blood sugars

[VBH]

Aarghh, my A1c target is 7.5 or below as prescribed by my DSN, I think because I am sensitive to insulin, so to avoid too many hypos

hmmm I wonder sometimes if there's a training course for DSNs which includes the comment "any diabetic with an a1c under 7.5 is in a permanent state of hypo". They do seem particularly convinced that a low A1c means a LOT of hypos.

But I think the "sensitive to insulin" bit might just be a bit misleading. I think it might just be a case of learning to adapt your regime to match your lifestyle (or perhaps a little in the opposite direction). That's basically what northerner's done over the last year (congrats Northie, btw 🙂 ).

But with you being a runner, I suspect that makes it a bit harder because there are more variables. I do sometimes think though that they put these handy labels on people out of pessimism. They're just unambitious with your health.

I think you can get a lot better than 7.5 so don't be put off by someone else's expectations of failure 😉

 

[SilentAssassin1642]

just back from town - checked again due to epic thirst again - 11.2 tried phoning the dsn but well...that didn't go well. And GAH, irritating arm pain again which according to the GP has nothing to do with the diabetes WHATSOEVER!. This is irritating me now. It's only up at 11 because I went low earlier...

well, appointment on friday morning to sort out various things again. Am going to ask the doc AGAIN about this arm pain and the sugars and whatnot, and I might even try the dsn again later or tomorrow. But dyu know what, I'm slightly fed up with the sub par diabetes care in winchester

ok, so i decided to give the dsn another call back to talk about it...as it was sort of brushed over earlier cuz she was busy...and it turns out she leaves at 4pm Oh well.........does anyone else have this issue? Like i say, its kind oif sub par, i remember when i was first diagnosed my dsn was on call 24/7!

I just want to get some advice on this stuff and it doesnt seem to be happening

 

[Northerner]

Well, it's probably not that helpful at the moment, but just wondering if, for the future you could get referred to the RSH in Southampton? It's only a short train journey from Winchester, and I'm sure they'd sort you out in a jiffy!

 

[SilentAssassin1642]

its definitely something I'll be asking about, what with thinking about moving there anyway (hopefully soon!) as Ive heard the team down there are brill.

But I've asked her to give me a call back in the morning or when she gets the message (so...the morning...) so I can ask her about the whole irritating high feeling when not actually high that also makes my arm tingle irritatingly

I sound like a hypocondriac 😛

 

[runner]

I think you can get a lot better than 7.5 so don't be put off by someone else's expectations of failure 😉

Oh yes, I am aiming for lower and my DSN has said I should aim for 'lower than'. My lowest so far has been 7.1. I wouldn't want to misrepresent him tho' because he's been very good and made a lot of effort to help me adapt my control to my individual needs and results, at the same time acknowledging my right and ability to manage my own diabetes. He's very encouraging, rather than having expectations of failure.

Thanks for the info tho'. 🙂

 

[Northerner]

...I sound like a hypocondriac 😛

No Sam, you sound like someone who is concerned about her health and wants to pre-empt any problems, which is a good thing!🙂

 

[runner]

its definitely something I'll be asking about, what with thinking about moving there anyway (hopefully soon!) as Ive heard the team down there are brill.

But I've asked her to give me a call back in the morning or when she gets the message (so...the morning...) so I can ask her about the whole irritating high feeling when not actually high that also makes my arm tingle irritatingly

I sound like a hypocondriac 😛

You're not! I can understand your frustration and hope she gets back to you tomorrow!

 

[aymes]

Hi Salmonpuff,

I remember the first time I had pizza during the DAFNE course. With my ratio, I needed to take around 16 units of insulin for it and I remember thinking I was going to hypo for sure, but nope it was spot on. There are a lot of carbs in pizza and it's still what I need to take most insulin to cover. I also need a lot of insulin to cover fish suppers from the chip shop, and thick pastry pies.

Just wondered if it was a shop bought pizza or from a takeaway as i heard takeaway pizza's can often have sugar in the dough!

I wonder if pizza is a common theme in dafne. We had one guy on our course who wen out for pizza on the second night, saw the amount the carb counter book told him to take and simply couldn't believe it so took a lot less, he won the prize for the highest reading of the week...!

But dyu know what, I'm slightly fed up with the sub par diabetes care in winchester

I am very lucky with the care up here in Norwich and it's seriously one of the main reasons why I wouldn't consider moving away anytime soon. I had the chance for a job elsewhere but the uncertainty of care ( and other things of course) put me off.

 

[PattiEvans]

Salmonpuff
Pardon me for butting in. I noticed that you live in Winchester which is not too far from Bournemouth. If you can get to Bournemouth by train for 4 days (1 day per week over 4 weeks) ask your Dr to refer you to the Bournemouth Diabetes and Endocrine Centre for a BERTIE course. The course will help you understand about how to titrate your insulin doses (it's similar to DAFNE but I think a better course). See here for more details http://www.diabetes-support.org.uk/joomla/dafneI know Dr David Cavan there, who is excellent and I know he would accept you on a course, because he offered me one if I could get there, but sadly I live near Land's End and it's just not practicable. I have done the online BDEC course though and I know several people who have done the real life course and all speak very highly of it. I really think it would help you to get to grips with your diabetes and help you tighten your control.

Even with just the online course I've never had an Hba1c over 5.7 for 5 years and I very very rarely see double figures.

Hope this helps.

 

[VBH]

Thanks VBH. Does the HbA1c actually help in this respect? For example, if all your meter readings look OK and your HbA1c is good, wouldn't that mean that you're not getting prolonged peaks? Or do you know if it is any peak - even sharp ones that subside quickly - that are thought to be harmful? I'm no scientist, but assuming that a short peak doesn't affect as much haemoglobin?

I didnt get around to looking around for a good summary, but Jenny Ruhl has a summary of research into BG/Damage here:
http://www.phlaunt.com/diabetes/14045678.php

Now I know its a lot to wade through and quite technical in places, but its worth a read. Interestingly the first study she refers to mentions this:

"Even more telling, the researchers found that the length of time a patient had experienced this nerve pain correlated with how high their blood sugar had risen over 140 mg/dl on the 2-hour glucose tolerance test reading."

But there's plenty of other references in there to peaks and damage so its interesting. There's references to the damage being caused by mechanisms which is separate from the mechanism which leads to the glycation of red blood cells. So damage would seem to be caused to cells in circumstances where the A1c is not affected.

One thing I should highlight though - most of those studies were done on tissue samples in the lab rather than in the body since that would be far more difficult to do. So there may be other factors involved which may mean things are not quite as bad as the research implies.

However I would expect that to just mean that things happen a little easier in the lab so perhaps some of the BG numbers would have to be a little higher in the body to get the same effect.

p.s. should this thread be split? Not that I am sure where you to split it 😉

 

[katie]

I know Dr David Cavan there, who is excellent and I know he would accept you on a course

he is my specialist too 😎😎