Improving HBA1c but worried about retinopathy

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kk9

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Hi,
I'm new to the forum but really could use some help. I've had Type 1 for 25 years with varying control. I've been trying to improve control for pregnancy for the last 6 years with not much success but gave up work at xmas in order to give it one last try. At xmas my HBA1c was 103 but after a lot of hard work on Monday I visited the specialist midwife with my latest result of 71. I was over the moon and finally felt I was on the right track, however was knocked a little when told that I needed to be careful as improving too fast can damage my eyes. I have background retinopathy that has never needed treating but is being monitored by ophthalmologist. I was shocked as didn't realise this and it has upset me some what as I am now unsure of how to improve slowly?! Also at 34 I don't want to hang around forever. I am at hospital for eye check on Friday so I know I can go through it there but I was wondering if anyone has had experience of this?
Thanks
 
Hello KK,
I don't really have an answer on how to improve things slowly (- perhaps ask your consultant about that ?) but just wanted to share my experience as its somewhat similar to yours.
I've been type 1 for 20 yrs (I'm now 39) - I have a 2 yr old son and I'm 32 weeks pregnant. I also have background retinopathy in both my eyes that doesn't need treatment (this was before I was pregnant with my first - it has remained unchanged up until now). I remember being told that sometimes it can get worse if your hba1c goes down too quickly (often the case in pregnancy!). So ironic isn't it.
All I can say is keep doing what you're doing - you've managed to bring your hba1c down massively which is great. As part of the pre pregnancy planning I needed to get my eyes checked (both times) and then they check your eyes 2-3 times during pregnancy and 6 weeks post partum so they WILL keep an eye on your eyes.

good luck !
 
Welcome to the forum, kk9. Good that your specialist midwife gave you the right advice about not reducing blood glucose levels too quickly. So much depends on your eye check on Friday. Only 2 sleeps to go, then you can get medical advice, specific to your situation. Hopefully your improvement hasn't been too rapid to affect your background retinopathy. Do let us know how you get on.
 
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Thank you. It helps to know others have had success stories! Does anyone know if there is time scale for improving hba1c and risk of damage?

Thanks
 
I don't think there is a timescale exactly. I had a very rapid improvement in control about six months after diagnosis and that resulted in background retinopathy, but and this is the important bit it actually went completely when my control stabilised. I'd guess it's unlikely to clear completely if you have existing background issues, but the additional damage on top can clear and settle. The best advice I've ever been given is to go for stability and ignore the numbers, the body doesn't much care if you're st a 6mmol/l level or 16 what it dislikes is wild swings in blood sugar, and that's what causes the damage. So try to avoid getting your hba1c down with corrections, aim to improve your core control. Work on getting ratios and basal perfected. The opthamologist who said that was brilliant and he was very useful, much more useful than the diabetes consultant to be honest, and the neurologist was brilliant and said much the same thing, aim for the mid way line and try not to get into a correction cycle because that's what causes the damage. That might not apply to your situation of course, but it was very useful for me, I keep in mind that I'm aiming for stable. Best of luck with it 🙂
 
Hi,
I've been for my fluorescein angiography this morning, waiting for a letter to see consultant again but it seems likely I will need laser treatment on my right eye. Pretty gutted but I know I've done this myself and now just have to face the consequences. My ophthalmologist was great and told me to concentrate on stabilsing my bloods and try not to worry about that eyes.
Thank you for your messages
 
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