Updated HBA1C

[Diabeticem2]

Well I’ve just had my first re test results back since being diagnosed as a type 2 at 25 years old (big shock)

I was first diagnosed at 126 mmol and am currently at 76 mmol. I take 1500mg metformin and 160mg gliclazide daily and have been monitoring my carbs.

As much as I’m happy with this (I think it’s a good result for my first 3 months correct me if I’m wrong??) I can’t help but feel confused as my daily levels still don’t really go below 10. Call with my nurse tomorrow to discuss this but just wanted to know if I should be proud of my efforts in my initial HBA1C drop??

 

[helli]

Welcome @Diabeticem2
I think you should be proud of your HBA1c drop. You are clearly working at managing your condition.
When you say your levels don't go below 10mmol/l when are you testing? Remember, the HBA1c is an indication of your average BG over all time. For example, thanks to Dawn Phenomenon, it is common for the fasting BG to be higher than average.
Remember, managing diabetes is a marathon, not a sprint. You have made it well past the starting line but the finishing post is not yet in sight ... and nor should you expect it to be at this stage.

 

[Eddy Edson]

Have you seen an illustration like this one?



I found it useful when I was getting my head around things. Obviously, 76 mmol/mol is way better than 126 mmol/mol, so congrats! But you're still up in the area where complications can develop. You want to get things back closer to the green area.

The relationship between HbA1c and fingerpricks isn't exact and varies from person to person, but you can see from this chart that your 76 mmol/mol HbA1c is consistent with an average daily BG level of around 12 mmol/l, so not surprising if you usually see readings above 10 mmol/l.

 

[harbottle]

That's a good drop!
Being around 10+ would fit in with a hba1c of 76 - although there's no direct link, as hba1c will depend on fasting levels and post-meal levels.

 

[Diabeticem2]

Welcome @Diabeticem2
I think you should be proud of your HBA1c drop. You are clearly working at managing your condition.
When you say your levels don't go below 10mmol/l when are you testing? Remember, the HBA1c is an indication of your average BG over all time. For example, thanks to Dawn Phenomenon, it is common for the fasting BG to be higher than average.
Remember, managing diabetes is a marathon, not a sprint. You have made it well past the starting line but the finishing post is not yet in sight ... and nor should you expect it to be at this stage.

Hey, I test fairly often so upon waking, 2 hours after every meal and before bed. Yesterday was the first time I’ve seen a 6 in a long time and I believe that was down to me unintentionally fasting for 24 hours (). Yeah I think I 100% see the dawn phenomenon as no matter what I tend to be between 13-14mmol every morning without fail!!

 

[Diabeticem2]

Have you seen an illustration like this one?

View attachment 34853

I found it useful when I was getting my head around things. Obviously, 76 mmol/mol is way better than 126 mmol/mol, so congrats! But you're still up in the area where complications can develop. You want to get things back closer to the green area.

The relationship between HbA1c and fingerpricks isn't exact and varies from person to person, but you can see from this chart that your 76 mmol/mol HbA1c is consistent with an average daily BG level of around 12 mmol/l, so not surprising if you usually see readings above 10 mmol/l.

I haven’t that’s helpful thank you! Yeah I’m well aware I’m still in the danger zone really just didn’t know how much I should expect to drop and whether a drop of 50mmol was shocking or okay haha! Yeah tbf my little finger prick machine says my average is about 12 daily so wondering wether I’ll have my medication upped as I know some people do 360 gliclazide a day so I suppose it’s an option!!

 

[Diabeticem2]

That's a good drop!
Being around 10+ would fit in with a hba1c of 76 - although there's no direct link, as hba1c will depend on fasting levels and post-meal levels.

Yeah my average daily level according to my little finger prick machine says 12 so wondering whether I’ll have my medication upped! I hope so as I feel so tired all the time from it being fairly high still

 

[Leadinglights]

You have made good progress so the combination of meds and diet is working pretty well for you and it is better to reduce blood glucose gradually as there is less likely to be issues with eyes and nerves that some people get.
It can make a bit of difference to fasting/morning readings if taken in bed before doing any of the daily activities.
If you haven't seen this link it may give you some ideas for diet as it is based on around 130g carbs per day which should be OK with the medications you are taking. But you have a monitor to check out your tolerance to meals. https://lowcarbfreshwell.com/

 

[Martin.A]

Yes, you can be proud of that HbA1c drop but it's early days so you just need to keep doing what you're doing and hopefully you'll see a further drop next time. Having a meds review with your DN is a good idea - let us know how you get on.

 

[silver minion]

Hey, I test fairly often so upon waking, 2 hours after every meal and before bed. Yesterday was the first time I’ve seen a 6 in a long time and I believe that was down to me unintentionally fasting for 24 hours (). Yeah I think I 100% see the dawn phenomenon as no matter what I tend to be between 13-14mmol every morning without fail!!

I will ask the idiot obvious question, but do you test just before eating? Also is the rise in BG post meal 3mmol or less?
Well done on the HbA1c reduction.
It does take time to get from 100 + down to under 50 .I am very much still work in progress since diagnosis a year ago.
Good luck and wishing you continued success on your diabetes journey.

 

[JITR]

Yesterday was the first time I’ve seen a 6 in a long time and I believe that was down to me unintentionally fasting for 24 hours.

That's a big hint. Diet is key. Have you tried intermittent fasting (e.g. 16:8, 5:2)?

Have you tried keeping carbs down to about 50-80 g/day, preferably in vegetables, to accelerate your escape from the danger zone.

How does your choice of foods compare with this?

 

[Diabeticem2]

That's a big hint. Diet is key. Have you tried intermittent fasting (e.g. 16:8, 5:2)?

Have you tried keeping carbs down to about 50-80 g/day, preferably in vegetables, to accelerate your escape from the danger zone.

How does your choice of foods compare with this?

I pretty much fast anyways as I work until 8pm 3 nights a week so usually eat my last meal 8:30 and then don’t tend to eat again until 1pm! And follow that the rest of the week as that’s what I’m used to now!

 

[Diabeticem2]

I will ask the idiot obvious question, but do you test just before eating? Also is the rise in BG post meal 3mmol or less?
Well done on the HbA1c reduction.
It does take time to get from 100 + down to under 50 .I am very much still work in progress since diagnosis a year ago.
Good luck and wishing you continued success on your diabetes journey.

Yeah I should’ve said that I do test just before I’m about to eat too! Honestly it varies sometimes it’s less and sometimes it’s more I suppose I’m still testing what makes me spike and what doesn’t 🙂

 

[snowball12]

Well done you. You should be very proud indeed.

 

[mashedupmatt]

You are doing a great job @Diabeticem2 - that is an impressive reduction in HbA1c - you should be proud indeed - well done 🙂

 

[Newbie777]

First of all fantastic news and well done.
The second point is fasting is good,but not sure how effective yours is due to the Glicizide, which does need some carbs for it work, so perhaps 8.30pm to 8.30am, have a low carb breakfast with Glicizide and then some carbs at lunch, so sounds daft but perhaps eating a bit more at the right time.

Also a low carb solution may help you also.

 

[harbottle]

Glic doesn't 'need' carbs to work, it will just stimulate the pancreas to release insulin - regardless of blood sugar levels. So you need to make sure you eat enough carbs to stop blood sugar going too low when taking it. It has to be used with caution alongside low-carb diets. Best talking to your HCP about it if you want to go low carb to make sure your levels are monitored properly.

 

[everydayupsanddowns]

Well done on your HbA1c reduction @Diabeticem2

When you say you are monitoring your carbs, do you have a rough idea of how many total carbs per day you are averaging?

It must be frustrating to still be fairly consistently seeing BGs in double figures if you are moderating your carb intake, and taking glucose lowering meds. Have your Dr or nurse said whether they would have expected more of a reduction on the doses you are taking?

You aren’t very old to have developed T2. Is there a history of T2 in your family? I recall you had a negative antibody result at diagnosis, but were showing ketones, and had experienced weight loss. I can’t remember how many varieties of antibodies they checked for. Are your Drs still pondering our diabetes type?

 

[Diabeticem2]

Well done on your HbA1c reduction @Diabeticem2

When you say you are monitoring your carbs, do you have a rough idea of how many total carbs per day you are averaging?

It must be frustrating to still be fairly consistently seeing BGs in double figures if you are moderating your carb intake, and taking glucose lowering meds. Have your Dr or nurse said whether they would have expected more of a reduction on the doses you are taking?

You aren’t very old to have developed T2. Is there a history of T2 in your family? I recall you had a negative antibody result at diagnosis, but were showing ketones, and had experienced weight loss. I can’t remember how many varieties of antibodies they checked for. Are your Drs still pondering our diabetes type?

I aim for under 130g per day but often come in at under 100g!

No one’s really saying anything as I’m kind of under 2 teams at the min and they both say the other person should be dealing with it

My mum and Nana both currently have type 2 and my dad had it around 10 years ago but put it into remission pretty fast and has been at a normal level with no medication for again around 10 years. They checked for 3 types of antibodies and all were negative but as far as I’m aware they’re pretty happy with it staying as type 2 and just think it’s more than likely genetics due to both parents and grandparent having it which is obviously unfortunate for me that I’ve developed it so young as I’ve been doing a lot of reading that says early onset type 2 tends to be more aggressive and often leads to needing insulin treatment sooner

 

[everydayupsanddowns]

My mum and Nana both currently have type 2 and my dad had it around 10 years ago but put it into remission pretty fast and has been at a normal level with no medication for again around 10 years. They checked for 3 types of antibodies and all were negative but as far as I’m aware they’re pretty happy with it staying as type 2 and just think it’s more than likely genetics due to both parents and grandparent having it which is obviously unfortunate for me that I’ve developed it so young as I’ve been doing a lot of reading that says early onset type 2 tends to be more aggressive and often leads to needing insulin treatment sooner

We have a few folks on the forum who don’t seem to fit into the simplistic boxes that the types suggest. I get the feeling that diabetes is a lot more nuanced and spectrum-y than it first may appear. Which can be slightly tricky where it comes to evidence-based treatment, which is all about working out what is the ‘best’ option for classic cases of each type using PICO trial analysis (population, intervention, comparison, outcome).

It’s one of the reason’s I keep banging-on about the importance of personalised treatment options within an evidence-based framework.