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I varied my insulin with what I ate ever since I switched to
a pen (12 years ago?).  I had extra injections to cope with
extra meals etc, all the usual things and have never had an
hba1c that wasn't 6. something.  BUT my point has always been
that perfect hba1c's do not tell the whole story.  My
specialist hadn't looked at my BGM's for over 5 years.  I
would see him once a year for 10 mins my hba1c would be great
and he'd send me off for another year telling me that i was
one of his best patients.  I kept trying to tell him that the
average BGM might be good but that was disguising wildly
swinging measurements.  He told me that all the studies
showed that good hba1c's was the key and that fluctuating
blood sugars didn't matter.  I don't believe this.  The
studies show good control to be the key and therefore a good
hba1c is ONE indicator of this.  In fact my BGM's for the
month prior to the pump swung from 1 - 20+.  I had a severe
hypo every night bar 3 and BGM's ranging from 13 - 24
following exercise.  Not good control in my book.

In short I think that you can manage with a pen adjusting
your dose with what you eat and I think a lot of people do
that but I have found that as your circumstances change (2
small kids + full time demanding job) it is too often not
good enough.


Beverley Smith
Principal Development Geologist
SNS Team Leader
BG Group

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