Understanding blood sugar

[bufc07]

If you had diabetes, you would see readings over 7 in the mornings.

Blood sugar doesn't stay static all day, it goes up and down due to hormones & activity and many other factors.

I haven't had a reading over 7 in the morning for a long time. Might just be me but usually I wake up anywhere between 4 and 6

 

[Inka]

I haven't had a reading over 7 in the morning for a long time. Might just be me but usually I wake up anywhere between 4 and 6

Because you’re Type 1 on insulin 🙂 I think this means if you haven’t got diabetes.

 

[bufc07]

Because you’re Type 1 on insulin 🙂 I think this means if you haven’t got diabetes.

Makes sense, misunderstood the message I replied to I think

 

[Inka]

Makes sense, misunderstood the message I replied to I think

Easily done 🙂

 

[Docb]

So the good news is my Hba1c came back at 37 although it has increased by 2 in the last 9 months which isn’t ideal.

Looking over the last 10 years it has gone from 32 to 37, I’m wondering if now being 41 years old it’s harder to stem the increase as your body gets older?!

Is it simply a case of cutting sugar out completely to get it lower?! I do exercise maybe 3/5 times a week and have put on maybe 5/6 pounds over last 6 months which I’m sure wouldn’t help although maybe lost 4 of these last week.

A thought for you..... your Hba1c at 37 is well below the diagnosis level of 48 so for what reason do you want to get it lower? It can be done but why put yourself to the inconvenience?

PS - this is a very serious question. There is no logical reason for trying to get one's HbA1c as low as possible. My HbA1c is in the mid fifties and that is normal for people of my age. I'm comfortable with that and simply happy to make sure it does not go into the sixties.

 

[Dave2014]

A thought for you..... your Hba1c at 37 is well below the diagnosis level of 48 so for what reason do you want to get it lower? It can be done but why put yourself to the inconvenience?

PS - this is a very serious question. There is no logical reason for trying to get one's HbA1c as low as possible. My HbA1c is in the mid fifties and that is normal for people of my age. I'm comfortable with that and simply happy to make sure it does not go into the sixties.

To give myself a greater chance of keeping Diabetes at bay as I get older, working harder now surely gives myself a greater chance as I get older?!

42 is prediabetes though and once in that cycle you have a very high chance of it turning into type 2.

 

[Docb]

To give myself a greater chance of keeping Diabetes at bay as I get older, working harder now surely gives myself a greater chance as I get older?!

42 is prediabetes though and once in that cycle you have a very high chance of it turning into type 2.

I can see what you are getting at and endorse the idea that preventative maintenance is a better approach than having to deal with problems later that could have been prevented. It just seems to me that blood glucose control for most T2's goes off relatively slowly and a periodic check of HbA1c is enough to keep an eye on things without the need to take the steps necessary to drive it to levels well below anything that would give rise to concern.

As we keep saying on here, there are many ways to approach improving blood glucose control when given a T2 diagnosis and different people will be most comfortable with different approaches. Targetting a very low HbA1c might be good way for some but i think we should be aware that there are people for whom such targets will be unattainable without extreme methods and nothing should be said that might stimulate any anxieties that group might have.

 

[Burylancs]

I can see what you are getting at and endorse the idea that preventative maintenance is a better approach than having to deal with problems later that could have been prevented. It just seems to me that blood glucose control for most T2's goes off relatively slowly and a periodic check of HbA1c is enough to keep an eye on things without the need to take the steps necessary to drive it to levels well below anything that would give rise to concern.

As we keep saying on here, there are many ways to approach improving blood glucose control when given a T2 diagnosis and different people will be most comfortable with different approaches. Targetting a very low HbA1c might be good way for some but i think we should be aware that there are people for whom such targets will be unattainable without extreme methods and nothing should be said that might stimulate any anxieties that group might have.

You might be interested in the work of Prof. Craig Christie, a diabetologist at Cardiff Uni. His work suggested that optimal range for T2s was 7-8% ( 53 to 63) and in a famous J shaped graph showed complications more likely at levels above and below those figures. His view is/was that 'lowest is not best' and some argue that a floor for T2 HbA1cs should be set.

Christie also found that Metformin Monotherapy was most effective approach in the early years of a T2 diagnosis.

 

[Docb]

You might be interested in the work of Prof. Craig Christie, a diabetologist at Cardiff Uni. His work suggested that optimal range for T2s was 7-8% ( 53 to 63) and in a famous J shaped graph showed complications more likely at levels above and below those figures. His view is/was that 'lowest is not best' and some argue that a floor for T2 HbA1cs should be set.

Christie also found that Metformin Monotherapy was most effective approach in the early years of a T2 diagnosis.

And that target is reflected in NICE in the guidance in their GPnotebook.

NICE guidance - glucose control levels – GPnotebook

An article from the diabetes and endocrinology section of GPnotebook: NICE guidance - glucose control levels.

gpnotebook.com

 

[silentsquirrel]

And that target is reflected in NICE in the guidance in their GPnotebook.

NICE guidance - glucose control levels – GPnotebook

An article from the diabetes and endocrinology section of GPnotebook: NICE guidance - glucose control levels.

gpnotebook.com

Note from the NICE link above:

If adults with type 2 diabetes achieve an HbA1c level that is lower than their target and they are not experiencing hypoglycaemia, encourage them to maintain it.

 

[Docb]

Note from the NICE link above:

If adults with type 2 diabetes achieve an HbA1c level that is lower than their target and they are not experiencing hypoglycaemia, encourage them to maintain it.

Yes I noted that comment as well, @silentsquirrel. It also says that GPs should be aware that there are other possible reasons for a low HbA1c level, for example, deteriorating renal function or sudden weight loss.

 

[Burylancs]

And that target is reflected in NICE in the guidance in their GPnotebook.

NICE guidance - glucose control levels – GPnotebook

An article from the diabetes and endocrinology section of GPnotebook: NICE guidance - glucose control levels.

gpnotebook.com

And no mention of the latest fad, 'remission', only Control and targets.
And no supporting evidence cited for supporting HbA1cs below target levels

 

[everydayupsanddowns]

I hope you are able to find ways to relax about your glucose levels @Dave2014

It is completely understandable that you want to keep an eye on things, but it feels like focussing on individual glucose results might be causing you more worry, than giving you information that helps you make changes towards a healthier lifestyle.

Are you hoping to be able to tame your sweet tooth?