Helmut: Thanks - I just wish I could find a solution to the pre-bolus issue. I had hoped Apidra’s quicker onset would be the ticket but for me it unfortunately did not work that way. There are a couple of promising fast acting insulins in the developement pipeline but given the way the FDA is working nowadays I’m not holding my breath. Faster acting insulins would makle all our lives a lot easier. Mike
Keep in mind the A1C is calculated differently than a 90 day average. The A1C tests weights the last 30 days, so that is going to give a different result than your Dex reports if there is any kind of variance. You have an excellent A1C, if you are a type 1 I don’t think it is worth chasing lower numbers. Congrats!
Kevin: I agree about the area of diminishing returns. However, whether it be OCD or perfectionism, i’ve continued to try to drive my A1c lower (against my endo’s admonishions…) and I’m curious what it entailed to achieve your remarkable 4.7. Did you accomplish this with very low carb or just a successful insulin regimen and also did you encounter a lot of hypos in so doing? Thanks for any light you could shed on this. Mike.
Mike, it was just done via brute force… a lot of fingersticks per day and short acting insulin to combat highs. I wouldn’t recommend it at all…too many hypos and it makes things hard for those around you (hard on my wife who had to deal with mood swings and other effects of low blood sugar). My doctor was very firm with me that I had to loosen things up, and I did. I’ve been in the mid-5’s now for a long while and life is much better. I have been T1 for more than 30 years and have zero complications. My first year when I was diagnosed I was managed by our family doctor under the old method…take one big shot of some sort of pork insulin in the morning and eat according to a schedule, and check your urine once a day. Thankfully after some bad incidents (hypo related) my parents took me to a great endocrinologist who changed things completely…taking me out of the dark ages. Some small stuff that appeared in my eye photos the first time I visited an ophthalmologist 25+ years ago (due to the old-fashioned control regimen) went away years ago and my eyes are clear.
Kevin: Thanks for the reply. This was very interesting to me as I have long wondered what it would take to get into the high 4’s. Based on your experience it’s simply not worth the price of admission which makes perfect sense. If there were eventually a faster acting insulin that mimicked the first phase insulin response of a normal pancreas, I could see the possibilities of safely achieving such low levels but I’m not holding my breath. My guess is that mid 5’s pretty much guarantees against complications which in essence is our consummate goal, so there’s no reason to stretch beyond that level. Even at 5.2 I encounter quite a few hypos (about which my endo is not happy…) but thankfully the dexcom for the most part provides great actionable data. Mike.
Wow! Everyone!!! I thought that my A1C of 6.8 was really great until I read this thread! I just received my Dexcom 7 Plus 4 days ago so I am really only in the starting gate here. What are you all doing to lessen the hypo and hyper events? How do I keep from getting over 180 after a meal or dropping below 70? I think my meal time highs are the worst culprit to my A1C levels not being better. I eat very modestly as the insulin weight gain has been simply awful (60 pounds over the last 4 years!!!) I just recently changed my diet to being mostly vegetables, lean protein and very low amounts of carbs - basically legumes and low glycemic carbs only. I have lost 16 pounds since December 12 with the help of my new eating and also I started riding my bike 12 miles each time I go out. I am joining a gym this coming Friday. (Up until a year ago, I was living in Indonesia with no chance of any type of exercise available due to safety issues and the food choices were very difficult as fresh vegetables etc were a health concern - can anyone say severe gastro-intestinal issues from parasites?)
Anyway, since I am now finally getting my food and exercise under control, how would you attack the highs and lows to make them even out more? What does everyone else here eat, especially for breakfast and lunch?