Hbac

[Bill Stewardson]

Saw the D nurse today who told me that my Hbac (?) is currently 107,

She says this is very high, Metformin doubled to 4 a day.

I know your likely fed up of being asked, however, what would you read into this ?

Cheers.

Bill.

 

[Kaylz]

Very high I was lower than that when I was diagnosed so it means your levels over the past 3 months have been quite high not quite sure what other answers you are looking for though? X

 

[Pumper_Sue]

In old money your A1c is 11.9, which is extremely high so you need to do something about it before you end up with major damage to your sight, limbs or kidney's.
Have you addressed your diet by looking at the amount of carbs and or type of carb you are eating? Exercise is that in the picture? If you have done all of these then you need to talk to your GP as a matter of urgency for a hospital referral or a different type of medication.

 

[Bill Stewardson]

Well, the nurse I saw was of the opinion that one third of my diet should be made up of Carbs which seems to contradict the theme in here. Nurse told me that most of what is said in here is relevant to people who inject.
I requested a testing kit, she said it is not necessary yet.
I do walk about 5 miles every day.
I am not looking for "other answers" more hoping for general pointers.
My diet has never been particularly bad, I have always been physically fit, I am not obese, 6-3 and 15st 10lb ish.
I do have other ongoing problems since Dec 2015 with pancreas and liver which require surgery, which is suspended until my D is under control.
My next appt is in one month.
That number worries me greatly, yet the nurse offered very little in the way of information re my future.
Hence my posting in the first place.

 

[Northerner]

Well, the nurse I saw was of the opinion that one third of my diet should be made up of Carbs which seems to contradict the theme in here. Nurse told me that most of what is said in here is relevant to people who inject.
I requested a testing kit, she said it is not necessary yet.
I do walk about 5 miles every day.
I am not looking for "other answers" more hoping for general pointers.
My diet has never been particularly bad, I have always been physically fit, I am not obese, 6-3 and 15st 10lb ish.
I do have other ongoing problems since Dec 2015 with pancreas and liver which require surgery, which is suspended until my D is under control.
My next appt is in one month.
That number worries me greatly, yet the nurse offered very little in the way of information re my future.
Hence my posting in the first place.

Hi Bill, as others have said, that is very high - slightly higher than I was at diagnosis. The thing about diet is that you need to discover what you tolerate well, and in what quantities - the only practical way to do that is to test before and after eating - see Test,Review, Adjust by Alan S which explains how to do this efficiently and effectively 🙂 I'd also suggest reading Jennifer's Advice and Maggie Davey's letter so you get a better understanding of diabetes - it appears that the advice you have been given by the nurse/doctor is wholly inadequate Definitely worth getting a meter yourself and using it for a while so you can see what's going on and use the results as ammunition to get them to prescribe. The cheapest option we have come across SD Codefree Meter which has test strips at around £8 for 50, a lot of our members use this very successfully 🙂

 

[Amigo]

Bill, a Hba1c of 107 equates to an average blood glucose level of 16.3. To keep under the 48 diabetic cut off point it would be no more than an average of about 7.7 on the meter.

Your level is very high and I hope the increased metformin helps because a level like that isn't advisable long term to avoid diabetic complications. Sue is absolutely right. You may even need a different or additional medication if your lifestyle and eating choices don't bring it down.

I'm sorry to be so blunt but your nurse is about much use as an ashtray on a motorbike and her advice isn't going to get your levels down. In terms of simple science and biology, carbs convert to glucose. Why on earth it's only relevant to people who inject defies understanding.

I think you need much more skilled advice than hers if you're to get your BG's down to levels where they'll do the operations you need. Can you ask to see your GP and ask for a specialist referral. Those levels are not sustainable Bill and not fair on you.

 

[Bill Stewardson]

Thankyou Northerner and Amigo.

Practical, go forward guidance is exactly what I was after.
Rest assured I will ring my GP, which should get me an appt in about 10 days.
All this indecision really bothers me, Im new to this and the complete contrast between advice from the nurse and views in here staggers me.

 

[Pumper_Sue]

Thankyou Northerner and Amigo.

Practical, go forward guidance is exactly what I was after.
Rest assured I will ring my GP, which should get me an appt in about 10 days.
All this indecision really bothers me, Im new to this and the complete contrast between advice from the nurse and views in here staggers me.

From your A1c result it's rather obvious your nurses advice isn't the one to follow. Even back in the year dot carb restriction was the norm for controlling diabetes.

My advice for what it's worth is do your own research, buy a meter and see exactly what different foods do to your blood sugars.
Don't expect instant results as that wont happen and the fact you are so dangerously high with your numbers you need to bring them down slowly so your body can adjust to being normal again.

 

[Bill Stewardson]

Perhaps it's worth me pointing out I received those numbers as 16-00 today.

Meter now ordered. They intend to sample my blood again on the 27th June.

Seeing my GP will not be easy, not sure what else to do. People keep pinpointing my diet, as stated, it is already balanced and healthy.

Also, I'm waiting for my damn exemption cert, with my other stuff I'm spending £15 per week which is severely difficult.

 

[Pumper_Sue]

Perhaps it's worth me pointing out I received those numbers as 16-00 today.

Meter now ordered. They intend to sample my blood again on the 27th June.

Seeing my GP will not be easy, not sure what else to do. People keep pinpointing my diet, as stated, it is already balanced and healthy.

Also, I'm waiting for my damn exemption cert, with my other stuff I'm spending £15 per week which is severely difficult.

Well ring up and ask where the certificate is.
Your diet may be balanced and healthy for a non diabetic but with numbers like your it obviously isn't healthy for you. 🙂 Can you give a daily sample of what you eat so others can help you out and or suggest an alternative.
Are you def type2?
I hope you are getting receipts for your prescriptions so you can claim back the money.

 

[Grogg1]

Well, the nurse I saw was of the opinion that one third of my diet should be made up of Carbs which seems to contradict the theme in here. Nurse told me that most of what is said in here is relevant to people who inject.
I requested a testing kit, she said it is not necessary yet.
I do walk about 5 miles every day.
I am not looking for "other answers" more hoping for general pointers.
My diet has never been particularly bad, I have always been physically fit, I am not obese, 6-3 and 15st 10lb ish.
I do have other ongoing problems since Dec 2015 with pancreas and liver which require surgery, which is suspended until my D is under control.
My next appt is in one month.
That number worries me greatly, yet the nurse offered very little in the way of information re my future.
Hence my posting in the first place.

Ignore the nurse! I was 117 Nov 16 when diagnosed and down to 42 three months later. I was given a meter and I'm on 1000g metformin daily. Aside from that I watch my carbs .

 

[Bubbsie]

Well, the nurse I saw was of the opinion that one third of my diet should be made up of Carbs which seems to contradict the theme in here. Nurse told me that most of what is said in here is relevant to people who inject.
I requested a testing kit, she said it is not necessary yet.
I do walk about 5 miles every day.
I am not looking for "other answers" more hoping for general pointers.
My diet has never been particularly bad, I have always been physically fit, I am not obese, 6-3 and 15st 10lb ish.
I do have other ongoing problems since Dec 2015 with pancreas and liver which require surgery, which is suspended until my D is under control.
My next appt is in one month.
That number worries me greatly, yet the nurse offered very little in the way of information re my future.
Hence my posting in the first place.

Bill if your nurse gives you advice like that...she is clearly in the wrong profession...at diagnosis I was not give an HbA1c breakdown...our local pathology lab does not provide that on the initial test...however my BG was given as 17.4...that was almost a year ago...since then I have followed a low carb high fat diet...managed to reduce my blood glucose down to an average of 5.9...a vast difference...my Metformin has been reduced to 500mgs daily...when I joined the forum as a member in September last year...I knew nothing...was advised to test my blood regularly...reduce my carbs...increase my activity...that is exactly what I did...most GP's & DSN's routinely tell type 2's not dependent on medication that may cause hypo's...there is no need for them to test their blood...absolute nonsense...for me testing routinely is the only way I have of seeing what effect the food I am eating has on my BG...we are given various excuses...too emotional...you'll become obsessive...the reality is it's all about cost cutting...diet is very much an experiment with diabetes...I follow a LCHF diet...that does not suit everyone...that's the benefit of testing...you are able to make your choices on the results your meter gives you...you probably do need to review your diet...some of what you consider healthy & balanced could be carb heavy ...some starchy vegetables...fruits can be full of sugar...even things like vegetable oil... have a look in the what did you eat thread...it will give you some ideas...proactive of you to order a meter & strips...best piece of advice I ever received here was to test my blood...good luck...keep us updated.

 

[Bubbsie]

Perhaps your nurse should join the forum Bill...then she may be able to give her patients the right support...advice & encouragement...qualities she sadly appears to be lacking in at present.

 

[trophywench]

Bill - there are carbs in all sorts of things we were brought up to think of as 'healthy' options. Sugar itself is MERELY yet another carb but being almost 100% carb it is obviously the first thing to try and cut down on.

But hey! - fructose - the thing that makes ALL fruit sweet - is carbohydrate. Lactose (in milk and cheese) is - oh yeah - carbohydrate. Anything with flour in in - will have carb. There's even carb in ruddy LETTUCE. It would be hellishly difficult to go completely carb free but absolutely nobody would even suggest that's what you did.

You just have to look at what your day's food consists of and learn to recognise where the main culprits in spiking your blood glucose are - and absolutely testing to see what any food does to your BG using a meter, is the only way of adjusting your diet so it doesn't do that to you - BUT remains sustainable for you. It's no good cutting out everything with a carb in it - because people's tolerances for different carbs in different things - will be - different! I don't eat bananas now because they send me sky high - and tell Nursie despite injecting half a gallon of insulin - nothing will ever change that for me and prevent it. Shame, I did occasionally enjoy a banana - but there are still a million things I like more than a banana and that don't do that to me, so I just eat them instead if I want fruit.

 

[Lilian]

I think the nurse has got it the wrong way round. When taking insulin you can, if you so wish, have a more carby meal and be able to inject more insulin. You cannot do this if you are just on oral medication. So to get your blood glucose down it is essential that your carbs are lowered. Plus of course exercise and making sure you do not have an infection. I suggest getting the book (or the app on the phone) called Carbs and Cals (or something similar). If you look through the foods there you will see what things are more carby, very carby etc. and the quantities. Eat foods that have plenty fibre in them (unless you have a medical problem that prohibits it), and do not be frightened of fat (again unless you have a medical problem that prohibits it). Fat helps you keep from spiking too much. Although fruit is not a good idea, you can have some berries but it is better to have them with some cream, or Greek full fat Yoghurt for example. You can get much tastier meals from a low carb way of eating than a low fat one 😉

 

[Bill Stewardson]

Ok,,, funnily enough I did ask the nurse to look at the forum, her reply being that she did not need to as her other half is D.
My daily food intake is usually cornflakes or porridge at brekky, lunch something light, tuna sandwich or maybe tin of soup with whole meal bread, main meal pork chop, or chicken ( no skin) oven chips, usually with veg or baked beans, no cake or chocolate etc, and later a tin of fruit,
that's about it, some nights I will have two beers.
Ive always been active, played RL for thirty years, and now bailiff the local river, so walk miles most days, no way could I be classed as a couch potatoe or a glutton,,,,, god knows what I will look to eat now.
I'm 6-3 and have never been over 16st, I used to be strong, struggle with my fishing gear now, and cutting the grass wipes me out.
Plus I'm totally knackered 24/7,, good innit ?????

 

[Drummer]

oh dear - high carbs galore, cornflakes, oats, bread, potatoes, baked beans and fruit, plus beer - no wonder your Hba1c is so high.
There are lots of foods with fewer carbs which could replace the usual culprits which send blood glucose soaring.
I stick to foods which are ten percent carbs or less and my numbers are normal, my cholesterol is good despite not eating anything low fat.

 

[pav]

Welcome Bill, going off my own experiences of your food bearing in mind everyone is different in the way we react to foods and this is where the meter comes in handy. Your breakfast is a no no for me cornflakes cause me to have a very rapid rise in levels and it is very rarely I eat them, worth having a look at the total carbs in them. Porridge is a mixed bag if it's the rapid or instant porridge then as its highly processed and will also cause a very rapid rise in levels, The old fashioned way of true porridge oats added to water and brought up to heat is the better version. For some porridge is ok, but for me it's another one that's off my list or once in a blue moon treat.

Tuna is ok for me, though I get the tins which are packed in spring water rather than the oils, each slice of bread is around 14 carbs wholemeal is far better than white bread or as a fair few on here eat Burgen bread which come in several varieties, not to my taste though. Not up to speed on tinned soup as it's been a good while since I have had any.

Your main meal for me is not to bad as long as the chips are not every day or to many, maybe a baked potato could be better again watch for the carb content in the potatoes, other will be able to offer alternatives to potatoes, but I don't like a lot of the alternatives. Don't know about baked beans as they are another food I don't like.

The real kicker is the tin of fruit espec if you have the tinned fruit in syrup as you will have a double whammy the sugar in the syrup and the natural sugars in the fruit (fructose). On the odd occasion I have tinned fruit it's the ones that come in juice, only I drain the juice and throw it away. Also depending on the size of the tin it could still be way to much to eat at once.

As other have said your nurse is well out of touch on the issue of carbs, when I did the EXPERT course a couple of years ago (since updated so I am told) they recommended that one should eat 130g of carbs a day, which is way far to many carbs a day, for me if I eat that many carbs I would put weight on drastically and already have problems with my weight.

 

[Lilian]

I am afraid Bill that is a truly high carb meal. Porridge might be OK if it is not the instant kind, but many diabetics still find porridge a problem. All cereal is very high in carbs. A better breakfast would be say an egg (fried if you like) with some bacon and mushrooms. Maybe one slice of the lower carb bread like Burgen, but better if you don't. Lunch if you have to have a sandwich, the low carb bread like Burgen and have plenty filling inside. Tin soup is high in carbs. Chicken good, but why no skin. Oven chips could be substituted by say sweet potato chips if you must have chips. Better to have something like cauliflower, beans, cabbage etc. I presume the tin fruit is in it's own juice, but usually it comes in grape juice. You would be far better to have a fresh piece of fruit, but preferably no fruit at all. If you must then fresh berries would be best. The beer is not very good either. OK so now you do not know what to eat and think you are going to starve. That is not the case I can assure you. Firstly as I said, you can start the day with a good English breakfast - fried if you like. Just leave out the hash browns. If you get good meaty sausages you can have them as well. Mix them around. One day bacon, sausage and some beans. Beans are OK in limited portion and preferably the low sugar kind. Another some eggs and bacon. Breakfast can even be left overs from the night before. Think of breakfast as just another meal. You can make your own soups very easily and they are much better. I was told when looking at labels that if the carbs were over 5% it is too high. You have to adjust where cooking is concerned. If you are often short of time I suggest you make - for example - a largish batch of stew (carrots, celery, tomatoes, onion, beef, tin of say drained beans (not baked beans) then when it is done freeze portions, so that when you are in a hurry you can just reheat a portion in the microwave. Same if you make your own soup, so it in a larger amount. Always keep a large bowl of mixed salad without dressing on in the fridge to take out as and when needed. Don't forget fish if you like it. You can have cheese. Keep some hard boiled eggs in the fridge. One of my favourite things is a cold Spanish type omelette made with ham, mixed veg, fried onions but no potato. Instead of spaghetti bolognese, I make the bolognese sauce and have it over shredded cooked cabbage, with some Parmesan over the top and it is lovely. Pan fried salmon with the crispy skin, with any veg like broccoli, spinach (also nice with smoked haddock) runner beans etc. or cold with salad, or even hot with salad. Meat curry with dhall (lentils) is nice and OK to have as a take away. I suggest keeping away from Chinese as that is full of sugar. They cannot even cook vegetables without adding loads of sugar. I am not keen on smoked mackerel although it is good for you, so I get smoked trout. This does not mean you can never ever have the odd potato or slice of bread but once your blood sugars have come down to a better level the odd slice of bread or a couple of little potatoes will not cause so much of a problem. I would definitely cut out the beer for the time being. If you are going to have the fruit as a snack on their own and not with a meal then it should have something like cream with it to stop the sugar spiking. If it is after a meal then the fat in the meal would do it so there would be no need for the cream. Salads should have real mayonnaise or something like a full fat plain yoghurt type dressing. I hope I have given you some ideas and that you do not feel overwhelmed or helpless. You will get plenty help here and no question is considered stupid so ask away.

 

[Ditto]

If it was a member of my family asking me this I'd just say do Atkins. Do it for a week, what can it hurt? See if you feel better. I've been off it for 3 or 4 days, never felt so rotten, slept almost all of today. Back on it now for sure...this is just me saying this though, nobody else, not this forum, just my personal opinion. I'm like Dale Winton, I do it (if I can) but I try not to bandy it about, 'people' don't like the Atkins. I have no idea why!!!