HbA1c etc

[spongey2010]

Hi All,

My boyfriend had what I think you call the HbA test a few weeks ago, he has got the results and apparently his blood sugar is averaging at 9. Is this worryingly high? I notice that people aim around the 5/6 mark, but I guess everyone is different. I'm just concerned about complications, he has foot and eye problems already. From what he tells me, his bp, cholesterol and urine are fine/good.

I would like to try helping him lower his blood sugar (safely), but I am really struggling when I can't be with him 24/7 to encourage him to test his blood sugar etc.

 

[bev]

9 is on the high side. Did his team offer him any advice or support on how he can get his levels down? How long has he been diabetic and what regime is he on?🙂Bev

 

[spongey2010]

Hi Bev,
That was a quick response 🙂

He is type 1, been diagnosed for about 23 years ish, slow release insulin in the morning (lantus I think) and Humalog with meals. The diabetes nurse made an appointment with him at the very end of November - These diabetes nurses seem a rarity indeed.

 

[bev]

Hi Spongey,
Does your boyfriend write his levels down or have a record of them anywhere. It would help to see perhaps a days worth of levels to see if there is anything obvious that could be tweaked. Is he often high? Do you know if this hba1c of 9 is what he normally is or is this higher or lower than normal?🙂Bev

 

[Northerner]

Ideally, the HbA1c should be 6.5% or below, as it is at this sort of level that you have the best chance of avoiding diabetic complications. It's good that his other tests were fine 🙂 Does he test regularly, before and after meals, and if so, what sort of levels does he get. Probably the best place to start in reducing the HbA1c is to try and get his waking levels in the 5-7 range on his meter. How he can achieve that is probably dependant on what sort of insulin regime he is on. Keeping records for a while and then returning to the nurse or doctor will be a good starting point, as they may then suggest adjustments to the insulin to get better levels. Diet is also important - certainly things like obviously sweet things are best avoided, but so are items made with white flour, like white bread, pitta bread, naan bread etc.

The thing to do is not to try changing too many things at once, or too quickly.

 

[spongey2010]

Hi again,

No he doesn't note his levels down, this is what the nurse advised for when she sees him and I am trying to encourage this now 🙂 I want to help, but I am finding I can only do so much, which makes me a little . I think there is a possibility that the nurse might put him on a carb counting course, which may well help. One doctor advised him to take his insulin before his meals, but he has reverted to just after, which probably isn't good.

I am caught between trying to help and interfering, which is tough.

 

[bev]

Hi again,

No he doesn't note his levels down, this is what the nurse advised for when she sees him and I am trying to encourage this now 🙂 I want to help, but I am finding I can only do so much, which makes me a little . I think there is a possibility that the nurse might put him on a carb counting course, which may well help. One doctor advised him to take his insulin before his meals, but he has reverted to just after, which probably isn't good.

I am caught between trying to help and interfering, which is tough.

It is very tough when you want to help - but dont want to interfere isnt it - but well done for at least trying!🙂

If you ring one of the meter companies they will send you a log book for keeping records of levels. Of course, you do need to have your boyfriend on side to do this as there is no point if he isnt motivated enough to do it.

He absolutely needs to go on a carb counting course - it is the only way to work out insulin/food ratio's - so try to encourage him to go if you can.

Injecting after eating isnt good - it can spike levels up too high and then it means high levels that need correcting all the time. Is there any reason your boyfriend chooses this way?🙂Bev

 

[Robster65]

Hi spongey.

He sounds very much like me for the past 30 odd years. Very hit or miss and near enough is good enough so as to get a better quality of life.

In the past year (less actually) I have started taking things more seriously. My girlfriend does all the writing down for me because I'm either too forgetful or too lazy (prob that one). We have found patterns where I thought there were none and have made a huge difference to the averages. I've seen the local DSN after a long wait and she is helping us make a few more changes, which I would have resisted a while ago but I cna now see that they will keep me in far better health.

If you are able to note down as much as you are able, you may be able to show him what he's doing and encourage him to go that extra mile.
It puts a lot of the effort onto you, which is unfair but some of us are very very stubborn and dont like change without strong evidence.

If you could get him to come on here or even just read a few threads, it may help. I spoke to no other type 1s until I found this place.

Rob

 

[katie]

Hi Spongey.

How does he determine how much insulin to have with each meal? Does he carb count? He really needs to go on that carb counting course. And It would be best if he took his insulin before meals.

 

[spongey2010]

Hey all,

I think after so long, he has a reasonable understanding of carb counting, which can be further enhanced by the carb counting course. We had a very nasty hypo incident when he took enough insulin for a meal and then (long story) we couldnt get a meal. I think that is why he is hesitant to take before meals. I think changing the insulin to pre meal could change a lot quite easily, but then again I'm far from an expert. Again, not an expert, I think that he sometimes gets too low and then boosts himself with something sweet and this takes a while to work out of the system.

I don't mind the responsibility and hassle, if it meant he was healthier. I'm just sure how I can make him see that this should take up more of his time/take more of a priority over work etc etc....

 

[Robster65]

There are many many stories on here and elsewhere of type 1s who have not taken things so seriously and ended up with problems. It's difficult to find an incentive to change if you're getting away with it but it only lasts so long before complications catch up with you.

If he's already had issues with his feet and eyes, he really should be tightening up control and the best way is by keeping records so you can both see where the improvements can be made. It needn't impact too highly on his work other than testing for a few days before and after meals and then reviewing the results after a few days to find patterns.

Rob

 

[Northerner]

If he doesn't want to write things down, then most meters have software applications available so you can download the meter to a computer and review the values there. The meter companies will often supply the software free.

One meter that a lot of people here like is the Countour USB. This can just be plugged into the USB port of a computer to download the results and is therefore simpler to use than some of the others. I wonder if it might be an idea to buy him one of these meters as a present and as a way of encouraging him to take more interest in his readings?

http://www.bayercontourusb.co.uk/

 

[bigpurpleduck]

Hi Spongey,

I don't have any further suggestions, but just wanted to say how lovely it is that you're so keen to help out your partner.

My A1c was around the 9% mark when I met my man, and he has been amazing. Over the past 4 years I've been with him, I've made huge steps forward with my control and currently my A1c is around 7%. I am eternally grateful to him for all his help and support.

If your partner finds it difficult to focus sometimes & struggles with motivation, offer to take over for him (if he's happy with this). When I'm struggling with it my man often checks my blood sugars for me, calculates the carbs and gives me the insulin I need. It's wonderful to have a bit of a break sometimes.

I just wanted to say thank you as another diabetic whose supportive partner has made a huge difference!

 

[everydayupsanddowns]

Hope you manage to make some progress together. The D can be a bit of a strain on a relationship. A little gremlin lurking in the corner of every single day. I think there are more people on these boards than not (myself included) who let things slide for quite a while, convinced ourselves that there was nothing else that could be done, blamed diabetes randomness or otherwise just thought we were doing the best we could while secretly knowing that our control really wasn't as good as it could be.

On the plus side, the benefits of better control far outweigh the effort involved. If he's been running high sugars for a while chances are he's got used to feeling lethargic and a bit worn down all the time. If he's often having little dips into hypoland he's used to that constant nagging back-of-mind worry that it could all go wrong any moment.

Not that these worries/problems ever completely go away, but little improvements in control, fewer highs, fewer post meal spikes, fewer hypos make a huge difference to your sense of well being.

I'd got used to waking up low 2 or 3 times a week. Sometimes nastily low where my wife would have to help out (never the sharpest tack first thing, me) and my kids would get quite scared about how weirdly I was behaving.

I've been putting in more effort, writing stuff down, trying new strategies that I've found on boards like this one for less than a year, but already I can recognise that my diabetes puts less strain on our family than it did. I'm almost never low in the mornings these days. Feel way better, more in control, and if I'm honest I'm less prone to the grumpiness that follows a few rubbish and/or 'inexplicable' readings.

If the prospect of sitting in a room with other diabetics fills him with horror, there is an online carb counting course (BDEC) which might be worth a look.

Mike

 

[Northerner]

One thing I know that can really motivate people is to come to one of our meets, so if you could both come along to the London one you'd be more than welcome! We're not scary axe-murderers or anything, and it can really help to just be amongst a group of people where you don't have to be guarded about anything you say, and people really understand what it all means. 🙂

 

[Twitchy]

Hi Spongey,
When I'm struggling with it my man often checks my blood sugars for me, calculates the carbs and gives me the insulin I need. It's wonderful to have a bit of a break sometimes.

I just wanted to say thank you as another diabetic whose supportive partner has made a huge difference!

Oooh, your partner sounds lovely! 🙂 Do you think you could get him to train mine?! 🙄

Spongey - just wanted to say I know how you feel - I have a t1 sister who is very 'relaxed' about her diabetes - and I find it soooo hard to walk the line between trying to nudge gently & nagging! It's really great that you care & have made the effort to find this forum - he's a lucky guy.

Twitchy x

 

[spongey2010]

Me again

Hi All,

Thanks for all your replies, some really good advice.

To Big Purple Duck - I would try and help him, but I have had quite a severe needle phobia for years!! LOL, which isn't helpful with a diabetic boyfriend. My friends think it's hilarious that a needle phobic like me has found a diabetic boyfriend 🙂 On the flip side, it could help me overcome it, but the fact that I collapse sometimes at only the mention of a blood test (yes really!), there is an issue! 🙂 However, I would be prepared to try, I seem to be able to handle the pens fine, but if he uses a normal needle for any reason, I am a mess.

To Mike - I can totally see what you mean about relationships. I knew him for a while before we got together, I knew he was diabetic and I thought oh that just means you have to inject etc. It wasn't until we got together that I realised what an impact it has on someone's life and the implications. Seeing someone collapse/fit etc is a pretty big thing for someone like me who has never had to deal with anything like this before, so I can't imagine what it is like for all of you with diabetes.

I can understand how he just wants to be normal, go out to dinner and just not worry about it all, but sometimes you can't bury your head in the sand. Today, I designed a quick spreadsheet for him to record his blood sugar results on...whether he will use it or not is a different story. I'm kind of feeling at the mo that you can lead a horse to water and all that....which leaves me feeling frustrated 😱