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Re: [IPk] Re: ip-uk-digest V4 #131

Hi J (sorry, can't see your first name in the "from" field)

Sorry to hear you're disappointed. You have made significant progress
in lowering your A1C by one whole point. The difference in the risk of
complications goes down more when your A1C goes down from 10 to 9 than
it does when your A1C goes from 9 to 8. Of course, the difference in
risk when you go from 10 to 8 is huge and worth pursuing; I just want
to say you deserve to be proud of the progress you've made so far.

In terms of tips for lowering your A1C, one thing to bear in mind is
that research has shown the hours after meals make the biggest
contribution to your A1C. Most people see a very big difference in
their A1C if they get their blood glucose level down to target within
2-3 hours after having a meal.

How to get your blood glucose down between meals? I'd say the first
thing to try is testing and correcting your blood sugar 6-7 times a
day on this sort of schedule:
1. Before breakfast
2. 2-3 hours after your breakfast bolus
3. Before lunch
4. 2-3 hours after your lunch bolus
5. Before dinner
6. 2-3 hours after dinner
7. Before bed (if bedtime is more than 2-3 hours after dinner)

As well, you're probably already testing your bg before and after
exercise - definitely the right thing to do. Are you reducing your
basal rate (temporary basal rate, or 'temp basal') when you exercise?
A correctly figured temporary basal rate so could really help reduce
the bg fluctuations you're experiencing around exercise.

Does your pump have a feature that tells you how much insulin is left
to act in your body? It is possible that you will need to adjust it to
get it to suit the way your body works so you can be confident about
taking a correction bolus.

Does any of that make sense?

All best

Type 1 18+ years; MiniMed pumper 7.5 years; Animas pumper 6.5+ years

On Tue, Jul 5, 2011 at 4:41 PM, J Barker <email @ redacted> wrote:
>  High HBA1c test
>   I only got type 1,  3 years ago after a GAD blood test at the age of 65.
>  Original test  was 10.1  Today it has only dropped to 8.9 with a pump.  I
> was having pump trouble to start with  a year ago.  I expected this  new
> pump regime to be much lower.
> Any tips?   I do a lot of sport which gives fluctuating bg's.  Sometimes it
> spikes for no apparent reason after a careful carb. counted meal.   I don't
> eat pasta which I know causes trouble. Should I be aiming for  higher
> steadier levels or try to keep under 6 say,  with lots of fluctuations,.
>  I have set the pump to average 5.3.
> Any ideas.how to get this HBA1c down?
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