Very high H1ac levels practical help

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grovesy said:
I have had bloods, foot check, inperson throughout, but review with Diabetic Nurse is via phone.
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my DN said new protocol is HBA1c every 6 months, one review over the phone, one in person with her
 
i think its far to say in covid this went to the wall, for me it was non existant. both them and me to blame.
 
I'm Type 1 and I don't always get an HbA1c every 6 months. Thankfully I don't feel I need it as Libre gives me probably a better indication of how I am doing with Time in Range than HbA1c, but I appreciate not everyone has Libre and I am happy and confident with my diabetes management. I am well overdue a consultant appointment but I would hope that they are fitting people in who need their support more than I do.
 
pinkjude said:
my DN said new protocol is HBA1c every 6 months, one review over the phone, one in person with her
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I have had six monthly reviews but only on the phone. The last was only 6 weeks ago.
Having been at this lark for 20 years, that maybe what your surgery are doing , but not nationally.
 
I think that if your levels are not stable and reasonable well managed then you need more support than if you are doing well and things are going more smoothly, but each area and indeed practice manage things differently. The common these these days seems to be that if you need help, you have to actively push for it.
 
yeah i agree and covid didnt help. it takes a long tiime for my surgery to actually see people and not lock them out. needs to be face to face and not phone or email. I have BUPA via my job and am considering using them to help.
 
Berksps said:
yeah i agree and covid didnt help. it takes a long tiime for my surgery to actually see people and not lock them out. needs to be face to face and not phone or email. I have BUPA via my job and am considering using them to help.
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If you have BUPA then you should definitely take advantage of it, after all your employer is paying for it on your behalf.
 
Just a quick update from todays nurses appointment.
1) i definitely did not react well to glicliazide and would be wary taking it again. i have been referred back to the diabetic clinic. next step would be insulin therapy which scared me. I associate insulin with type I only but was advised of the slow release type. Would prefer to manage through diet but i do understand.
2) was given a blood glucose monitor and a follow up next week. did a test today which was 13 mmol. I think from an HB1ac of 107 that is an improvement, told to monitor fasting and 2hrs after food. important to know how foods react..re blood test its a 3 month review so next one end of August is correct.
3) we spoke about cholesterol. Have never been on statins before any advise?
4) spoke about education and nutrition. good information,
 
Was the 13 mmol a fingerprick blood test on the meter you've been given or a similar meter ? Reason I ask is because the meter results do not measure the same thing as an HbA1c test. It doesn't measure how much glucose has stuck to your red blood cells over the last 3-ish months, it solely tells you what glucose is in that tiny drop of blood right now at this very second and that's all it tells you. So, unless you knew what similar fingerprick test results were in the 90-120 days prior to the blood being taken for that HbA1c you can't really make much comparison. For folk without diabetes, somewhere around 5 ish would be normal.

And, how soon after eating anything was that 13?
 
no i agree with that but for a small win i have to take it. the nurse said it wasnt the worst result she had seen and furthermore had seen double. i had eaten about an hour befpre and again i know it goes up depending what you eat. we spoke about breakfast as i know its very important. i do feel hungry mid morning and dont have a lot of time due to work. so yes have to get it right for me and my welfare. i wont lie sometimes i do gravitate towards bad things its about me trying to change the general direction of travel. do unerstand its a 3 month view ie your last 3 months.
 
Berksps said:
Just a quick update from todays nurses appointment.
1) i definitely did not react well to glicliazide and would be wary taking it again. i have been referred back to the diabetic clinic. next step would be insulin therapy which scared me. I associate insulin with type I only but was advised of the slow release type. Would prefer to manage through diet but i do understand.
2) was given a blood glucose monitor and a follow up next week. did a test today which was 13 mmol. I think from an HB1ac of 107 that is an improvement, told to monitor fasting and 2hrs after food. important to know how foods react..re blood test its a 3 month review so next one end of August is correct.
3) we spoke about cholesterol. Have never been on statins before any advise?
4) spoke about education and nutrition. good information,
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Brillliant you have been given a monitor but you will not know how you react to foods unless you test both BEFORE you eat and 2 hours AFTER, paired readings are much more useful.
Once you establish a meal is OK then you would not need to test that one again.
 
latest update
most recent blood reading 12.3. yes i know treat with caution but happy with that its lower than last week and shows something positive. am now going to be put on statins for chlosterol. one thing i got which i wasnt expecting was a pneumonia jab. next week i go see the diabetic clinic for review.
pluses on diet cutting down on bread and carbs. eating more fruit and chicken.
 
I can really empathise with how you feel about your doctors feel exactly the same. I was diagnosed last August while on holiday in Spain with an hb1ac of 117 was prescribed xigduo , when I returned home I was prescribed metformin and dapagliflozin as doctors said they couldn’t prescribe xigduo. ( a pain as instead of one tablet now 4 a day)
I’ve now got my hb1ac down to 35 ( May 4 th) however feel I’ve been operating in a vacuum with no advice. Decided to cut carbs myself from reading this forum Haven’t seen a doctor ( since the spanish one on holiday). Have seen the nurse but she hasn’t offered or responded to my question about what to eat I asked about monitoring my glucose levels she said I don’t need to the same response when I asked about a nutritionist. I’m in my 70s and would like more guidance
it seems they are only interested in doling out pills and not in helping you help yourself.
 
Anji53 said:
I can really empathise with how you feel about your doctors feel exactly the same. I was diagnosed last August while on holiday in Spain with an hb1ac of 117 was prescribed xigduo , when I returned home I was prescribed metformin and dapagliflozin as doctors said they couldn’t prescribe xigduo. ( a pain as instead of one tablet now 4 a day)
I’ve now got my hb1ac down to 35 ( May 4 th) however feel I’ve been operating in a vacuum with no advice. Decided to cut carbs myself from reading this forum Haven’t seen a doctor ( since the spanish one on holiday). Have seen the nurse but she hasn’t offered or responded to my question about what to eat I asked about monitoring my glucose levels she said I don’t need to the same response when I asked about a nutritionist. I’m in my 70s and would like more guidance
it seems they are only interested in doling out pills and not in helping you help yourself.
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Given you have had no help you have done marvellously well to get your HbA1C to 35 which is very normal, most people would kill for an HbA1C as low as that. It might be wise to get a medicine review as it may be that you are not on too high a dose of the meds. I would say there is no need to be doing anything other than what you are doing in terms of diet.
Yes cutting carbs is the way many people find successful in reducing blood glucose but it can also depend on if you need to lose weight as well. If not then make sure you are having enough protein and healthy fats.
There are some menu plans in the main DUK site of various approaches.
 
Thank you for the information about the DUK site
I did need to lose weight but am now the right weight for my height
They did reduce my meds at the last review in May , however what I find so worrying is not knowing exactly how much carbohydrate to eat
The DN said go away and have a sandwich, eat more normally
when I said ‘ if I do that and my metformin has been halved won’t my numbers go up? She said not with them being as low as they are’
I’m afraid they will go up and would like a ‘plan’ to keep to.
I also don’t have great confidence in the advice anyway as back in February she wanted to cut out the dapagliflozin but I was too concerned , this time she said that they won’t ever cut that out even if I am able to cut out the metformin totally as the benefits of dapagliflozin are so many!
 
Anji53 said:
Thank you for the information about the DUK site
I did need to lose weight but am now the right weight for my height
They did reduce my meds at the last review in May , however what I find so worrying is not knowing exactly how much carbohydrate to eat
The DN said go away and have a sandwich, eat more normally
when I said ‘ if I do that and my metformin has been halved won’t my numbers go up? She said not with them being as low as they are’
I’m afraid they will go up and would like a ‘plan’ to keep to.
I also don’t have great confidence in the advice anyway as back in February she wanted to cut out the dapagliflozin but I was too concerned , this time she said that they won’t ever cut that out even if I am able to cut out the metformin totally as the benefits of dapagliflozin are so many!
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There are a few people here who have been on medication and once they have reached the normal range which is below 42mmol/mol they have been able to reduce medication or cut it out completely and have kept their HbA1C the same by maintaining their chosen dietary regime.
If you were in the diabetic zone over 47mmol/mol and were embarking on a low carb approach the suggested amount of carbs is no more than 130g per day. This is a reasonable amount that people find achievable, however everybody is different in the amount of carbs they can tolerate so some will have less that that especially if they are dietary managed without oral meds.
 
That’s very helpful thank you
this has been a steep learning curve for me
I had a phone call from my doctors while on holiday in Spain ( English mobile) who told me to go to a doctors asap as my routine blood tests ( I’m hypothyroid) showed HbA1C was 117 so I was quite scared
the doctor in Spain was great very reassuring and I had the results from another test day after the appointment which confirmed glucose levels were v high and so he prescribed xigduo and tested again just before I came back to see if it was working
however after I got home I’ve found it very difficult to get any advice and lots of contradictory things on the internet
no groups in my area that I can find
 
my latest fasting blood test came back 9.7. first one i had done fasting so quite pleased with that. shows to me my reduction in carbs and at least thinking about the junk i am putting in my system is having positive vibes. i have no idea what a good fasting number looks like?
 
Berksps said:
my latest fasting blood test came back 9.7. first one i had done fasting so quite pleased with that. shows to me my reduction in carbs and at least thinking about the junk i am putting in my system is having positive vibes. i have no idea what a good fasting number looks like?
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What units are attached to the result as that will clarify what test was done.
Was it a sample from your arm and sent to the lab or a finger prick test.
 
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