Golly, you don't say!

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Wooly - 29 Mar 2006 19:55 GMT

The educator at my endo's practice pointed out to me today in the
course of my bolus insulin training that a "good" hbA1c isn't
necessarily indicative of good control. I've seen this little factoid
mentioned here a couple of times and it makes perfect sense that this
should be the case.

I continue to be impressed with this endocrinologist and the practice
she's partnered with.

+++++++++++++

Reply to the list as I do not publish an email address to USENET.
This practice has cut my spam by more than 95%.
Of course, I did have to abandon a perfectly good email account...

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David - 29 Mar 2006 20:39 GMT

> The educator at my endo's practice pointed out to me today in the
> course of my bolus insulin training that a "good" hbA1c isn't
[quoted text clipped - 10 lines]
> This practice has cut my spam by more than 95%.
> Of course, I did have to abandon a perfectly good email account...

I agree with that statement that a "good" A1c doesn't necessarily relate
to really good control. I'm a perfect example. I swing from 40's to
300 with an A1c of 6.1. That's not good control!!

Dave

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Elizabeth Blake - 30 Mar 2006 04:19 GMT

>> The educator at my endo's practice pointed out to me today in the
>> course of my bolus insulin training that a "good" hbA1c isn't
[quoted text clipped - 12 lines]
>
> Dave

For some years before going on the pump last year, I had "perfect" A1c
readings in the 5's. One time I hit 4.9. But like you, it was due to many
lows mixed with highs and the occasional readings in range. Since I started
pumping the lows & highs have not been as frequent, except for the last few
weeks (lows). I've been cutting back on basals, upping my insulin:carb
ratios and today my BG readings (8 so far) have ranged from 36 - 94. I had
3 readings in the 30's and it's driving me crazy. I already made 3 changes
today (two basal rates and upped my breakfast i:c ratio) and don't want to
change anything else at the same time. Guess when I have blood drawn in a
couple of weeks for my next A1c, I can expect another reading in the 5
range.

Signature

Liz
Type 1 dx 4/1987
Minimed Paradigm 715 5/2005

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David - 30 Mar 2006 05:29 GMT

Elizabeth Blake wrote:

>>>The educator at my endo's practice pointed out to me today in the
>>>course of my bolus insulin training that a "good" hbA1c isn't
[quoted text clipped - 24 lines]
> couple of weeks for my next A1c, I can expect another reading in the 5
> range.

Liz:
Yeah, 30's are waaaay too low. I get irritated if I hit the 40's. 50's
I don't mind, as I bounce back pretty quickly if I stop running around
for a few minutes and eat some appropriate. I tend to overtreat if I
get below 50. Then it's roller coaster time for much of the rest of the
day.

Dave

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Elizabeth Blake - 31 Mar 2006 04:01 GMT

> Liz:
> Yeah, 30's are waaaay too low. I get irritated if I hit the 40's. 50's I
[quoted text clipped - 3 lines]
>
> Dave

I don't really overtreat anymore, since I tend to not feel any symptoms
unless I'm in the 30's, and sometimes not even then. It was the panic, the
shaking & sweating that would cause me to overtreat in the past and since
those feelings are gone, so is the tendency to overtreat.

However, I'm thinking that going all-out with the treatment might not be a
bad thing. This morning I woke up at 69, and I was happy with that. In the
past, my BG would always rise once I woke up. Used to go up 50-80 points on
average. I take Levoxyl for my thyroid so I wait an hour before eating.
So, 1 hour later I check and I'm 50. I went down, not the usual. I had 2
servings of All Bran Extra Fiber, a banana (3 oz) and a cup of skim milk. I
deducted all the fiber from the cereal to calculate my carbs. Take my 2.1
units of insulin for the meal, finish getting ready and go to work. When I
got to work I felt funny so I tested (a little less than 2 hours after
eating) and I was 26. What the hell?! I drank a juice box, and then had a
graham cracker with a tablespoon of peanut butter. Two hours later, before
lunch, I was 41. Aaarrghhh. Calculate carbs for grilled chicken breast,
mini wheat pita, carrots, butternut squash mashed with some butter, cinnamon
& brown sugar, and a cup of Kozy Shack no sugar added rice pudding. Pump
tells me I need 1.2 units, after taking away for the low. 2 hours later I'm
72. 3 1/2 hours after lunch I'm 63. I have a cup of sugar free cocoa with
skim milk. Not many carbs total, 7 I think. Check before leaving work, 77.
Get home from work (I take the bus, no driving) and I'm 50.

This is what's been happening for awhile. I made several changes to rates
today, in addition to changes yesterday and two days before that... I've
been upping the Insulin:Carb ratios and lowering the basal rates. I'm using
at least 1/3 less insulin than I was 3 months ago. It's been less than 90
minutes since I ate dinner and I think I'm feeling weird again, so I'm going
to test. I usually test 2 hours after a meal and again an hour or so after
that. Now I think I have to test sooner since I'm going low constantly.

Lows suck.

Signature

Liz
Type 1 dx 4/1987
Minimed Paradigm 715 5/2005

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