Frustration!

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Pigeon

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Type 1
Hi there, had my clinic appointment today and my HbA1c had gone up to 7.4, after getting it down to 7.1 last time. I just seem to yo-yo every 4 months, I've only got it below 7 once!

I was just so frustrated as I've been trying so hard (keeping diaries, plotting spreadsheets to look for trends), but it never seems to pay off. I didn't see my usual doctor today, who is lovely and takes time to get to know me as a person. Instead I saw a registrar, who was nice but didn't seem at all interested, just said "well it's 7.4, worse than last time, do you have any questions, see you in 4 months" and I was out the door then cried all the way home! I'm usually so positive and optimistic, but today it just all got to me. There was a blind lady in the waiting room, and I kept thinking about her and that amputated toe on the Hospital programme, and thinking that'll be me if I don't get things sorted. Don't want this anymore.

I think the trouble is that I like to do lots of different activites which are never the same twice (In the last week I did walking, cycling, swimming indoors and in the wild, sauna, steam room, rock climbing, trampolining...) and just when I think I have it sorted something changes, or often I end up just eating sweets to keep me going as it's not practical to stop and test, e.g. the rock climbing. Also we tend to eat large, carby meals which take ages to digest, so I can go to bed on a good level but wake up high because dinner was still digesting. But I don't want to eat less as I have quite a low BMI and I don't really want to lose weight.

But I think I have done enough moaning for one day, so it's just back to the diaries and the meter to try again... going to do all the post-meal tests for a couple of weeks to see what's going wrong. Sorry about the whinge.
 
Hi Pigeon.

You sound a bit like me. Except I don't do the acivities apart from walking these days. Used to do rock climbing though.

We've been keeping meticulous records for weeks and have got things better but there's still plenty of lows and the odd high that niggle. I'm hoping my HbA1c is below 7 for the first time but I've got a few months to wait until the next test.

Don't give up. Have you tried pasta as a carb source ? It seems to digest a lot more evenly without the late spikes. We've also switched tomain meal at midday so I'm a bit more active if any biggies come through the stomach wall !

Keep doing what you're doing. You'll get some good advice regarding the sports. I have a book "The Diabetic Athlete" by Sheri Colberg which may help you to get better balance. I must admit, it was never really helpful for my climbing but I spent a lot of time belaying in between which never helps.

Rob
 
Thanks for your reply Rob, it's nice to hear from someone in the same boat. I've never actually read any books about diabetes, maybe it's time to start! I went on an advanced carb-counting course at my clinic which was meant to cover exercise but they ran out of time for it, and I found the nurse quite patronising, which has made me reluctant to ask for help there. Perhaps I will have a spree on Amazon!

I don't like eating a main meal at mid-day as it makes me too sleepy! But yes, I have found pasta is a bit more even than rice or bread. I was camping in Scotland for the last 2 weeks (hence all the activities) and I had some crazy middle-of-the-night highs after barbecues, I didn't even eat much bread but I think the fat and protein did strange things. But then I had some strange unexpected hypos too, I think just crawling round a tent lots on hands and knees uses a lot of energy!
 
Always difficult to get the carbs right when camping. Until I joined the forum, I'd never really discussed my diabetes with anyone bar doctors/nurses.

It was something I tucked away and brought out when I had to, if you see what I mean. I've discovered so much about carb counting which we're trying our best at without any formal help and even insulin resitance was a new concept to me. It can be so hit or miss unless you follow a pretty fixed routine every day. Spontaneity will win out if it takes us years to sort it ! 🙄

Rob
 
Like Rob, I'd certainly recommend the Diabetic Athlete's Handbook, and also Think like a Pancreas (although I found the latter a bit too 'American', but has some good helpful stuff in there too). It's certainly worth reading up on the theory as it can help you prepare better for the different types of exercise you plan and at least have a god basis for planning your food and insulin needs - even if they don't quite match 'your' diabetes!

You will get there Pigeon! Sorry to hear the registar was one of those who just sees your number isn't dreadful and just wants you out of the door - that's been my experience on my last two annual reviews. He seemed too bored to bother thinking about answers to my questions, which was annoying when I had had to wait over an hour beyond appt time for him.
 
Northerner said:
You will get there Pigeon! Sorry to hear the registar was one of those who just sees your number isn't dreadful and just wants you out of the door - that's been my experience on my last two annual reviews. He seemed too bored to bother thinking about answers to my questions, which was annoying when I had had to wait over an hour beyond appt time for him.
Click to expand...

Cheers Northerner! It was exactly like your experiences, they seemed to be running 30 mins late even though my appointment was 5 mins after the clinic starts! I had wanted to ask about the possibility of using shorter needles as I have lots of horrible bruises at the moment, but I was so disappointed and felt rushed that I just left without asking.

Onwards and upwards, I'm going to buy some books to give me new ideas.
 
Pigeon, you could just ask for smaller needles from your GP when you get your next prescription, I'm sure they would give them to you.
 
That's a good point, Katie, I'm going to the GP next week so will ask then.

Thanks.
 
I'm off tomorrow for the bank holiday weekend in the Lake District. I'll be marshalling on TERREX race (see http://www.adidas-ar.com/newsite/index.php to follow athletes, although a few photos of marshals may be slipped in) As the race consists of prologue on Thursday evening, then day and night from very early on Friday morning until midday day Monday, I expect I'll be awake at every one of 24 hours over the 4 days, with some sleep in every 24 hours, but no guarantee it will be all at once; walking up hills carrying large amounts of heavy ropes, climbing gear etc; meals will be as and when. We'll be "wild camping", so I'm taking all food with me, as not sure if / when I can buy more; water will be from streams; guaranteed showers only at sports club on Thurs night / perhaps Fri morning / Monday afternoon. Personally, I rely on pitta bread (in vacuum packs), scottish oatcakes, muesli bars, jelly sweets, cup a soups with pasta, flavoured instant cous cous for carbohydrate, plus cheese, fruit, hot drinks, cold drinks for flavour.
Fortunately, I know enough about how I react to activity, weather etc to know to adjust my basal insulin (2 injections in each 24 hours really helps in these situations) and I'll eat when I can, bolusing as appropriate. Sure, my HbA1c would be better if I stayed at home all weekend, but I prefer to do things I enjoy, in places I love, with lots of friends.
 
Hi

I just want to say congratulations what a great HbA1c. Probably not what you expected to hear is it. But I'm serious, its a great result. Anything under 7.5 is a great result.

I was told that what people don't understand (me included by the way) that the HbA1c will go up and down by . something lots and sometimes it will be a few . (points) up and sometimes a few . down. This is normal. So long as you strive to keep it under that 7.5 you are doing great. That in itself is hard enough. It is a bit like weight which can differ half stone to half stone on difference days or times of the day.

It could be you have had a few more 8 or 9. somethings instead of a few more 5 or 6. somethings. It could be as small a difference as that.

Hope that has cheered you up.

Re the needles, just find out the size you want and get a script from the doctors. I wouldn't bother making an appointment to ask, it is not skin of their nose what size needle you use and quite frankly you don't need to see your GP about anything to do with your diabetes other than your scripts so I would put in a repeat or a letter stating this is what I want please instead of the others.

Good luck and take care.

🙂
 
I'd like to second Adrienne's comment about your great HbA1c (must admit, that's the sort of levels I get, so I might be a bit biased!) Also agree about making prescription requests by letter (or email if your surgery accepts emails from patients) - I can't remember when I last saw any staff at GP (not even for flu jab last autumn, as got it at work), but they seem happy to respond to notes from me about eg new insulin pens.
 
Hi Pigeon,

Reading your post, it could have been me writing! I experienced the same thing at my last appointment - 7.1 up to 7.4 and the doc just wanted me out. I also eat carby meals and have borderline low BMI so don't want to eat less. I still struggle with carbs & boluses, etc.

I wanted to second Adrienne's comment about the A1c fluctuating a bit. When I got my 7.4 result my DSN said, "Congratulations, that's great!" and I was like, "But it's higher than last time?" She said it's kind of like the monitors - you can test from one finger and get 6.0, test from another with a new strip and get 7.2. So she said essentially my A1c was the same.

I guess you're on MDI since you mentioned needle sizes. I'm on a pump and have a Carelink USB which plugs into my computer, & using the software gives me loads of charts of my readings. It is AMAZING. Makes it so much easier to spot patterns & adjust insulin accordingly without doing too much too quickly. I actually just came accross a super cool monitor that does much the same, but doesn't need a pump. See here:

http://www.bayerdiabetes.co.uk/shop/shop-detail.aspx?id=apollo&PID=14&utm_source=facebook&utm_medium=ppc&utm_content=ppc&utm_campaign=usbaug&dsc=USBFBP

Em
x
 
Aw, thanks everyone for your support! It's nice to have people say it's actually quite good, I just find the diabetes centre a bit doom-and-gloom sometimes.

I'm feeling more positive today; as Copepod points out it is my activites and meals with my boyfriend which give me quality of life, and I'd rather live like I do than be inactive and eat less to give me a good A1c. I'm going to try to tackle lunch better as I've discovered I actually spend most of the afternoon above 10 , so I'll work on that and hopefully that will make a slight difference.

Thanks for the suggestion of the monitor PurpleDuck - I've got the older one, the Contour, which you can connect to a computer with a lead and use the stats etc, so I shall try to use that a bit more to analyse things. The USB one looks quite cool, but I'm waiting til they start giving them away free rather than paying ?25!
 
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