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Re: [IPk] High A1C was [Re: ip-uk-digest V4 #133]



Hi Tricia,

Glad you have somewhere to start from.  A couple of things, I find that it
helps to think of the diabetic readings and results as moving ratios - I don't
believe that there is a fixed value for anything.  Sometimes you will need
more insulin, sometimes less depending on a large amount of variables, e.g if
you are 10 it may take 1u to bring you down to 7, but if you are 7 it may only
take .6u to bring you down the 3 to 4. (It is common to have more insulin
resistance at higher values so you need more to have the same effect)

That is why it is so good being on a pump so that we can adjust basal for
different times of the day, and more precisely control amounts if insulin
other than the standard .5/1u of pens.
If you are going to go to bed lower, one thing that will help is if you try to
make sure your last meal is as far away from bedtime as you can.  I try to
make sure to leave 4-5 hrs so that all the bolus from it has acted, as I quite
often have large drops at 4-5 hrs.  This will also make it safer as hopefully
if you do go low it will be a slower affair rather than a very fast drop.

What are you aiming for? it would help to know where you want to be, and also
what your usual routine is and what you have tried.  A1C can be anything you
want it to be (providing you don't have other complications/conditions), but
the lower you go the more effort you will have to put in to achieve it.  It is
totally up to you, but the driver for me is that every 1% reduction in A1C
cuts the risk of complications by 40%!
I usually test about 10x a day as I don't have leeway for a large swing with
tight control, and I don't want to loose my hypo awareness.

Iain
T1 Essex, UK
MM515 pump
Current A1C Feb 11 5.7

http://www.insulindependence.org

--- On Thu, 7/7/11, J Barker <email @ redacted> wrote:
High HBA1c

iMelissa, Iain and Nanette

Thanks a million.  I have only visited this site for about 3 weeks and have
learnt loads.  Today I am at home all day and have taken my usual
breakfast.  Was 5.6 at lunch time.   Ate M &S meal and will do the same for
the rest of the day.  No snacks.

I think Iain's idea of going to bed on a lower bg is a good start. (if I am
brave enough)   Last night I went to bed on 5.6 and topped it up to what I
thought was 18g =  +3.points,  that should have raised me to 8.6. if it was
daytime..    It actually raised me by 3am to  11.3 and 9.9 at breakfast.  As
you say, I have been high for many hours.  Your tips are so helpful as I had
thought a reasonable breakfast reading was sufficient.

I don't know what FPG means but think PPg is often too  high.

I will take these two steps and review.   i.e. lower at bedtime and
commercial carb. counted meals all day.  I did read last week or so that
packages aren't always 100% correct in their carb count, but it is a start.

AS I am newish to type 1 and pumping I suppose I have a lot to learn.   I do
feel exceptionally well most of the time.  Better than for the few years
before when I had lots of niggly things.

thanks again

Tricia
.
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