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my HbA1c
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MeiChanski
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Hello, welcome!
What insulin are you on? Do you carb count? If you are on basal/bolus regimen, do you do a basal test? Is it stress?
What insulin are you on? Do you carb count? If you are on basal/bolus regimen, do you do a basal test? Is it stress?
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I am on basal bolus regimen
I am on basal bolus regimen. may be stress because I am always afraid diabetes complications
MeiChanski
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Have you been able to address that with your team? Possibly therapy or someone to talk too.
ert
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I'm sorry you're worried about complications of higher blood sugar. I'm there, worrying with you. I recommend reading Dr Richard K Bernstein's Diabetes Solution.
it is always above 9%
I don't know why
Do you have a CGM or Libre? The first step is to understand when your BG is rising, what is causing it to rise and how long it is staying high for. Then it will be easier to do something about it.
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No , I don't have as these devices are difficult to obtain and maintain in my country
MeiChanski
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Your hospital might be able to let you borrow one for a week to identify patterns and trends.
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Also my hospital don't have any of these devices. We sometimes have shortages in some insulin preparations, to be able to imagine the situation. I have to use the glouce test strip every 30 min if I want 24 patteren
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You run at 180-190 all the time while fasting and just on basal?
You might need to look at carb ratios then and bolus timing.
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Not quite sure what you mean by that reply. If your basal is correct and you go to bed 4 hours after your last bolus and food, your morning blood sugar should be the same as your night time one.
An hba1c of 9% (or 75 mmol/L)means an average blood sugar of more like 12 mmol/L or 215 mg/dL) While it's not that bad (I've spent years at that level when I was younger) many people can improve on that. Usually it's a question of doing more blood sugar tests and working out
1) correct basal amount
2) insulin ratio for units of insulin to carbs (so you'll need to be reasonable at carb counting) ie units of insulin per carb
3) correction ratios - ie how many mg/dL does 1 unit of insulin bring your blood sugar down by if you're not eating. ie mg/dL per unit of insulin
So, assuming your basal is correct, and your target level before meals is eg 100mg/dL, and you test before your meal of 40g and get a reading of 180mg/dL, you'd take the following bolus
insulin ratio * 40g + (180 - 100) /insulin ratio
So if your insulin ratio was 1 unit per 10g and your correction ratio was 20mg/dL per unit of insulin, you'd take 4 units for the food plus 4 units for the correction = 8 units.
(My apologies if you already know about insulin ratios and correction ratios but I actually spent decades as a diabetic before they were formally explained to me).
But I don't know if your clinic has you counting carbs or whether you eat the same thing each day and you just match the insulin to that? (That can work too).
Personally, I've always found that my hba1c dramatically improves when I do more blood tests, as my blood sugar never gets the chance to stay out of range for very long and it also becomes easier for me to predict how my insulin is going to work. Do you have as many blood testing strips as you want or are you limited? Though continuous glucose monitors are wonderful, they don't work for everyone, and it is possible to get good results without.
