LMAO! Good one ar.
My doctor has used the fructosamine when my A1c seemed repeatedly "off." There have been fewer studies to establish what a good range is and how the frutosamine maps to average blood sugar.
I am glad to see the input on how to interpret these lab numbers. I think it can be confusing. In "most" cases, labs provide reference ranges for test readings, but in the case of A1c and average blood sugars, I believe they actually quote recommended diagnosticy interpretation levels as recommended by the ADA or the AACE. I believe that the thinking is that since the HbA1c is calibrated against a standard, that is ok.
But criteria for diagnosis is not a target for diabetic control. And my target is not your target. I think there is a lot of feeling that the ADA control targets are laughable, but the AACE has also published targets. They suggest that you maintain your fasting blood sugars < 110 mg/dl. They don't say "except in the morning," they say your fasting blood sugars.
In my view, many doctors are just minimizing the worst cases. To tell a patient that it is ok to routinely have a fasting blood sugar of like 130-180 is not a good practice (I also think that starting your day high can ruin your blood sugar control for the day). If you have a pump, there may well be some simple adjustments to your basal that can bring your morning fastings under better control. We each need to choose our own targets, but personally, I would recommend that you make a concerted effort to lower those fastings at least to an intermediate level.
ps. You can also take "Advanced Type Classes" as a type 1 from the Sensei himself.
Gerri I changed my basal rates last night and woke up still running high. I think I miss calculeted some carbs last night. I have been on a pump since last Oct. and have never had the morning basal set right.
I am getting the dp effect.
Do you "tune" your pump with a basal "bump" in the early AM hours, to cover DP? My pump trainer recommended that and I've done it ever since. DP suxx as it sort of starts every day on a sour note. I still get it sometimes and have to adjust the bump but bumping seems to work pretty well?
Okay. An A1c of 5 nets out to 97 mg/dL. In any case, if the 'target range' for eAG is 90-120 for diabetics (unless that has chenged in recent years...), then I was led to believe the 'normal' average would be in the middle of that somewheres, not at the bottom of that scale.
Also, the Pearson's r) product-moment correlation coefficient on this calc is .84. Does anyone know how that factors into the mix?
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you are not confused.after having t.1 for 75 years my numbers should be higher to prevent hypo.i have hypo-unawareness & my doc. recommends it higher.i don't always do what the pump says.i know my body better.GOOD LUCK TO YOU & DON'T GIVE UP.....SMILE.....
Basal is the hardest to get correct. A pain!
In case this helps, several things helped my DP. Not eating 5 hours before bed & not eating a dinner heavy in protein/fat that slows digestion.
WHATEVER IS GOOD FOR YOU MIGHT NOT BE GOOD FOR SOMEONE ELSE.EACH BODY /DAY IS DIFFERENT
ESPECIALLY AFTER 75 YEARS W. T.1.
those "normal" ranges they put on your lab work are for people without diabetes. They give us some wiggle-room so we don't all pass out from hypoglycemia.
Pearson's r is a measure of how strong the correlation is between the two variables. A "perfect" positive correlation would be 1. The correlation between A1c and eAG is pretty strong at .84.
Bascially, you can say that as A1c goes up, eAG will go up as well, and vice versa, with a lot of confidence.
What's missing is the amount of error. None of this says that YOU will have an average BG of 97 mg/dl if YOU have an A1c of 5.0.
All it says is that if you take the people from this study, on average, an A1c of 5.0 will equate to an average BG of 97 mg/dl. It's more reasonable to expect that your own A1c and avg BG will vary either a little or a lot, depending upon the error around the regression.
Certain high fat meals can increase your sugars 4+ hours after eating, usually when in bed if the meal was dinner, so while carbs may be correctly calculated the delayed reaction from the fat can cause a delayed raise.
That makes perfect sense. I'd been reading up on it, but just couldn't figure out how the .84 related here. Thanks for the help.
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I think what you will find palomino, is there is no right answer, and many roads and way to be as healthy as possible with Type 1. There are many people on this board who are Bernstein adherents and it is a very positive and successful aspect of their overall D management. I will also let those people respond so far as "scientific method" because I'm sure Dr. Bernstein's philosophy wasn't pulled out of a hat, but represents years of experience, his own as a Type 1 and his hundreds (thousands?) of patients. But I'll let other people speak to that.
Bottom line is what seems "extreme" to one person may just be what they do to another. If someone sets goals they can't achieve or sustain and then beats up on themselves about it, then that's not useful. But if someone is able to successfully incorporate low carb into their D regimen, while eating healthy and feeling good, I applaud them. It wouldn't work for me for various goals, and perhaps some things I do might seem excessive to others (like being on TuD 24/7..lol).
After you've been around for awhile, palomino you will get used to hearing the acronym YMMV - your mileage may vary. Another good saying is "there are many kinds of diabetes as their are diabetics". That doesn't mean "types", but overall experience of symptoms and treatment results. What I do is "take what I need and leave the rest" (god, I'm full of cliches today!). I listen to what each person does and then decide if any part of it might be something I want to incorporate in my own treatment.
If someone says, "my A1C is 10.4, I'm usually in the 300s with an occasional foray into the 30s. I eat whatever I want and wouldn't know an I:C ratio if it hit me in the head. I might say, Hmmmm...is what you're doing really working for you? I also know we all have different goals. Some people of the "Bernstein persuasion" aim for non-diabetic A1C's in the 4.0's. Myself I was over the moon with my recent 5.7. If someone was 10.4 and are now down to 7.5 they are doing great.
Thank you, Zoe! I really agree. I was really struck by what I heard at the October Diabetes Sisters event from Bill Polonsky of the Behavioral Diabetes Institute. Bill says maintain the best control possible while not having severe lows and living your life. Wise words indeed.
I sort of see the point however I don't think that it's necessarily convivial to say "that sucks" when a ton of people here have worked really hard to get to that level or just to stay there?
I am with you, AR, I don't think 6.5 sucks at all! For many, that is dang good!
I AGREE WITH ZOE THAT WHAT IS GOOD FOR ONE PERSON IS NOT GOOD FOR ANOTHER.ALSO EACH DAY IS DIFFERENT I DON'T ALWAYS DO WHAT THE PUMP SAYS .IT WORKS FOR ME.
If you look at the TuAnalyze map, most regions’ averages are > 6.5%. I agree with Alan that it should be improved upon. People with diabetes have been using about the same tools, BG testing, 'log, Lantus/Levemir for almost 25 years now. To me the part that needs to change is the approach to goal setting. If you are at 8%, then challenge yourself to take it to 7%, but don’t stop when you get there. If you are at 5.8%, challenge yourself with SD and smoothing things out. We have data coming out our wazoos and have to conceive of the struggle as winnable. One test at a time. I think that doctors and other medical providers are the element that needs to be changed now.