Nw new HBa1c.

[Akasha]

Just been to hosp.
Nurse was very disapionted that my hba1c had gone up to 7.7.
I told her that was because i was having fewer hypo's.
She said we could tweak my ratios and insulin to bring that down.
She then asked if i knew that i could change my own insulin amount?
She told me to drop my lantus by 1 unit. Puzzled i asked why when she wanted my hba1c to come down.
She said it was because she was worried about the 3.9 i had yesterday morning.

*head*desk*head*desk*head*desk*

 

[Northerner]

Hi Akasha, it's only a tiny rise, and I quite understand the 'fewer hypos' making it rise, I have had the same experience. How unusual was the 3.9 and are you able to explain it? If it's not your usual waking level then adjusting your lantus because of it does seem a little knee-jerk - I usually wait to see if it's a trend before I alter my lantus.

 

[Ellie Jones]

For T1's the HbA1c can be so miss leading indeed as every hypo suffered masks the high's... Our HCP's don't always get that..

As to your lantus is there a pattern that shows that at this point you BG is constantly getting very near to hypo?

As to changes to background insulin these if you see a pattern emerging, I know that in your case that she doing in response to a 3.9 reading, what are the reading like on previous days, as it might be that your readings are in the low end of 4mmol/l's if they are then it's probably the right move.

If the not it could be that it was a one off, so waiting a couple of days to see if it becomes a pattern would be wise..

 

[Akasha]

I had been having trouble with hypo's durning sleeping hours, but the last CGM proved that i had got that sorted.
I told her that it could have been a blip of a night time drop just rising, or just droping. I had had half a unit less with breakfast and was only 7.8 two hours after.

The whole thing riled me. The constant patronising, and the fact that they seem to want me to go there every 2 weeks.

 

[Akasha]

Ellie. Sorry missed your post.

My blood have been between 6 and 12. With the occasional 4-5's. which altho i dont want too many 12's i am more then happy to have bloods between 6 and 9 as i do a fair bit of driving, which sends me down.

It has basically put me in a downer, as i had been trying realy hard, and having had a semi cold recently (causing bloods to shoot up to 19's after lunch despite having double insulin.) Made me feel like im not trying hard enough.

 

[Northerner]

That's really unfair - really makes you feel like they just don't understand. You shouldn't come away from your appointment feeling like that, they should recognise the effort you are putting in and encourage you to continue improving. Some people just don't listen properly or see the person in front of them.

Don't be discouraged, just keep up your good work and I'm pretty sure you'll have a nice improvement next time around! 🙂

 

[Robster65]

Occasionally it does pay to argue with them, rationally, so that they can see that it's not just a 'snapshot' to us. We have to adjust every time we test and inject and, as you say, fit it around realities like driving.

You're obviously doing as well as you can within your lifestyle and I wouldn't pay too much attention to their tellings off. If you think you should do something different, so it, document it, and if it improves things, you can show them that you know best.

Sometimes they do give good advice and can see things in an unclouded way but sometimes they ignore the person and just look at the condition.

Best of luck.

Rob