Yet another HbA1c

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Cliff

Cliff

Well-Known Member
Relationship to Diabetes
Type 2
Off to nursey in a few minutes to get some blood taken for my HbA1c. 5.6% last time. I confess I've eased up a little on the diet and the exercise, which might have it going up. On the other hand, I'm 16lb lighter than last time which might have it going down. So, what do you think it will be?
 
Well done on the weight loss Cliff! I'm going for 5.6% again - I just had mine done and it was 5.6%, and 5.6% last time, so I've decided it is the perfect result! 🙂
 
Oooh, difficult to guess. But I think it may have come down a little so will go for 5.4
 
I will go for 5.5 and well done on your weight loss 🙂 x
 
Hi Cliff,

I'd guess with what you have learnt that you will not have let it go up.

I'm going for 5.3%.

Good luck and best wishes - John
 
I'm hopeful, but who knows? My meter average over the last 90 days is 5.4 although I have less readings this time round than last. Hoping for a result in the low 5s but no chickens counted yet.
 
Cliff - Knowing you a little bit through this forum, I'll go even further than my guess of an HbA1c of 5.3%. I'll also guess at a total cholesterol below 4.0 and triglycerides down below 1.0 - i.e. all very similar to my results these days.

I think that you are well down the right track. We will see!

Good luck and best wishes - John
 
wallycorker said:
Cliff - Knowing you a little bit through this forum, I'll go even further than my guess of an HbA1c of 5.3%. I'll also guess at a total cholesterol below 4.0 and triglycerides down below 1.0 - i.e. all very similar to my results these days.
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John

This time it's HbA1c only. They seem relaxed about my lipids since I brought them quickly back into normal range and so they'll be doing those less regularly than the HbA1c.

Interestingly, nursey was quite relaxed about low carb diets. She takes the view that if it shifts the weight and gives good HbA1c results, then carry on as before.

And finally I got a straight answer to a straight question - how low should I go in terms of weight? BMI currently 23.2. She said that the weight loss that gets you into the top end of the normal range is the most effective in reducing insulin resistance. Thereafter it's up to me but don't make efforts to get lower than 22 - there's no diabetic advantage.

Gentle nudges towards the BP meds however - it's the one thing that I cannot get under control despite best efforts - reduced yes, but not sufficient for anyone including me to be happy about it. I think I have no option now but to medicate.
 
Cliff, that is interesting information about the BMI level and impressed you got a straight answer!! Well done.

are you d/e controlled? I wish I had been given the opportunity to control by d/e but practice nurse thinks it wastes time letting patients try and control it themselves.

Nuff said.
 
Marg

Yes, I'm d/e controlled. I suspect I was borderline meds when diagnosed with an HbA1c of 7.1%. I see yours was a little higher at diagnosis, 7.3%, so little to choose between the two.

As far as I am aware, the clinical guidance suggests an initial period of d/e control and then meds only if you don't achieve the HbA1c target agreed with your GP. The experience of others on here indicates that some GPs will put you straight on to metformin, particularly if your HbA1c is above 7% on diagnosis.

With me, there was no push to go on to metformin immediately although I was told I was mad not to take a statin because of my high lipid levels. Fortunately, when I got my BG into line, the lipids fell back to normal range and now there's no suggestion of statins at all.

I do wonder if the medics have low expectations of their patients sometimes and go straight to the meds because they think most of us will not achieve much by d/e. Their experience may bear that out to some extent. The members of this and I guess other forums are different from the 'typical' diabetic, if there is such a thing - all of us here either have good control or are determined to achieve it. Maybe the medics are not used to that.
 
Cliff said:
...I do wonder if the medics have low expectations of their patients sometimes and go straight to the meds because they think most of us will not achieve much by d/e. Their experience may bear that out to some extent. The members of this and I guess other forums are different from the 'typical' diabetic, if there is such a thing - all of us here either have good control or are determined to achieve it. Maybe the medics are not used to that.
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I think this is a very valid point Cliff. If you consider that there are at least 2m diabetics in this country, only a tiny proportion are, for example, members of Diabetes UK (c160k), and an even smaller proportion actively seeking advice and support on forums such as ours, despite a high number having access to online resources. Voluntary groups (community based) tend to be apathetic in their membership also, and I personally know of some diabetics who are very fatalistic and accepting of either poor medical advice or the idea that their future is bleak. Given this situation, I imagine a lot of GPs can't spare the time and effort (or haven't the skill) trying to motivate people into improving their own outcomes.
 
Northerner

Just to pick on your very last point, I have noticed a distinct change in attitude at my GP practice as time has gone on (with the exception of my regular GP who has been a star from the start), particularly the nurses.

When they look at my records and see the weight loss, the disappearance of the dyslipidemia and the reduction in HbA1c, they seem far more prepared to positively engage with me about my treatment rather than simply trot out the same old spiel, which is how it was at the start.
 
That's good to hear Cliff 🙂 It's a shame that they don't start off in a more positive frame of mind, at least until they are able to ascertain whether it is likely to be beneficial or futile. Maybe some of them don't spot an eagerness to learn and work at it until the figures are staring them in the face. Others here have described how they have self-funded test strips and got their doctors to precribe them after being presented with the figures and evidence of how they have been achieved.

I know that there should be a great deal of personal responsibility in all this, but not everyone who would be willing to make big efforts knows how to go about it, and they are being demotivated unnecessarily. I feel a cmpaign coming on! 🙂
 
I do wonder if the medics have low expectations of their patients sometimes and go straight to the meds because they think most of us will not achieve much by d/e. Their experience may bear that out to some extent. The members of this and I guess other forums are different from the 'typical' diabetic, if there is such a thing - all of us here either have good control or are determined to achieve it. Maybe the medics are not used to that.[/QUOTE]

To some extent, Cliff, the medics' expectations are a self-fulfilling prophecy.

The instruction that many of us received at the time of our initial diagnosis was: see the practice nurse and she will check your diet so that a diet that is well-balanced can be drawn up for you.

So - we do just that.

We return to see the doc 6 months later - our BG is up from 6 months previously - so we're put on metformin.

The fact is that we CANNOT achieve much by d/e if the d is a well-balanced diet!

As so many on this message board have testified, a diet that has an imbalance against the intake of carbohydrates is the only diet that can bring improvement.
 
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Jean said:
The fact is that we CANNOT achieve much by d/e if the d is a well-balanced diet! As so may on this message board have testified, a diet that has an imbalance against the intake of carbohydrates is the only diet that can bring improvement.
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I'm completely with you on that Jean, 100%. Carbohydrates are key for sure.
 
The result is now in and it's 5.5%, a drop of 0.1%. Quite pleased with that given my very intermittent gym attendance recently.
 
Cliff said:
The result is now in and it's 5.5%, a drop of 0.1%. Quite pleased with that given my very intermittent gym attendance recently.
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Well done Cliff great result.
 
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