HbA1c worries

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nikkiwhyte

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Type 1
Hi, I've been having a lot of problems with my diabetes recently and have not been looking after myself for years. My last HbA1c was 11.3 which I know is extremely high and I'm due to get another soon and fear it will be higher.

I know this is an inticator of how things have been over the last few months. I've been told by my specialist to start off controlling my BMs to stick a level around 9 - 12 so I'm not dropping too low too soon and grately I will make the drop to "normal" BM range.

I'm struggling ALOT with this carb counting thing too!

Any one else been in this situation or have any advice?

Thanks
 
Ok, good for you for starting to make a change, my advice would be this

*Get a diary and write everything down (or can use a meter that downloads your results)-can't emphasize this enough, if you aren't recording you cant see what sort of patterns you have.

* I'm not giving you medical advice here! Always check with DSNs about altering insulin if you are unsure. I was told to look at patterns (where blood sugar goes up and down) rather than individual numbers before alterning insuln-which is why its so important to record it.

*Use your DSNs as much as you can when you are unsure

* Dont beat yourself up when it doesn't happen overnight-it will take time but you'll get there. Remember every 1% reduction in HbA1c leads to a 30% reduction in risk of complications.

Whats the problem with carb counting? I struggle with it too- I cannot eyeball amounts so I have to weigh everything (which some people disapprove of), got a set of carb counting scales that have helped.....
 
Ye I've been keeping a record of what my BM's are before meals and in between sometimes too so I can get a better understanding of what is going on.

I just start to think I'm understanding things and something else comes along! I know it's learning process just hope after so many years of mistreating it it's not too late.

I just don't understand the measurements of the carbs and so carb counting scales sound great! Spent an hour before tea tonight working out how much carbs and still did too much insulin as feeling low now and off to have some toast!

How are you coping with the carb counting now?
 
sunflower_harvester said:
Ok, good for you for starting to make a change, my advice would be this

*

Whats the problem with carb counting? I struggle with it too- I cannot eyeball amounts so I have to weigh everything (which some people disapprove of), got a set of carb counting scales that have helped.....
Click to expand...

Whats wrong with using scales?My sons dietician told us to buy digital scales for the purpose of carb counting. Bev
 
Been to see nurse at hospital today for a refresher on carb counting. she gave me a booklet with all the carb counts in it.
 
i know how you feel may last hbc was 13 i ben trying really hard the last 4 months had a new test this week and seeing consultant i really hope it has gone down i really dont know what i will do if it is higher.im interested in carb counting never done this i thought you had to go on a course to learn how to do it.
 
I've left a message with my specialist to help explain carb counting properly as not sure how they expect me to control things when I don't fully understand what I'm doing.

I wouldn't be surprised if mine was even higher than that too. It's scary isn't it but sometimes the reality kick we need. I feel quite low when my BM is at 8 so likely mine with be high.

Let me know how you get on with your results this time.
 
carb counting is awkward for the first 2 mnths or so, but i find that i tend to eat the same things so you learn to be able to tell how much is in some things. some things you can't relly learn - restaurant etc. but it does get easier and i can honestly say its changed my diabetes. sometimes i get it wrong but then i know for next time. i would definatly get some carb scales rosemary conley i think- i got mine free when i got a pump. and a small pocket carb counter you can get in most stores and highlight things you have often.

i used to get hypos at 8 mine were that high, i thought i was doing well if they were below 20. i was ill all the time, but since carb counting i sometimes don't feel hypos until 3-4 now. my normal level is 6-7 whihc im extremely happy with.

hope you get your head round it as it works when you do (speaking from my experience)
 
It''l take a bit of time to get used to doing it. Thats good that you are writing things down, it will help you identify patterns.

an A1c of 11.3% represents being around 16-18 mmol, so aiming for 9-12 should show you an improvement in A1c.
 
Your levels sound exactly like mine too! I'm trying so hard at the moment to get things down (been advised to stick between 10-12 at the moment and then gradually work down). Thought I was starting to get the hang of things last night and then went to bed on a level of 10.8 and woke up to 5.5! Confused!

Out of curiousity how long did it take you to get back to feeling "normal" again? I'm so inpatient and struggling with the fact nothings working over night but I guess you learn from your mistakes! I'm always tired and feel "spaced out" and realise now that is becuase of my high blood levels. But I've been like that for so long I didn't know any different.

Well I tend to have the same for breakfast every morning and weekdays same for lunch all the time so once I can calculate those it'll be easier for me. Bit of guess work at the moment as having to do it myself - but I guess it's just trial and error.

Worry is I've done myself permanent damage having mistreated this for so many years but only time will tell and I can only look forward and try makes things better for the future.
 
Hi Niki, that 5.5 was a brilliant result this morning 🙂
As already stated you need to learn to carb count and adjust your insulin in accordance with carb intake.
One thing that I don't think has been mentioned is that until your basal is correct you will get wacky results.
Even though this is aimed at pumpers the same principle applies

http://www.diatribe.us/issues/13/learning-curve.php
 
bev said:
Whats wrong with using scales?My sons dietician told us to buy digital scales for the purpose of carb counting. Bev
Click to expand...

Personally I think theres nothing wrong with using scales-it helps me immensly and makes me feel more confident as I just can't guesstimate carb amounts-I wouldn't dream of guessing my blood sugar before doing insulin so why would I guess the carbs?

I believe some people disapprove of using scales (and my dietician tries to discourage it) because you cant always weigh everything (for example if you are at a friends or eating out or your scales break) so being able to eyeball is more practical. Think its down to personal preference really.

Nikki its good your recording and your trying with carb counting. Has a dietician or DN gone through how to do it with you? If you are working out your insulin dose based on carb content then you need to be clear how to do this so get them to go through it with you again until you are happy.

To be honest the easiest way to do it is (using scales-at least at first then when you get more confident you can start eyeballing if you want to) is to work out carbs per 100g divided by 100 multiplied by the weight of the food
e.g. cereal 100g=80g carbs 80/100= 0.8 0.8x40g portion= 32g carb (So if you use a ratio of 1 unit of insulin to 10g carbs you would then inject 3units-check your personal ratio with your DSN as different people need different ratios!!!)

Most foods have this info on side of packet plus the carb count per portion which might make things a bit easier. A book like collins little gem carb counter or calorie carb and fat bible will tell you most things. It is a bit of trial and error too and different foods will affect your blood sugar in different ways but persevere, dont give yourself a hard time when it doesnt go to plan-keep looking at the bigger picture and remember that just 1% drop in HbA1c will bring you huge benefits-and you'll start feeling better too.
 
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