Hi, im new here. I’m a very bad diabetic. Diagnosed 12 years ago. I’ve always had a terrible HBA1c result. Currently in the 90s. I need to make changes. I have now got the Libre and noting everything down in there. Im on a pump. I’m active and I eat relatively healthy. Advice appreciated.
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Very bad HBA1c
- Thread starter Jewelsfc
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Bruce Stephens
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- Type 1
Presuming you have lows as well as highs, try to understand and then reduce the lows first. (And generally, go after the biggest highs and lows first.)
Flower
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- Type 1
Hello and welcome @Jewelsfc , glad you've joined us
I'd look at it as you're having a bad time, not that you're a very bad diabetic 🙂
With a pump and the Libre, being active and eating relatively healthily you sound like you've got all the right bits of the plan but they just aren't working as well as you'd hope in terms of glucose results.
Have you done a basal test recently as that is such a vital framework to have, if your basal rates aren't as good as possible - and they do take some tweaking and revisiting - then nothing else works efficiently - carb/insulin ratios and correction factors. I'd start with that if you haven't done one lately.
Do you pre bolus for your meals to give your insulin a bit of a head start to get working before the glucose from food starts to hit your bloodstream? That's one of the best things I've learnt to do since joining the forum. It takes a bit of practice to get the timing correct so you don't hypo before the food hits but it is one of the best bits of advice I've had to flatten out post meal spikes.
Keep a record of everything you do as it it is so helpful to look back over what worked and what didn't. Even though diabetes can be a massive pain there is usually a pattern somewhere that you can work on to improve results.
I'd look at it as you're having a bad time, not that you're a very bad diabetic 🙂
With a pump and the Libre, being active and eating relatively healthily you sound like you've got all the right bits of the plan but they just aren't working as well as you'd hope in terms of glucose results.
Have you done a basal test recently as that is such a vital framework to have, if your basal rates aren't as good as possible - and they do take some tweaking and revisiting - then nothing else works efficiently - carb/insulin ratios and correction factors. I'd start with that if you haven't done one lately.
Do you pre bolus for your meals to give your insulin a bit of a head start to get working before the glucose from food starts to hit your bloodstream? That's one of the best things I've learnt to do since joining the forum. It takes a bit of practice to get the timing correct so you don't hypo before the food hits but it is one of the best bits of advice I've had to flatten out post meal spikes.
Keep a record of everything you do as it it is so helpful to look back over what worked and what didn't. Even though diabetes can be a massive pain there is usually a pattern somewhere that you can work on to improve results.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
I’m active and I eat relatively healthy. Advice appreciated.
The healthiest, loveliest diet in the world won’t help if your insulin isn’t right. So my advice is to keep eating well and exercising, but to take a very close look at your basal and bolus doses over a period of weeks.
Basal first. I think @trophywench has a handy link for that. Then once you’ve got that right, look at your individual meal ratios (ie breakfast, lunch, etc). While you’re sorting your ratios, it’s easiest to stick to pretty much the same meals each day so you can remove one variable at least. Be prepared for lots of changes in your insulin if you’ve been running high all this time.
That’s some practical advice, but if you’re asking more about motivation, then read up on the complications of high blood sugar. It’s what I think about when I’m tempted not to be bothered. You don’t have to be perfect all the time, but aiming to stay in range most of the time is good.
Also, speak to your DSN. Because you’ve been high for some time you might be advised to lower your sugars slowly to avoid damage eg to your eyes. So you might be given slightly higher targets at first and then have them gradually reduce to the usual range.
Learn your correction factor too and correct when you’re high. Your HbA1C will soon come down. Please don’t think we’re all ‘good’ and perfect all the time. We’re not. But taking a little extra care and keeping your blood sugar down will not only reduce your risk of complications but make you feel better too on a day to day basis. That’s another big motivation for me. I hate the feeling of being high.
The healthiest, loveliest diet in the world won’t help if your insulin isn’t right. So my advice is to keep eating well and exercising, but to take a very close look at your basal and bolus doses over a period of weeks.
Basal first. I think @trophywench has a handy link for that. Then once you’ve got that right, look at your individual meal ratios (ie breakfast, lunch, etc). While you’re sorting your ratios, it’s easiest to stick to pretty much the same meals each day so you can remove one variable at least. Be prepared for lots of changes in your insulin if you’ve been running high all this time.
That’s some practical advice, but if you’re asking more about motivation, then read up on the complications of high blood sugar. It’s what I think about when I’m tempted not to be bothered. You don’t have to be perfect all the time, but aiming to stay in range most of the time is good.
Also, speak to your DSN. Because you’ve been high for some time you might be advised to lower your sugars slowly to avoid damage eg to your eyes. So you might be given slightly higher targets at first and then have them gradually reduce to the usual range.
Learn your correction factor too and correct when you’re high. Your HbA1C will soon come down. Please don’t think we’re all ‘good’ and perfect all the time. We’re not. But taking a little extra care and keeping your blood sugar down will not only reduce your risk of complications but make you feel better too on a day to day basis. That’s another big motivation for me. I hate the feeling of being high.
Thanks so much. Lots of great advice - I can’t believe I’ve not been on here before. I’m looking to get 4 weeks of Libre readings with notes and get a good feel for what is happening. I think my Basel pattern is completely wrong so will definitely start there.
- Relationship to Diabetes
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- Pronouns
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Great to see you've had some usable and very practical pointers already.
And I agree with @Flower - you aren’t a ‘bad diabetic’ - according to tennis ace Arthur Ashe you are a great diabetic... or at least, on your way to greatness.
And I agree with @Flower - you aren’t a ‘bad diabetic’ - according to tennis ace Arthur Ashe you are a great diabetic... or at least, on your way to greatness.
“To achieve greatness, start where you are, use what you have, do what you can”
- Relationship to Diabetes
- Type 1
- Pronouns
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Here’s a useful guide to basal insulin adjusting on a pump
Basal Testing Made Easy
Here's a link for basal testing, which will hopefully clear up the myths for anyone starting on their pump journey http://diatribe.org/issues/13/learning-curve Plus this might help as well. http://diatribe.org/issues/26/thinking-like-a-pancreas
forum.diabetes.org.uk
And if you’ve not seen it already, this is a great book
Pumping Insulin: Everything You Need for Success on a Smart Insulin Pump by John Walsh (you may need to check for the latest version)
Squirrel768
Well-Known Member
- Relationship to Diabetes
- Type 1
Hi Jewels, and welcome 🙂
I started Libre 33 days ago. One of the first things I noticed was an 'after breakfast' spike, which never showed up on finger-pricks, as it was coming down again by the time I would have tested again! So, initial plan has been to try to flatten that spike (while still keeping other levels reasonably in range ... today has been one of those 'yo-yo' days LOL). I now do my morning insulin (Tresiba 18 units, and Novorapid 10 to 12) before I start preparing breakfast. Now I'm getting the hang of that one, start moving on to try and work on the others. Still on MDI, not a pump, so I can do additional bolus between meals but of course, can't 'switch off' the insulin if I'm heading low. Still, loving all the new data from my 'bionic' arm LOL.
Hope you can begin to persuade your levels to be more stable and consistent. Loads of helpful and encouraging people in here, all looking to support others from their own experiences 🙂
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