how to achieve the hba1c of you lot?

[andybeet]

Just wondered i've only recently been diagnosed and got results of 7.5 hba. Seen as everyone is an individual how do you get your results as well everyone seems to get them?

most people are around 5 so i feel like it impossible especially cos i wanna run a marathon again

 

[moonstone]

Hello Andy, I wouldn't say it's at all true that most type 1 diabetics have hba1cs in the 5s. That can be, and often is, dangerous ie life threatening. Have you been reading around in other parts of the forum? Lots of type 2s aim for that figure and have great success with it. For type 1s, it's a different ball game, because of the grave risk of becoming hypo unaware. So if you're a type 1 diabetic and you are aiming for under 6% you mustn't go ahead with that plan unless you've had discussions with your nurses/consultant and let them advise you on the best course of action. The current advice for type 1s is that overall the best results, short and long term, come from being between 6-7%.

 

[iHs]

Hi

My consultant recommends insulin dependants should try and aim their hba1c to be somewhere between 6.9 - 7.5% for good control. When I had really tight control my a1c was 6.4% and I had an awful lot of bg readings between 2 - 8 all day long. I thought I was doing fairly well but it was at the expense of dealing with mild hypos nearly every day where my awareness started to become variable and someone said to me that I was trying to balance on a tightrope

Personally, I think 7.1% is probably ideal as long as there are not too many up and downs.

 

[Snodger]

What a sensible thread this is!
I totally agree. I don't know any type 1s who have gone down to the 5s, and as others have said, to get down that low could be dangerous.

The big DCCT trial on type 1s a few years back found that complications were significantly reduced in their experiment group, which had an average HbA1c of 7.2. As far as I know that's still the gold standard benchmark research for managing type 1 - nothing as big or serious has been done since.

The NICE target guideline for all diabetics is 7.5. And only a third of type 1s manage to get there. So andybeet - you are already doing extremely well, and you are seriously reducing your long-term risks. So congratulate yourself and go for that marathon.

The best HbA1c I have ever had, I got the other day, and I think the reason I was able to get it down was because all this summer I've been a student doing a Masters dissertation. In other words I was able to plan every aspect of my own day, check my blood whenever I liked, take a break to exercise when I wanted to, risk a hypo here and there if necessary, and so on. When I was working full time I never was able to manage the whole day to fit with what I wanted to do/eat/exercise. Having full control of what happens to you makes a big difference to how easy it is to manage the blood sugar. I don't know if anyone else has had a similar experience in terms of life control/bg control?

 

[donnellysdogs]

I agree with two postings before. Never hear of any diabetic in 5's. The lower your levels the more likely you are of having hypo's.

My hospital like levels to be around 7-7.5. They do not want people being so strict that and inflexible that we for go our living due to the diabetes. I have always been told that diabetes lives with you, you don't live with the diabetes. We all need to be able to live and if we want a 'treat' etc to have one. To live as normal lives, as non diabetics. Yes, we have target HBA1C's to reach of about 7, but I for one personally believe that persons of HBA1C's of 5 / 6 either aren't living their lives or they are, and having more levels's in hypo ranges than anybody really admits.

My life is to live and to do everything and anything in moderation...... T1 25 years...probably lucky, but I haven't as yet had any complications and I haven't been an 'angel', but neither have I been the devil.....

 

[janabelle]

Hi
Donnellydogs said "Yes, we have target HBA1C's to reach of about 7, but I for one personally believe that persons of HBA1C's of 5 / 6 either aren't living their lives or they are, and having more levels's in hypo ranges than anybody really admits."

I've been told my Hba1c results of 5-6 were fine, yes I was having a few hypos, but I was certainly living and working. However when I had my worst BG control while I was on Lantus-daily BG swings anything from 2-15, bad hypos most days, hypo unawareness & generally feeling like death, I was told my Hba1c of 7 was fine too!! Clinic was off the hook, and i was offered no help.

I feel in recent years there has been far to much store set by Hba1c results generally; we must remember they are only an average; as my situation shows you can be swinging all over the place and still have an Hba1c result "within the normal range". I'm also sceptiacal as to what has prompted NICE' s decision to change the goal-posts when it comes to acceptable Hba1c results.

With specific regard to children, I wonder how many parents leave the clinic being told their child's control is fine( Hba1c 7 or below); when their child's daily control could be erratic; also a child is less likely to admit that they are having difficulties-they will want to please their parents and the doctor.
I hope kids and newly diagnosed patients are still given a monitoring diary, that's the best way to see what's actually going on and adjust insulin/diet accordingly.
Jus

 

[phoenix]

OK, I do have an HbA1c in the 5s, but I wouldn't say I have to strive very hard for it. I'm sure that it is partly luck or perhaps I still have a bit of my own residual insulin which helps.
I've certainly realised on these forums that some people seem to have far greater difficulties in control and their glucose levels fluctuate far more than mine. What I do works well for me, at the moment. It might not for ever. It would't work for someone else who had more volatile glucose levels than I have at the moment..
My doctors used to be worried that my levels were too low, and at one time they were right, as I was losing hypo awareness. Now I use a pump and I have fewer hypos and I catch them before they are too low. They have seen what my glucose levels are doing on a continuous glucose monitoring system and they are happy at the moment.
I exercise a fair amount, mostly running, daily swimming in summer and Pilates. I don't do it because of diabetes, I did it before I had diabetes and when diagnosed was determined to carry on. In fact it motivated me to run my first marathon. I know that this keeps my fasting levels low, if I miss it for a few days my fasting level rises.
I still have some hypos, not very low, normally in the 3s. I've done a lot of testing and they are mostly totally predictable ... though even on a pump not totally avoidable, (I'm getting better at it. ).My hypos, occur during or several hours after exercise and at the moment I seem to be fortunate in that I seem to be able to treat them very conservatively. I use a couple of dextrose tablets, recover very quickly and carry on with what I am doing.
I carb count always, and when at home normally weigh starches. I eat a moderate amount of carbs, similar amounts daily because I'm a creature of habitnot because I think I have to but it might help. If I eat out I probably eat more flexibly and sometimes get it wrong. I don't snack but never have, I live in France where snacking isn't normal so there aren't the temptations there are in the UK. It works for me, in fact I'm shocked when I get the odd high post prandial level.
BUT what works for me might not get anywhere the same results for someone with a different metabolism.


edited to add; One thing the DCCT found was that people with similar average blood glucose levels didn't always have the same HbA1c! One might have a HbA1c much lower than another, another reason for not making comparisons.

 

[Pneu]

Every diabetics control is personal and what works for one will not necessarily work for all.. It's about making an informed choice in collaboration with your DCT.

I am type 1 and regularly achieve around 5% sometimes a little under sometimes a little over... typically my fasting readings are under 4.5 and 2h post meal I would correct if they weren't under 5.5.. this is my own choice as I believe that by sticking to this very tight control I am slowly sorting out some of the complications I did have (eye / foot problems)..

Hypo's are a concern for all diabetics but I have a lot less now than when I was more carefree with my control... I guess on average I have a mild hypo (less than 3.5) once a month and haven't had a major hypo in over a year. To achieve low HBAC1 you need to understand your body and your diabetes a side effect of that understanding is better control and less hypos..

 

[totsy]

hya,
answering the first post....i think 7.5 isnt bad considering you are recently diagnosed, when on novomix my levels were always in the 7.s, after advice from here and going basal bolus i managed a 5.9, then 6.3 which im happy with, we are all different and what works for one wont work for everyone,
you will find your own way in managing your diabetes and given time may get in the 5,s but if not , dont worry