Us old Type 1

[Lucyr]

I was told recently to increase my HbA1c as I am now considered elderly - I am 66.
I can't find any relevant information regarding this. Has anyone else been advised to do this?
I also can't find any reason for doing this. I was told, rather coyly I felt, that I might fall down the stairs whilst having a hypo at night.

The older you get, the less you have to worry about long term complications, and the more damage that can be done if you have a fall whilst hypo

 

[JonathanGi]

Thanks for that. Yes I suppose I don't need to worry about long term complications as I don't have long to go. I hope to last as long as this weekend without falling over as I am running Cambridge half marathon on Sunday.

 

[trophywench]

Not quite as old as yourself; not had T1 quite as long either - but I was gobsmacked last year when one of my consultant's housemen snapped at me why on earth was I concerned about my HbA1c 'which is well within range!' I said because it's always in the low 50s and it's now 60 which is far higher than I've ever been used to - so what, pray, was my range supposed to be? 'Up to about 58ish of course!' she snapped back at me, with a look like I was a squashed slug she'd just trodden on. Condescending bitch. Nobody medical that I have ever seen had ever mentioned before her, that I'm not supposed to even aim for under 50 any more.

PS - I sincerely hope you survive without harm too! 🙄

 

[JonathanGi]

I don't ever get that sort of response because I don't see a consultant et cetera.

 

[JonathanGi]

My HbA1c is 37.

 

[Satan’s little helper]

Not quite as old as yourself; not had T1 quite as long either - but I was gobsmacked last year when one of my consultant's housemen snapped at me why on earth was I concerned about my HbA1c 'which is well within range!' I said because it's always in the low 50s and it's now 60 which is far higher than I've ever been used to - so what, pray, was my range supposed to be? 'Up to about 58ish of course!' she snapped back at me, with a look like I was a squashed slug she'd just trodden on. Condescending bitch. Nobody medical that I have ever seen had ever mentioned before her, that I'm not supposed to even aim for under 50 any more.

PS - I sincerely hope you survive without harm too! 🙄

I’m not going to ask you your age. Brought up to guess “21” & take five years off?
But the last 2 or 3 years. I haven’t even been told my A1c. I have to work an approximation between my meter & the librelink app.

The older you get, the less you have to worry about long term complications, and the more damage that can be done if you have a fall whilst hypo

Cheery, thanks.

 

[trophywench]

We're exactly like the other poster and own and also live in a small, one bedroom detached ground floor flat - that estate agents normally term 'a bungalow'. Thing is though - most bungalows are imagined to be 'spacious' - and ours certainly ain't that !

 

[Lucyr]

Not sure why a couple seemed upset that I said at 66 you don’t need to worry about long term complications as much and that’s why you can run a higher a1c. The average life expectancy is 80 so that’s about 14 years to go on average, that’s without any adjustments for medical conditions like diabetes.

As I’m in my 30s I need to work harder on a1c to prevent any complications in the next 40-50 years. At 66 it’s simple fact that you don’t need to worry about what complications you might develop in 50 years time.

 

[Robin]

Not sure why a couple seemed upset that I said at 66 you don’t need to worry about long term complications as much and that’s why you can run a higher a1c. The average life expectancy is 80 so that’s about 14 years to go on average, that’s without any adjustments for medical conditions like diabetes.

As I’m in my 30s I need to work harder on a1c to prevent any complications in the next 40-50 years. At 66 it’s simple fact that you don’t need to worry about what complications you might develop in 50 years time.

Both my parents lived to be 94, and I’m hoping to do the same, that means another 26 years for me. Also, if I were newly diagnosed now, I’d feel I was 'starting the clock' and maybe didn’t have to worry. But having already had diabetes for 17 years, and having just had my first 'background retinopathy' letter, I feel the clock is already running for me, and I need to keep as decent and HbA1c as I can (currently 47, has been the same for the past few years, and I don’t think I could 'relax' it if I tried, that’s just what I seem to end up with, doing what I’m currently doing).

 

[Lucyr]

Both my parents lived to be 94, and I’m hoping to do the same

Not everyone is going to live to 94 though, if they did the average lifespan wouldn’t be 80

 

[trophywench]

At 66 most people haven't even reached retirement age yet @Lucyr! - how the heck am eg I (now very nearly 74 so clearly well past caring about everything by your apparent outlook) going to stop being naturally concerned about such things as losing my eyesight or my kidneys failing at some point before I shuffle off my mortal coil? Are we all supposed to just accept death and sit with our hands folded until we fade slowly into the sunset? Sod that for a game of soldiers - shedloads of us take on extra work not less, once the day jobs cease - whether its looking after our grand or great grand kids eg running errands for them, doing work at their homes or volunteering duties with charities. I stopped volunteering with DUK some years ago now, but took on the duty of director/company secretary for the camping & caravanning organisation we belong to whilst Peter was its chairman, and now we are both also much involved as Trustees of a local Prostate support charity - Pete's the Treasurer and I'm just a Trustee. We both still need fully functioning brains and eyesight to do this properly thank you. Not to mention still being mobile!

I still want to die, which Oh yes is indeed of course inevitable, in my sleep - not in misery or pain!!!!

 

[Bruce Stephens]

Are we all supposed to just accept death and sit with our hands folded until we fade slowly into the sunset?

Nobody's suggesting that. It's just that as we age there are increased risks of harms from falling and less time for increased BG to cause complications, so it may make sense to reduce hypos by allowing higher BG.

I think it may also be that that's an outdated view, that now that we have CGMs with alarms there's not nearly so much need to worry about hypos. And once most (or all) of us are using pumps with HCL (or smart insulin or whatever) maybe the targets will be the same for all ages just because it's easier.

 

[Inka]

I agree @Bruce Stephens and @Lucyr As with so many things, it’s all about balance - in this case balancing the risks of very tight control against the risk of age-related incidences related to very tight control. As I understand it, these risks aren’t just falls, they’re arrhythmias and possibly other things too, eg memory loss.

Drawing people’s attention to this is sensible. We all have different requirements and things to think about at the various stages of our life. That doesn’t mean we should aim for an HbA1C of 70, just that, as we age, we don’t need to be quite so ultra-strict, and, indeed, there might be benefits in being a few points higher on the HbA1C.

This idea isn’t coming from @Lucyr She’s merely explaining the thinking behind it.

 

[Robin]

Not everyone is going to live to 94 though, if they did the average lifespan wouldn’t be 80

Oh, nothing's guaranteed, and I could die of something tomorrow. You’re right, 80 is an average, but we don’t know which side of it we’ll be when we die, so I'd rather aim for having as few diabetic complications as possible for as long as possible. But it is a balance, there’s no point in me aiming for no complications at the age of ninety, if my control is so tight it gives me hypos, and I fall and break my hip and die of pneumonia as a result.

 

[Lucyr]

At 66 most people haven't even reached retirement age yet @Lucyr! - how the heck am eg I (now very nearly 74 so clearly well past caring about everything by your apparent outlook) going to stop being naturally concerned about such things as losing my eyesight or my kidneys failing at some point before I shuffle off my mortal coil? Are we all supposed to just accept death and sit with our hands folded until we fade slowly into the sunset?

I’m not saying that you give up on it all, just that you don’t need as tight control at 66 or your nearly 74 because you only have 10-20 years left, so if your a1c is slightly higher than younger people’s but you have less hypos then that’s good. The risk of doing yourself serious damage if you fall whilst hypo (you might live in a bungalow but I’m sure you encounter steps, uneven pavements, things you could stumble on whilst going hypo when out) is getting higher as you’re older.

 

[Lucyr]

This idea isn’t coming from @Lucyr She’s merely explaining the thinking behind it.

Yes thanks, I’m definitely not inventing this it’s my understanding of it that I’m trying to explain.

My grandma is 90 with T2 diabetes. She eats anything she likes and so a1c is slightly high, but as long as she feels alright day to day and can do the things she wants to, then that’s fine. Yes her risk of complications in 20 years time is theoretically slightly higher than if she went really hard on low carb diet and medication, but she’ll be dead by then anyway. That is how it was explained to me as her not really needing to worry about her diet or blood sugars.

As usual I apparently haven’t explained it well enough here though, so thanks for explaining also

 

[JonathanGi]

My aim is to continue living because I think it's better than the alternative.

 

[Pam123]

Not quite as old as yourself; not had T1 quite as long either - but I was gobsmacked last year when one of my consultant's housemen snapped at me why on earth was I concerned about my HbA1c 'which is well within range!' I said because it's always in the low 50s and it's now 60 which is far higher than I've ever been used to - so what, pray, was my range supposed to be? 'Up to about 58ish of course!' she snapped back at me, with a look like I was a squashed slug she'd just trodden on. Condescending bitch. Nobody medical that I have ever seen had ever mentioned before her, that I'm not supposed to even aim for under 50 any more.

PS - I sincerely hope you survive without harm too! 🙄

I know I'm T2 but i did have a conversation with the DN who condescends to visit our surgery When diagnosed my HbA was 87 i went down to 57, 5 weeks later and she said that was perfect for my age i didn't attach any thought at the time
however i am now 49 my age is 71

 

[Satan’s little helper]

I know I'm T2 but i did have a conversation with the DN who condescends to visit our surgery When diagnosed my HbA was 87 i went down to 57, 5 weeks later and she said that was perfect for my age i didn't attach any thought at the time
however i am now 49 my age is 71

What I’ve noticed the last few years with many HCPs (even non diabetes related contact.) As I surpass the average age of these professionals myself. Is a form of ageism.
To put things straight, I’ve noticed it doesn’t seem to happen with the health pros who are in my own age group. I don’t always see the same DN. but there is a contrast between the language & the perceived assessment used regarding the aforementioned age groups.
My mother is in her 90s & enjoys an eclectic taste of music played on Alexa from Vera Lynn to the Killers.

We need to change the way we think about ageing | Age without limits

The Age Without Limits campaign aims to change the way we all think about ageing and support a growing movement of people and organisations working to make society more age-inclusive.

www.agewithoutlimits.org

 

[JonathanGi]

I am much older than any HCP's I ever see. Not that I have much contact. Always better not to is my opinion.