Lowering hba1c too quickly?

[H4yi3y]

Hi!
I have a question.
Basically for a few years my control has been awful, and by awful I mean like I just haven’t been doing anything at all for my diabetes. Recently I’ve realised what I’m doing and started sorting it out. Since I’ve started getting better with it I keep having funny turns with my eyes where I lose my peripheral vision and get spots on my eyes and then I get an insanely painful migraine for hours after. It usually happens when my blood is almost at a hypo. Should I be worried? I was never told to lower it gradually but my friend told me it was possible I’d lowered it too quickly. The thing is because of how badly my diabetes was controlled before I don’t really see how I can lower it much slower because anything I do now is a massive improvement so it’s going to go down quickly regardless. I’m worrying myself over it though. I do have background retinopathy but I was told I can reverse it if I behave myself.

 

[Ronancastled]

Numerous studies have shown that lowering BG too quickly can temporarily worsen retinopathy.
Also going through a rapid reduction in BG changes the amount of glucose circulating in your eyeball.
It can often take weeks if not months to regularise.
If I were you I would get a scan just to be sure & catch any problems early.

Great work on getting in control btw

 

[In Response]

If you are used to having high blood sugars, you could be experiencing false hypos - your body thinks you are having a hypo although your levels are not that low.

 

[Jaylee]

Hi!
I have a question.
Basically for a few years my control has been awful, and by awful I mean like I just haven’t been doing anything at all for my diabetes. Recently I’ve realised what I’m doing and started sorting it out. Since I’ve started getting better with it I keep having funny turns with my eyes where I lose my peripheral vision and get spots on my eyes and then I get an insanely painful migraine for hours after. It usually happens when my blood is almost at a hypo. Should I be worried? I was never told to lower it gradually but my friend told me it was possible I’d lowered it too quickly. The thing is because of how badly my diabetes was controlled before I don’t really see how I can lower it much slower because anything I do now is a massive improvement so it’s going to go down quickly regardless. I’m worrying myself over it though. I do have background retinopathy but I was told I can reverse it if I behave myself.

Hi,

If you are getting symtoms with the eyes within normal range? This could also be just your body getting used to the new normal after prolonged high BGs?

However, as @Ronancastled pots out in his post.. A sharp shock to the system can be detrimental too. It's safer to steadily acclimatise to to reaching the improved managment.

When is your next eye appointment?

Best wishes.

 

[NicoleC1971]

Firstly well done on taking back a bit of control. I hope your body gets used to lower insulin and lower blood sugars.
I think the thing to focus on is getting consistent in lower bgs and insulin rather than a perfection that you can't sustain. I understand that other posts here are correct in saying that it is the rapid changes that cause the damage as well as sustained bad control i.e the worst thing you could do is to rapidly drop your bgs then shoot up high again on the other side. This could happen if the changes you make are hard for you to continue or something else throws you off track (illness, stress, life crisis etc)>
As type 1 we have similar experiences of rollercoaster blood sugars and adjusting to normal range 4-7 when you've been high can feel strange and I certainly notice that my eyes feel blurry if my control is rocky.
As for the eyes they are very delicate little blood vessels and are going to be susceptible as they cope with repairing the damage caused by excess glucose. Mine went through pregnancy (was terrified into getting low blood sugars throughout!) followed by the chaos of a new born premature baby which did cause retinal bleeds. NOT saying this will happen to you because it is rare just take it easy because it is what you can sustain for the next decades that will ultimately keep you healthy and not getting a perfect hba1c next nurse or doctor visit.
Hope you have all the testing kit and dietary tools that you need. Your body is amazing and it is very good at looking after itself given the right foods and movement.

 

[H4yi3y]

Hi,

If you are getting symtoms with the eyes within normal range? This could also be just your body getting used to the new normal after prolonged high BGs?

However, as @Ronancastled pots out in his post.. A sharp shock to the system can be detrimental too. It's safer to steadily acclimatise to to reaching the improved managment.

When is your next eye appointment?

Best wishes.

I had an eye screening three weeks ago that’s when I was told I had the background retinopathy but the eye screening was when I was ignoring my diabetes, then these three weeks since I’ve been back from that appointment is when I’ve started doing it well, to be fair it’s not like I’ve tightened my control extremely it does go up&down but overall it’s running at a normal level now.

 

[Ronancastled]

I had an eye screening three weeks ago that’s when I was told I had the background retinopathy but the eye screening was when I was ignoring my diabetes

That's good so.
I had BR picked up in one eye post diagnosis.
A year later after good control it cleared up.
You're on the right road.

 

[Grace2059]

Firstly well done on taking back a bit of control. I hope your body gets used to lower insulin and lower blood sugars.
I think the thing to focus on is getting consistent in lower bgs and insulin rather than a perfection that you can't sustain. I understand that other posts here are correct in saying that it is the rapid changes that cause the damage as well as sustained bad control i.e the worst thing you could do is to rapidly drop your bgs then shoot up high again on the other side. This could happen if the changes you make are hard for you to continue or something else throws you off track (illness, stress, life crisis etc)>
As type 1 we have similar experiences of rollercoaster blood sugars and adjusting to normal range 4-7 when you've been high can feel strange and I certainly notice that my eyes feel blurry if my control is rocky.
As for the eyes they are very delicate little blood vessels and are going to be susceptible as they cope with repairing the damage caused by excess glucose. Mine went through pregnancy (was terrified into getting low blood sugars throughout!) followed by the chaos of a new born premature baby which did cause retinal bleeds. NOT saying this will happen to you because it is rare just take it easy because it is what you can sustain for the next decades that will ultimately keep you healthy and not getting a perfect hba1c next nurse or doctor visit.
Hope you have all the testing kit and dietary tools that you need. Your body is amazing and it is very good at looking after itself given the right foods and movement.

Hi NicoleC1971,
Sorry I know I'm late to the post but I am type 1 diabetic and 29 weeks pregnant. I had terrible control of my diabetes for about ten years, I then quickly reduced my A1c to 51/6.8% and got pregnant once my A1c had come down. Unfortunately the effects of my poor blood sugars for those ten years had already started taking a toll and I had background retinopathy/stage 2 retinopathy in which they were monitoring closely. I went for my pregnancy eye screening a few weeks ago and they've come back saying I need to see a specialist. I'm really worried because last time they said it wasn't advanced enough to refer me to a specialist, so I feel like now it has advanced because of my pregnancy. I'm so scared that I'm going to have a retinal detachment or bleed or need surgery/treatment that affects my sight permanently.

What was your experience of having retinopathy during pregnancy? Did you have it before pregnancy as well? Any background or anything?
Any advice at this point would be greatly appreciated as I've been freaking out for days! Thank you so much.

 

[TeddyTottie]

We cannot diagnose here, but your symptoms are not dissimilar to those associated with just regular old migraine - I don’t have many, but all of my migraines are of the ocular variety - they start with a spot, like a dazzle spot, right in the centre of my vision in one eye (most common in one eye only). This expands across my field of vision with classic ziggy zaggy banded patterns at the edges. Vision returns in the centre but as the band moves out I get tunnel vision and lose all peripheral sight from the affected eye. After about 30-45 minutes the jagged band has moved all the way across and ‘off’ my eye and normal vision returns. I may or may not have a headache, but it’s never really awful, for me. Mine are fairly classic ocular migraines.

Visual disturbance is very common in many types of migraine, but all visual problems should be treated as serious so I would make an appointment and discuss this with your doctor. I imagine that rapid changes in BG and/or diet could trigger migraines, although it does not for me.

 

[NicoleC1971]

Hi NicoleC1971,
Sorry I know I'm late to the post but I am type 1 diabetic and 29 weeks pregnant. I had terrible control of my diabetes for about ten years, I then quickly reduced my A1c to 51/6.8% and got pregnant once my A1c had come down. Unfortunately the effects of my poor blood sugars for those ten years had already started taking a toll and I had background retinopathy/stage 2 retinopathy in which they were monitoring closely. I went for my pregnancy eye screening a few weeks ago and they've come back saying I need to see a specialist. I'm really worried because last time they said it wasn't advanced enough to refer me to a specialist, so I feel like now it has advanced because of my pregnancy. I'm so scared that I'm going to have a retinal detachment or bleed or need surgery/treatment that affects my sight permanently.

What was your experience of having retinopathy during pregnancy? Did you have it before pregnancy as well? Any background or anything?
Any advice at this point would be greatly appreciated as I've been freaking out for days! Thank you so much.

Hello

Sounds a bit like me. I only got my (diabetic) act together when pregnant.
Please see the specialist and ask about the effect pregnancy has on your retinopathy. Mine progressed quickly (possibly due to high growth environment of pregnancy?_ and I had laser treatments but the sight loss bleeding only happened 7 months afterwards so perhaps it was my slide from rigid control whilst pregnant into less rigorous control that exacerbated the speed of my bleeding.
The obvious point here is that you must get the support you need as a new mum to keep up the good work with the control (fsl, supportive family) as your diabetes care is really important for your baby as well as you. I feel bad that when my daughter was barely a year old she had to spend time away from me as I was recuperating from eye surgery (bilateral vitrectomy so had to lie prone for hours of each day.
I have really useful sight now but am not allowed to drive so you can imagine this has had an effect on my independence. It has helped my fitness levels though and I am working full time in spite of the terrifying prospect of losing sight.
This was also 18 years ago too so it is possible that better treatment is available not that you may be anywhere near to needing it.
Best of luck with your visit to the specialist and research the options offered without guilt that your blood sugars weren't always perfect. Diabetic pregnancy plus new motherhood is hard enough without putting that on yourself too!