Just need advice on improving Hba1c

[Violet hill]

Had 41 years experience of Type 1 Diabetes but the last 11 years I've gone to being in control to not and I'm at a loss to know how to solve this issue!!!
I think the start of my problems have been as a result of Malabsorption diagnosis, busy family life and hectic work schedule but just need some guidance from existing type 1 sufferers who have managed to regain control?

 

[Northerner]

Had 41 years experience of Type 1 Diabetes but the last 11 years I've gone to being in control to not and I'm at a loss to know how to solve this issue!!!
I think the start of my problems have been as a result of Malabsorption diagnosis, busy family life and hectic work schedule but just need some guidance from existing type 1 sufferers who have managed to regain control?

Hi Violet, welcome to the forum 🙂 What sort of problems are you experiencing? Getting a lot of highs, a lot of lows, or a bit of both? What insulin regime are you using? How recent are the problems you have been experiencing, and have there been any particular changes to your life and diet in general? When you talk about malabsorption, do you mean of insulin doses or food?

Apologies for all the questions, but it helps to know where things stand for you right now 🙂

 

[Matt Cycle]

Hi Violet and welcome to the forum. 🙂 Sorry to hear of the control issues you're going through. As Northerner says an idea of what insulin(s) you're using will help us to advise. I have lipohypertrophy on my abdomen and thighs and this can affect insulin absorption - obviously avoiding these areas is critical. I've found the biggest help for me in regaining some sort of control was going on to an insulin pump. Are you already on one or has it been mentioned by your DSN/diabetic team?

 

[Bruce Stephens]

just need some guidance from existing type 1 sufferers who have managed to regain control?

For me, it started with talking with the DSN team. My GP has an interest in diabetes and she's pretty good, but really the hospital team have much more experience. They changed my regime to be more like the recommended MDI one (so two doses of Levemir daily rather than just one, and then the action of the bolus is easier to understand and change). And a bit later I got to go on a proper carb-counting course (one of the various I-Can't-Believe-it's-not-DAFNE courses that regions have).

Probably just as significant, a DSN suggested (while not recommending it) that I have a look at Freestyle Libre since at least some people find it helpful. (Fortunately I tend to spend less than I'm paid so I can afford it.)

 

[Violet hill]

Hi Violet, welcome to the forum 🙂 What sort of problems are you experiencing? Getting a lot of highs, a lot of lows, or a bit of both? What insulin regime are you using? How recent are the problems you have been experiencing, and have there been any particular changes to your life and diet in general? When you talk about malabsorption, do you mean of insulin doses or food?

Apologies for all the questions, but it helps to know where things stand for you right now 🙂

Thank you so much for replying
Ok so it started with lots of lows

Hi Violet, welcome to the forum 🙂 What sort of problems are you experiencing? Getting a lot of highs, a lot of lows, or a bit of both? What insulin regime are you using? How recent are the problems you have been experiencing, and have there been any particular changes to your life and diet in general? When you talk about malabsorption, do you mean of insulin doses or food?

Apologies for all the questions, but it helps to know where things stand for you right now 🙂

Thanks for the welcome and yes I agree the details are a little scetchy!!!
Ok so as I understand it I take creon for the Malabsorption as my body does not absorb efficienctly nutrients in food.
I have struggled with frequent hypos and was diagnosed with this on a trial for pump therapy as was having trouble with hypos that did not improve with the pump.
Took the creon but ended with side effect issues and the dosage was reduced.
Hypos continued and could go days just constantly low and have days of rebounds.
Sought advice to stop this and was given medication to sort adverse side effects of creon and creon dose tripled to help absorb nutrients and to hopefully reduce hypos/hypers.
The problem I think it has left me with is that I'm going high now as I can't detect properly what hypos are and I have a customer facing job in the food industry and test very frequently but I can feel my sugar dropping, will test before I eat, it can be something like 9.0 so will carry on with my work and then 9 times out of ten I will be hypo within the next half hour. The times I eat something to keep me going to avoid hypo I am then high and the times I don't I end up low!!!
Just don't trust my instincts anymore and don't know how to reset the button in effect?
Have done fasting to test Basel levels and they seem ok it's only when I eat I have a problem!

 

[SB2015]

Hi Violet and welcome to the forum.

I do not have experience of malabsorption and use of Creon but others on here do, so hopefully they will be along sometime.

One thing that jumped out for me reading your post is whether with the malabsorption you are therefore not taking in as much glucose from your carbs, so do you need to alter your insulin to carb ratio. That might account for the hypos after food.

When you do treat a hypo what do you do. I used to overtreat, because I did not allow enough time before retesting. To counter that I changed the retest prompt on my handset to 15 min. With this and a consistent treatment for a hypo I had fewer rebounds.

With regard to picking up hypos and hypers have you come across the Libre. It records your glucose level every few minutes and you can access this data by passing a reader close to a sensor that you wear in your arm. I have found it invaluable, and in some areas these are now available on the NHS, so it could be worth discussing this with your DSN or consultant.

I hope that makes sense, but do ask any questions that you have.

 

[khskel]

Hi and welcome from a fellow creonista. I too was having frequent post meal hypos so here is what I did.

1. Checked my basal insulin was correct by skipping meals and frequent testing. There's an item on basal testing in the pumping section on the forum.
2. Recorded the carb content and insulin taken with every meal along with timings and amount of carbs required to treat any hypos.
3. Recorded pre meal 2 hour and 5 hour BG levels.

Once basal levels were on track I could look at bolus levels.

If 5 hour post meal readings were somewhere near the pre meal reading it suggested that the amount of insulin was correct for the carbs including any taken for hypo treatment was correct.

Post meal hypo suggests insulin taken too early, a spike suggests too late.

I could then play around with timings.
It has worked for me.

Got to go into work now. Ask away if any more questions.

 

[HOBIE]

I have found its NOT a science being T1. Every day its different. What gets me is stress etc & lowers my BG. T1 for more than 50 odd years. Good luck 😉

 

[KARNAK]

Hello Violet also a fellow Creonista welcome to the forum. I`m surprised your levels drop so quickly but find Creon does affect my BGLs although in theory it shouldn`t, we are all different. I go back to @Northerners post a little bit more info would help e.g. medication any other health problems only if you wish to divulge, do you take Creon every time you eat? More questions I know but a lot of knowledge available and help is at hand.