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What’s the best hb1ca

Discussion in 'Type 1 Diabetes' started by m786xxx, Sep 10, 2020.

  1. m786xxx

    m786xxx Type 1 · Well-Known Member

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    Hi I would like to know what’s a good hb1ca?
     
  2. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    The closer to 'normal' the better. Normal is below 40. Complocation risk increases as HBA1c rises above 42 (6%).
     
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  3. EllieM

    EllieM Type 1 · Well-Known Member

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    A lot of people have different targets, according to their circumstances, The UK's main target level for T1s seems to be 48 (or 6.5% in old units) , but a pregnant T1 might have a target lower than that and someone who has reduced hypo awareness might have a higher one (my doctor prefers me to keep above 50).

    And some people's bodies seem to tolerate higher levels better than others, so your target can be influenced by the onset of complications, which mean you need to run your levels a bit lower.

    And if you'd been regularly running an hba1c of 70 then you'd probably be very happy to attain one of 60, so it all depends on the person.

    And you can argue that TIR (time in range) is a lot more important than hba1c since you can mask high blood sugar levels by having a lot of hypos. The technology for young T1s like you has improved dramatically in the last decade (eg continuous glucose monitors, pumps etc). Also, the screening and treatment for diabetic issues (eg eyes) seems to have improved.
     
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  4. m786xxx

    m786xxx Type 1 · Well-Known Member

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    It’s all so confusing to me, I have been a type 1 for 10 years and my hb1ca has never been lower than 70, however no complications or hospital visits. They are convincing me to go on a pump but I refuse. I wish there was a better way to control it
     
  5. Juicyj

    Juicyj Type 1 · Moderator
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    Hello @m786xxx

    What’s your reasons for refusing a pump ?

    I was apprehensive about using a pump but it’s brought my HbA1c down to its lowest since having t1 - 42. I wouldn’t discount a tool which would enable me to improve my control, I couldn’t live without mine now, it’s helped me exercise more, reduced my anxiety with testing and injecting, a game changer, whatever doubts you have discuss them as it would help you greatly.
     
    • Agree Agree x 1
  6. porl69

    porl69 Type 1 · Well-Known Member

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    @m786xxx I would have to agree with @Juicyj on this. I was 48 years into my type 1 and offered a pump. Been on it 18 months now and wonder why I never pursued one beforehand. It is a game changer. A1C down in the 40s now with pretty much perfect control 90% of the time
     
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  7. EllieM

    EllieM Type 1 · Well-Known Member

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    If it's any consolation, I'm pretty sure my hba1c was way higher than yours for my first ten years of T1, pre glucometer.

    Have they offered you a continuous glucose monitor (libre)? Do you know how to count your carbs? I always found that my control improved dramatically the more I tested, so a cgm is a big game changer.
     
  8. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    The trouble with higher bgs is that you get used to them and imagine that all's well with the complications. This may be so now but the reason the doctors try and keep you under 7% (58?) is because afer about 20 years you'd be at much greater risk for those complications (this came out of research done circa 2008 in various studies).
    I think FSL is a great idea if you've got access to that as there is a difference between someone who is 70 all the time and someone who's going up and down a blood sugar rollercoaster! The former is better than the latter hence the comments on this thread about TIME in Range.
    The good news is that the pump/monitor tech is getting better but don't wait for it or stick your head in the sand (speaking as someone who got away with it until I didn't anymore and now have sight loss).
     
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  9. m786xxx

    m786xxx Type 1 · Well-Known Member

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    I was shown the pump before twice but I refused, that time my hb1ca was above 100. Now my last two results have been 70 so I think they are wondering if the best option is to use a pump. I don’t know how I will hide and I work at the airport so going through security a few times in a day could be an issue, I also sleep on my front and twist and turn a lot lol so I’m scared that I will do something wrong. What’s the best pump to use? I heard some people benefited from trying different insulin?
     
  10. m786xxx

    m786xxx Type 1 · Well-Known Member

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    No they haven’t but I have my hospital appointment in a few days so I’m trying to gather as much information as I can. 5 years ago I become extreme insulin resistance and the doctors kept blaming me for it until on the forum people suggested that I try metformin and honestly that changed my life and I can’t be thankful enough.
     
  11. m786xxx

    m786xxx Type 1 · Well-Known Member

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    I agree that 10 years is a long time and one day it will catch up. What pump are you using right now?
     
  12. m786xxx

    m786xxx Type 1 · Well-Known Member

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    I like the glucose meter libre, it’s more manageable and I can hide it better and even not have it on when attending weddings but that’s another one of my concern. I don’t know why they didn’t offer this to me.
     
  13. Pam R

    Pam R · Member

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    I got my HBA1c down to 44 from 103 in about three months but it slowly crept up to 50. I take Lantus basal insulin 4 units in the morning and 4 at night and my glucose levels are between 6 and 10 every day. I eat a low carb diet. I agree that we are all different and your HBA1c will vary. However I wouldn’t want mine to go any higher and I will probably have to start bolts insulin as I feel my “honeymoon” period may be waning!
     
  14. m786xxx

    m786xxx Type 1 · Well-Known Member

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    That’s really good compare to mine, I take lantus 12 in the morning and 7 at night and than depending on what I’m eating I take novorapid 8-12 units with every meal. To be honest I’m bad with carb counting, did you get any complications when you reduced your hb1ca within 3 months?
     
  15. EllieM

    EllieM Type 1 · Well-Known Member

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    How confident are you that you are on the correct amount of insulin. The first thing to get right is your basal. If it's right your readings should stay level when you are fasting eg overnight. Ideally your team should be checking that your doses are right when you go to the clinic. My team get me to keep a food and glucose level diary for a few days before my appointment, it really helps with the dosing.
     
  16. m786xxx

    m786xxx Type 1 · Well-Known Member

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    I think I’m ok with lantus because I was taking higher and than I would go into hypo during the night. My hormones are different during the day and I need more insulin. The meals one I could be wrong but than again I don’t do carb count or wait 4 hours before eating something again. I think if I can convince them to give me the new blood sugar meter reader than I can give myself insulin accordingly and also check sugars before think I’m going in hypo and eating .
     
  17. m786xxx

    m786xxx Type 1 · Well-Known Member

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    Do you recommend I try something else?
     
  18. EllieM

    EllieM Type 1 · Well-Known Member

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    Not really my area of expertise, as I'm on basal/bolus myself (lantus and humalog). I self fund a dexcom because I became allergic to the libre and I have very poor hypo awareness. I would definitely agree that the libre could be a game changer for you. Pre cgm, I always found that my control improved dramatically when I did more testing.

    Have you been on the DAFNE course? It's supposed to be very good, and might help you understand your diabetes. Though doctors can change our insulins and advise us on dosing most T1s find they do better if they take control of their own dosing, as you know your own body much better than a consultant who sees you for 15 minutes every year....

    Good luck.
     
  19. m786xxx

    m786xxx Type 1 · Well-Known Member

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    Yes I agree just like I figured out that I was insulin resistance and convinced them to put me on metformin. I do think the libre will help me a lot in terms of how much insulin I need so it’s worth a try before last option is pump. I just don’t know if I can get it on nhs, but I guess the pump and the libre will add the same amount of cost so They shouldn’t have a problem. I do have hypo awareness but I end up going in hypo a lot during my sleep which is risky and it’s mostly because either I have taken too much insulin or just tired of pricking my same fingers agin and again. The DAFNE course I was put in the waiting list twice but everytime I missed it so I’m really going to push them for this blood sugar meter because I think this wil really help me get in control. Thank you for your advice and information it’s helped me x
     
  20. Pam R

    Pam R · Member

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    I felt absolutely fine! Started on 6 units of Lantus and increased it to 12 over a short period of time and then had to decrease it to its present level. Got my latest HBA1C results on Thursday and I have dropped again to 48! Really pleased with that! The low carb diet and plenty of walking are my mantra!
     
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