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Strange advice?

Discussion in 'Diabetes Discussions' started by noblehead, Feb 3, 2010.

  1. noblehead

    noblehead Type 1 · Guru
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    I was just browsing the net looking at info about hba1c, and came across this article:

    http://www.everybody.co.nz/page-46cae43 ... 5eae2.aspx

    What caught my eye was the sentence that said people who use insulin and have a hba1c below 6.2 were probably having frequent hypo's, or words to that effect.

    I don't agree with that, I would hate to think that my next hba1c is below this figure, and my consultant thinks I am having hypo's 2 or 3 times a day! Surely this isn't the case. :?

    Nigel
     
  2. suzi

    suzi · Well-Known Member

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    Hi Nigel,
    My sons consultant would probably agree with the report, as in the fact that children who have perfect hba1c's usually experience regular hypos and thats how they manage to get good hba1c result (his opinion, not mine, though i understand where he's coming from, children are definately different!!) and frequent hypos regardless of good control are affected by puberty/adolecense/lifestyle.
    For an adult it's a whole new ball game and good hab1c levels can surely only be acheived by good control, and therefore i don't agree with the report, but if the report was aimed at a childthen i'd have to agree completely.
    (don't wish to upset any other parents,or open up a can of worms! it's only 1 mothers opinion)
    Suzi x
     
  3. kay957

    kay957 Type 2 · Well-Known Member

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    My last test was 6.2 but I didn't have many hypo's at all, so they can't be right about that.
     
  4. Doczoc

    Doczoc · Well-Known Member

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    Complete rubbish if you ask me.

    My last was 5.3 and the only hypo I've had was after a very heavy night on the beer :D . Went down to 2.3 or so, not nice!
     
  5. phoenix

    phoenix Type 1 · Expert

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    Doczone, this was about people who use insulin.

    My HbA1c is below 6% and I still have more hypos than my doctor likes.For example I was 3,8mmol just before lunch, I tend to think about this sort of pre meal level as 'normal' but it's technically hypo.
    People normally have many more less severe hypos than severe ones but long term evidence from the DCCT seems to support the idea that people with lower HbA1c levels also have more risk of serious hypos. This graph shows the rate of severe hypos, ie those that resulted in coma or needed third party help. . One thing worth considering though is that for most people the insulins used and also the self monitoring practice(?) have changed since the DCCT .
     

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  6. hanadr

    hanadr · Expert

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    Followers of the Bernstein method, don't have frequent hypos. and his HbA1c is aboutt4.5% I think he said.
    Hana
    Ps I know here's a rumour on the web that Dr. B is frequently hypo, but I asked and it's not so.
     
  7. noblehead

    noblehead Type 1 · Guru
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    Doczone,

    Pheonix is right, its refering to insulin users, but good to see that you have a hba1c of 5.3 without many hypo's.

    Kay957, your hba1c of 6.2 is fantastic considering you don't have many hypo's, this is where I am aiming for, 6 with very few hypo's.

    Suzi, I think I intend to agree with your consultant there given all the many obsticles that face children as they grow-up, but I would imagine there are exceptions to the rule.

    Pheonix, interesting graph there, I can see that the lower the hba1c the more severe hypo's there are, although as you say things have moved on.

    My own personal experience, is that I tended to have more hypo's when I ate a conventional diet of 250g+ of carbs daily, and had hba1c's of 8-9%. I've been cutting back on the carbs for a while and changing my eating habits, what this has meant is less insulin. When I say less, I mean by only around 1/3, but this has resulted in fewer hypo's than before. I believe the less insulin floating around in the system, the less chance of it causing hypo's. It is all about finding the correct dosage of insulin to match the food you eat and your daily routine/exercise.

    Its difficult to be a exception to the rule, when at annual check-ups consultants ask people how many hypo's are they experiencing, so if the majority of folk in the 5-6 range are saying that they have frequent episodes of hypo's, this is what they base their information on. So for the ones that don't experience them often, but achieve good hba1c's of 6 or less, they are stereotyped just the same as the rest, disappointing but no doubt true.

    Nigel
     
  8. hanadr

    hanadr · Expert

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    >>My own personal experience, is that I tended to have more hypo's when I ate a conventional diet of 250g+ of carbs daily, and had hba1c's of 8-9%. I've been cutting back on the carbs for a while and changing my eating habits, what this has meant is less insulin. When I say less, I mean by only around 1/3, but this has resulted in fewer hypo's than before. I believe the less insulin floating around in the system, the less chance of it causing hypo's. It is all about finding the correct dosage of insulin to match the food you eat and your daily routine/exercise.<<
    This is the essence of Bernstein's doctrine of small numbers
    Hana
     
  9. noblehead

    noblehead Type 1 · Guru
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    Hana, believe me...............................I didn't get this from Bernstein!

    As I said, it was through my own experience and endeavours, I don't follow anybody's doctrine, don't want too, don't need too!

    Nigel
     
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