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Ideal result or not?

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Gareth

Gareth

Active Member
Relationship to Diabetes
Type 1
Hello everyone, long time no see. I've just got back from seeing my diabetic nurse with my latest Hba1c results and I would like to get your opinion on something we discussed.

The nurse is concerned that I have too much control and has advised me to let my BG levels rise slightly. Thing is I don't see the problem. My first Hba1c result after Dx was 5.4% (36 mmol/mol) back in January. In May it was 5.5% (37 mmol/mol). After our last consultation, I decided to follow her advice, so my current Hba1c result is 5.8% (40 mmol/mol). The nurse still reckons this is too low whereas I believe it is ideal (I usually aim for a result between 5.5 - 6.0%).

Is my nurse overreacting or am I just being awkward? :confused:
 
Do you FEEL well? If so, I'm sure Nursie would be better off worrying about people who do have a problem! Personally I think you have every reason to be a bit smug.
 
Hi Gareth,

It really depends on how many hypo's you are having in order to achieve these results - which by the way are great! If your levels are normally single figures and little hypo's then nothing to worry about - unless of course you are starving yourself! Quality of life is important and although your results are really good - if your quality of life is such that you arent really enjoying yourself or are too restrictive then your Nurse may have a point. Only you will know about your quality of life so its difficult to judge by using your HBA1C as the only guide.🙂Bev
 
On what bases did the nurse give her opinion?
If you are happy with few hypos and are well in yourself, then whats her problem?
 
Gareth, your numbers are excellent and very similar to mine. They assume that if you have really good numbers then you must be hitting 1.2's several times a day or something. My HbA1c has been in the mid-5s practically since diagnosis but my meter software tells me I hardly have any hypos below 3.2. If I do it's due to particular circumstances that I can generally account for and easily treat. I'd say keep doing what you are doing if you are happy with it - they don't seem to understand how hard it can be to 'just run your numbers a little bit higher - do they think it's as easy as turning a dial or something? Makes me quite angry when they suggest good control must in fact be poor control! 😡

You're doing great! 🙂
 
Patti's had this argument with em ever since she went on MDI and was able to actually control her diabetes. Yes her A1c is great. No she doesn't live in hypo-city.

My hospital insist I treat every single 3.9 even though my dinner is steaming on the plate in front of me. I say OK. But I don't mean it.

Yes, I WAS having too many hypos - and that's another thing, sometimes you do quite a few tests, with 15min gaps, under 4 until some of that carb kicks in. But to me that's only ONE hypo. Not to them. It's 2 or 3 hypos.

Wish all HCPs would sing from the same flipping hymnsheet.
 
Gareth said:
Is my nurse overreacting or am I just being awkward? :confused:
Click to expand...

May we ask how many hypos you are having and how serious they are ?
 
bev said:
Hi Gareth,
It really depends on how many hypo's you are having in order to achieve these results - which by the way are great!
Click to expand...
mcdonagh47 said:
May we ask how many hypos you are having and how serious they are ?
Click to expand...


That's just it, I've never had a hypo. I've had one "near miss" back in May when my BG dropped to 3.6, but I was able to self correct before it escalated. My nurse insists on asking me if I feel ok and I insist on giving her the exact same answer. I feel fine, to be honest, I feel no different than I did before diagnosis. Looking over my results for the year, nearly all are between 5 and 7 mmol/mol, with only a few dropping below 5 mmol/mol

Back when I first joined, I took Northerner's advice and purchased "Type 1 Diabetes in children, adolescents and young adults" and have been applying it's advice whenever appropriate. I just feel that she assumes I'm jeopardising my health to reach some arbitrary target when all I'm doing is living a normal life with a good understanding of how to control my condition.

In regards to my eating habits, other than changing to healthier options (whole meal bread and the like), drastically cutting down on the take aways and very fatty foods and eating more regularly, I've been eating pretty much the same foods as before and in similar quantities.
 
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Even more impressive Gareth! 🙂 Sounds like it's a case of just nodding politely when you see the nurse and promptly forgetting anything she said once you're out of the room 🙂
 
Gareth said:
That's just it, I've never had a hypo. I've had one "near miss" back in May when my BG dropped to 3.6, but I was able to self correct before it escalated. My nurse insists on asking me if I feel ok and I insist on giving her the exact same answer. I feel fine, to be honest, I feel no different than I did before diagnosis. Looking over my results for the year, nearly all are between 5 and 7 mmol/mol, with only a few dropping below 5 mmol/mol

Back when I first joined, I took Northerner's advice and purchased "Type 1 Diabetes in children, adolescents and young adults" and have been applying it's advice whenever appropriate. I just feel that she assumes I'm jeopardising my health to reach some arbitrary target when all I'm doing is living a normal life with a good understanding of how to control my condition.

In regards to my eating habits, other than changing to healthier options (whole meal bread and the like), drastically cutting down on the take aways and very fatty foods and eating more regularly, I've been eating pretty much the same foods as before and in similar quantities.
Click to expand...

Hi Gareth,

Then you can honestly say to your Nurse that you are doing very well indeed and she should be pleased that you have a HBA1C similar to that of a non-diabetic!:D How long ago were you diagnosed? I am just wondering whether you are still in honeymoon? Sometimes this can help with great levels such as yours and as you havent been above 7 I am thinking you might be. However - that doesnt mean that you havent put huge efforts in and your Nurse should be pleased at these results.🙂Bev
 
I was diagnosed in November last year after I developed Haemolytic Anaemia, as a result I was on a high dose of steroids for several months afterwards (started around 60mg and was gradually reduced).

I was give the impression by the doctors that the Anaemia destroyed my Beta cells outright, so I wasn't expecting a honeymoon period, maybe I was wrong to assume that.

For now, I'll just keep doing what I'm doing and if anything changes, I'll cross that bridge when I come to it.
 
Well did you tell her Ragnar Hanas provides your day to day strategy and that's why you are doing well?

Fraid I would have. I mean my DSN uses his book day to day! so if she doesn't know who he is, shame on her.
 
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