So my A1c is not coming down fast! We have changed my insulin… I’m active… I eat healthy… I’m not over weight, all other labs are normal…yet I’m staying at 13 points for my A1c. Dr has put me on baby aspirin to help thin my blood. Is this going to work? As well as drink plenty of water to flush my system. I have never heard of this. Does anyone know. Does it work??? Is there something else I am missing to be doing?
Perhaps increase your insulin dose, both long- and rapid-acting?
Maybe I’m missing something here, but I seriously doubt that taking low-dose (or even high-dose) aspirin is going to make a big impact on a dangerously high A1c of 13%.
And A1c’s do not come down “fast” (depending on your definition of “fast”). An A1c measures the level of hemoglobin A1c in the blood as a means of determining the average blood sugar concentrations for the preceding two to three months with more emphasis on the most recent month. So it takes a while of maintaining BGs that are in a much better range before you will see a significant improvement in your A1c.
Before offering advice, we will need to know more specifics: Are you Type 1 or 2? or other type? How long have you had diabetes? What insulin(s) do you take and when? What doses? How often do you check your BG? Do you also take BG-lowering oral meds? How many carbs on average do you consume per day? Do you have any other health issues? Do you take other non-diabetes related meds?
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By fast i mean… its been that way for 9 months now. And at 13.9 in March. Type 2 is what they think , as i was diagnosed at age 26, 11yrs ago. I take Lantus ( 26 units taken in the AM) and Apidra( 10 units daily meals) My blood sugars are tested before each meal. I was suggested to test at night 1-2x now as well as after each meal and before bed. 4 minimum tests aday, I take folic acid, and children vitamins. I am not a starch eater… I prefer meats and veggies and 2 fruit (apples) servings aday., My meals average 4-5 choices per meal with only 1 choice as a starch. and 5-6 for supper times. Snack for bedtime is 1-2 choices. The only other health problems are sinus’s acting as I live in the country and deal with hayfever and animal allergies. I take a antihistamine for that.
“What they think” is not a confidence-inspiring diagnosis. You may indeed be Type 2, but there is a strong bias, particularly among PCPs, to diagnose Type 2 simply based on age and without performing definitive tests. From your description, it sounds as though that may be your situation. Misdiagnosis of adult Type 1s is a significant problem. See this link.
Before a realistic treatment regime can be developed, you need to have as definite a diagnosis as possible. From what you posted here, it sounds like you and your medical team are still shooting in the dark, so to speak. You should require them to perform the tests for T1, if only to rule it out.
What exactly constitutes a “choice”? Are you talking about “exchanges”? That “system” is antiquated and essentially no longer used. Fruit contains a lot of carbs. Three portions of “starch” daily means a relatively high carb count for the day. Again, how many grams of carbohydrate do you consume on average daily? 26 units of Lantus plus 10 to 30 units of Apidra daily (it is unclear to me whether you are saying that you take 10 units of Apidra or 30 units of Apidra daily) is not anywhere near a large dose of insulin. Why do you take the same amount of Apidra at each meal? Don’t you adjust your before-meals dosage of rapid-acting insulin based on the number of carbs you are going to consume? Don’t you bolus for everything that you eat in addition to the three “standard” meals per day? What is your ISF? Your I:C? Have you done basal testing? On average, what are your BGs before meals? What is your fasting BG level (when you wake up in the morning)?
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Seconding the point made above: mealtime insulin doses need to match what is being eaten. Always using 10 units regardless of the contents of the meal or snack is like always putting 4 gallons of gas in your car regardless of whether you are driving to the corner store or across the country.
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Just read this article on MODY which might be of interest:
So sorry to hear you are having such a hard time here. It sounds like the medical care you have might not be top rate. I know how hard it is to find good medical care when in rural areas.
And whether you have type 1 or type 2, you are taking insulin. And with an A1C that high, you need more. So starting slow here, I would check your blood sugar 2 hours after eating to see what is really happening. Most people with high A1C’s have them due to post meal rises. And if that is indeed the problem, you need more insulin before meals.
Of course starting with basal rates is best, but I would be very interested in hearing what your post meal tests look like for a few days.
And I agree, you really need to find someone who knows the current medical treatment for people with type 1 diabetes.
Again, so sorry you are struggling but yeah for you that you are trying to find the answers. Just take it one step at a time and don’t try and “fix” everything right again. It’s a long journey, so little baby steps are ok. Good luck and keep us posted.
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A low dose of aspirin is often prescribed to slightly thin the blood if the doctor thinks the person may be at risk for heart attack. Since diabetics have a higher rate of heart disease than non-diabetics, that might be your doctor’s thinking. But it certainly doesn’t replace the appropriate dose of insulin - or correct diet.
Approximately half of type 1 diabetics these days are being diagnosed as adults, not children. But the old stereotypes live long. With adults, type 1 often comes on more slowly than it does with children, so it can be rather confusing at first. I didn’t become diabetic until age 70, and was misdiagnosed as a type 2. It wasn’t until a year and a half later that I was finally sent to an endocrinologist who diagnosed me as a type 1. So much for the idea that type 1 is “juvenile diabetes.”
Getting the correct diagnosis could be helpful because if you have insurance or are on a government program, type 1 and type 2 are treated differently in some respects. But since you are on insulin, getting the right dose to control BG is likely the primary concern, no matter which type you turn out to be.
May I suggest that you get one of the following books, which would help you to better direct further conversations with your doctor about your care.
Using Insulin by John Walsh
Think Like a Pancreas by Gary Scheiner
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A “choice” is usually a serving of 15 grams of carbs. (And, sadly, based on my visit to the hospital diabetes clinic this past summer, the “exchange” system is alive and well and being taught to people with diabetes…) So four to five “choices” would be 60-75 grams of carbs. That’s quite a high-carb diet (many of us eat 60-75 grams of carbs, or less, per day not per meal). And the exchange system that these “choices” are based off of is 20+ years old. I agree with others, if you are using mealtime insulin, you should learn how to count carbohydrates and adjust the amount of insulin you take based on how many carbohydrates you are eating.
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The “exchange” system belongs in a museum, along with the “sliding scale”. The best available way to control blood sugar is to count carbs and match medication to what you eat. The closer the match, the better the control.
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HI there hb1 and so sorry to hear of your struggling with whatever type diabetes you have. In either case it is a serious disease that can affect ALL or most all of your organs over a period of time. It is like a little faster rate of decline to all of your organs even when good control is maintained BUT it can be done. I have had it now for 53 years and have almost lost my eyesight but not quite yet… have had liver failure from fatty liver common in diabetes of both kinds, decreased kidney function of both, stiff tight joints and skin from just having years of extra glucose running through my bloodstream along with atherosclerosis… and this is all with tight control except for a few times that I felt like I deserved to eat what I wanted. I went for depression counseling to help with that. So I said all of that to tell you please get a second opinion or at least tell your doctor that you are ready to fight with both fists and you need his help. Sounds like too many carbs a day you are eating… I only eat a day 1/4 of an apple as they have a lot of carbs in each. One whole apple makes my glucose rise to 200 or more. We are all concerned for you and the baby aspirin is for your heart as diabetics do have a higher incidence of heart attacks. Hoping to hear soon that you are on track and have a good doctor in your corner.
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Lots of good advice and references here the best being “Find an Endocrinologist asap”. If your current Dr is an Endo, look around for a different one.
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Many of us were dx’d T1 in our 20s (I was 28). Age has nothing to do with it–that’s the whole reason we USE the terms T1 and T2 instead of “juvenile” and “mature” as in the old days (the days of exchange diets, too, matter of fact). If that was a significant factor in why you were dx’d T2 you should see another physician.