Query as to what Type 3c are being told to keep HbA1c at…

Cumbrianjudith

Active Member
Messages
26
Type of diabetes
Type 3c
Treatment type
Insulin
Just had my 90 day plus appointment with temporary diabetic nurse at Gp surgery following changes in regime to Libre 2 sensor, shift in insulin to Toujeo and Fiasp, and removal of gliclazide, but maintained metformin. My HbA1c was 44 mmol/ mol, with the Libre estimating 42, and showing over the previous 90 days BG was in high 80%-low90% in range, with only 3-5 episodes per week in under 3.9 hypo range, and 6-7 in 10.1-13.3 range. This includes two separate periods when the sensor was failing and had to be renewed. I now find periods perhaps of a day or two of poorer control, and less predictable rise in BG occur after unexpected spikes ( strange recipes eating out!) and not from lows which are easily corrected by getting up and waking to next room, or if absolutely necessary some jelly beans. Anyway the nurse thought my blood sugar was too low, and I need to reduce my daily Toujeo…what have others been told about ? 5 days a week I swim 45 mins/ day and intermittent fast ( 16 hours fast).
 

becca59

Well-Known Member
Messages
2,919
Type of diabetes
Type 1
Treatment type
Insulin
I would say those results sound fine. In Range is what my consultant looks at now. Personally I wouldn’t take much advice from a Gp based diabetes nurse. In my opinion they don’t know enough. My surgery still works on the old out dated higher HbA1c expectation, which the hospital clinic definitely does not.
My advice would be to set Libre low alarms at a higher level to enable treatment before going too low. I did this about 6 months ago and I am now registering only 2 lows for the last 3 months.
 
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Tony337

Well-Known Member
Messages
756
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Not being on holiday....
Hi
The NHS is obsessed by hypo territory and whilst there has to be a measure for it with me personally it doesn't work.
They think if you are below 3.9 you are going to pass out and require an ambulance.

Hold that thought when they tell you you are running too low.

I am in my 50th year and never passed out nor hospitalised and can function normally at 2.9.
They give you no credit for analysing your own data and acting accordingly.

If i get to 2.9 i would know as my alarm would have already gone off.
I would already have jelly babies on board working their magic.

I would be finger pricking as at that point as it is more accurate than my libre.

Please don't think i'm being rude or argumentative nor disrespecting the NHS its just how i deal with my own diabetes.

My advice to you is do what works for you and i wish you well.

Tony
 

EllieM

Moderator
Staff Member
Messages
9,547
Type of diabetes
Type 1
Treatment type
Pump
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hypos and forum bugs
Disclaimer, T1 here not T3c but suspect your DN will be treating you as a T1.

Well, as a T1 I'd be very happy with those figures, but not sure whether the 3-5 hypos a week is ideal. A potential issue with some T3cs is that glucagon is produced by the pancreas to tell the liver to pump out glycogen when you are low. If your glucagon production is low along with your insulin production then that takes a layer of protection away against hypos. So am guessing that they may be extra worried that too many hypos may cause you to lose hypo awareness???

Having said that, am skeptical about how much a GP diabetic nurse knows about insulin management for T1s, let alone T3cs, but maybe I am overly cynical and out of date.
 
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