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Re: [IPk] High A1C was [Re: ip-uk-digest V4 #131]

Hi Melissa,

Makes sense, just I suppose we're all different and to my way of thinking I
would go after overnights first, just seems simpler with no
food/excercise/bolus to cloud the issue.

Whichever way, still needs addressing, so will see if more info is forthcoming
so we can get together and provide some more suggestions!


--- On Wed, 6/7/11, Melissa Ford <email @ redacted> wrote:
Hi Iain

I should have qualified that reference with the context that while FPG
makes a proportionally large contribution to A1Cs above 8.5%, the
persistent foundation of the high A1C is revealed to be postprandial
as you chip away at the FPG and get closer to 7. So while it's
important to resolve FPG and that may be achieved through refining
overnight and early am basal rates, the postprandial glucose levels
still need to be addressed.

In terms of priority, resolving high FPG may take weeks of overnight
basal rate testing (a person can reasonably be expected to wake up
several times in the night just a couple of nights in one week, so it
may take several weeks to get the basals straightened out). A week of
seven-point glucose profiles can be a quick way  to identify daytime
excursion patterns and it's perhaps quicker to iron out daytime basals
through testing basal rates during waking hours as well.

Both FPG and postprandial glucose need to be addressed, it's just a
question of in which order.

Does that make sense?

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