate from the meal kicks in... i.e. you are injecting at 30 mins pre-meal for instance to try and peak the insulin at the right time..

Personally if I am eating something new or something I am not sure of then I will test at +1 and maybe even give a correction at +1 if calculate that my blood glucose are going to end to high.. I would then test at +2 and +3 and +4 on a meal with a significant 'unknown' element to it.

Given I rarely eat high carbohydrate meals I tend to test at +2 and +4 as I don't need to worry about the spikes.. So I guess what I am saying is that +2 is not a perfect indicator.. but as an 'average' indicator it's pretty good.. if you want to maintain tight control however you may need to adjust your testing pattern and injecting pattern to compensate depending on the amount and GL of the carbohydrate you are eating.

nikkihc said:

I'm T1 and have been for 2 years ( diagnosed at 36). I went on the DAFNE course last year and was also clearly told doesn't matter, so long as you carb count. Ive gleaned from forums and once a nurse mentioned about checking levels after 2 hours, something along the lines of "should be 10" ..... Any links to more info on this?

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I will see if I can find the link.. I would suggest 7.8 mmol/l as a maximum +2 hour target for a type I on the basis that above this level is shown to be when elevated blood glucose causes damage. The NICE guidelines are 9 mmol/l for a type I. Many of us choose to run tighter control.. my personal +2 hour target is sub 6.0 mmol/l however I eat a relatively low carbohydrate diet which means my blood glucose rarely spike..

I have also been told that I can eat what I like.. which to a degree I do.. I allow myself the odd treat but generally stick to a low GI (or GL) & low carbohydrate diet. Carbohydrate increases blood glucose; if you eat less of it and what you do eat you make sure is low GL then the effect on your blood glucose will be less pronounced and you will find control much easier.