I’ve been wondering something, there seem to be quite a lot of ppl with HB1ac levels over 7 and even 8 which is bloodsugar levels that are a lot higher than with non diabetics. I know that that is understandeable, it is quite impossible to have perfect bloodsugar levels at all times when you dont have a perfectly functioning pancreas… I’m just wondering why people are not taking care of their bodies?
I’m not trying to pick a fight with anyone, but if you are a diabetic, on insulin and constantly testing your bloodsugar, how is it not possible to lower high bloodsugar levels. For example if I have a meal and my bloodsugar levels shoot up afterwards I always ask myself, why did it get so high? did i eat to much or did i take too little insulin to cover this? and then I know that next time i will take a little bit more insulin or have a little bit less to eat.
Is it costs that make people have really high hb1ac? is there not enough money for insulin? Or do they simply not test their bloodsugar levels after meals? Are they okay with walking around with raised bloodsugar levels? Do they have set dosages of insulin that they take with each meal and dont change them even if levels are high afterwards?

It’s not quite as easy as you are making it sound. I have an A1C under 7 right now and the last few times I have had it checked, it has been. It wasn’t always though, especially when I was younger.

Back when I was younger the doctors didn’t even do things the same way as they do now. I’m sure a lot of the people who have had it for a long time, remember when 150 was a great average to have. Old habits die hard I guess.

What they were telling me back in 1987 is a lot different than what they are telling me now. Also, when I was younger, being a bit high never bothered me, in fact I preferred it as I hated being low. Having an ac1 around 8-9 didn’t bother me then and I didn’t feel unhealthy either as I was pretty active and wasn’t too concerned about it. I feel the effects a lot differently now than I used to, but I completely understand why someone has a higher one.

It’s pretty easy for me to be structured with my meals and schedule now, but when I was in college, the times I ate, slept etc, varied all the time.

for me, if i am high after a meal i cannot take another shot of humalog for 3 hrs. and then another and another etc…i will slam at a very fast rate. i have to wait 3 hrs…then correct he high and by then it is time for the next meal…and another shot…not always perfect, but try.

i also do bolus extra for a food that made me high 4 days ago and have ended up taking too much for the same food…different day!!! it isnt always the same for me, depends on how my body wants to behave!!

Your questions are difficult to answer because what I think you’re suggesting in your posting is basically a one size fits all approach to diabetes: if x = y then do z and hey presto, you’ve got a (good) result.

I’ve had diabetes long enough (almost 30 years) to know that this doesn’t work all the time. If I could predict exactly what was going to happen and when and if all Type 1s were to react similarly in the same kind of situation, then I’d be a diabetes guru and everyone would be rushing to my door. The best I can do is follow general patterns that have been shown to be effective by medical experience and listen to my own body, which is something all diabetics learn to do.

What I also dislike is the feeling of guilt, blame, lack of will-power, motivation and moral fibre that your comments subtly imply.

I agree…you can try to do everything right and still you can’t be perfect…I am s person not a number.

My A1C is 7.7 right now and that is down from a 10.5, 3 months ago. I was doctoring locally and they really weren’t showing me what to do to get the diabetes in control. I went to a specialist in the city (1 1/2 hrs away) and he changed some things and I saw a pump specialist to get me on my road to a pump. So in 3 months I came down 3 points and I am hoping to keep on coming down. I do not test after meals but I do test at least 4 times a day, always before meals. If I am high for my next reading I definately try to figure out why - did I not correct enough? Did I eat too much? What happened. I also don’t want to take so much insulin that I cause a low. Especially with being on quick and slow acting at the same time.

I think a big factor for alot of diabetics is denial. It is hard to test and take care of yourself all the time, it can burn you out. Plus if you are a teen or in your 20s, you think you will live forever and you want to be like everyone else. So you eat what you want and don’t test like you should. Money can be a factor, especially if someone does not have insurance. Also when you were diagnosed plays a factor. Like Glen I was diagnosed in the 80s and diabetes treatment was different, not as precise as it has gotten today. There is also the factor that many docs think that a 7 is a great a1c which we now know if not really the case. The closer we are to staying between 5 and 6.5, the better chance of staving off complications. The ADA still says 7 or below is tight control. If you run at a 7 all the time, your risks for complications.

I can tell you that when I went through my denial phase, I never tested at all, let alone after a meal. I also didn’t have insurance, making it very hard to afford any level of care for my diabetes. I just took my set dose of humalog and N in the AM and PM and that was it. My sugar ran high all the time and my body got use to it, I didn’t even notice the symptoms of a high anymore. As far as was OK with walking around like that, no, I wasn’t I just thought I was OK. I was a ticking time bomb. I suffered from depression, I had 2 DKA episodes and ended up with some complications because of this behavior. Now that I am a born again diabetic, a blood sugar of 160 makes me feel high and icky. I do ask myself now if a sugar spikes after a meal, what was different here?

So there are lots of factors at work here. You are doing a great job with your care, keep it up!

Our endo has been emphasizing to us that there’s much more to it than just what food Eric (my T1 son) eats. It’s also about how much exercise he gets, how much sleep, sometimes even the weather (if it’s really hot or cold, your energy needs change and that can affect your BG). He says the more we learn to account for all the variables that can affect Eric’s BG, the easier it will be to get that number down without having too many lows. Maybe it’s a little different with T2s than T1s, but I shouldn’t think it would be too different.

Hi Delores,

As everyone else has said, it is just not cut and dried. And the A1c level itself only represents an average. For example, in Dec '08, my A1c was 6.8%. Not bad from just looking at that number. If, however, you looked at my daily numbers, you would have seen swings going from below 60 to over 300. Every single day. Average a really high bad number and a really low bad number and you get a really wrong good number right in the middle. 6.8 was not in control

My A1c in Mar '09 was 6.2%. Fantastic! oh wait, while I’ve managed to get rid of most of the severe highs, I still am plagued by severe lows. So again, great number, lousy control.

I actually expect my A1c to rise a little once I can eliminate the lows and have a more consistent sugar level. Once I get it consistent, then I can look at bringing it down some. I started pumping 6 months ago and it has taken this long to get where I am now. I expect it to take just as long for me to get the kind of control I’d like. Now, personally, I’d like to see my A1c under 6, but that’s not going to tell me that I have good control. Looking at my daily numbers over time will do that. And those daily numbers will give me the info I need to make better changes. Heck, I could have stayed at 6.8 doing exactly what I was doing.

Costs can be a factor, trying to consistently manage this type of condition every single day is a factor, real life stresses, illness, denial, depression, et al. I don’t believe that you can point at any single factor as a why, let alone apply that to everyone. Add in other issues such as insulin resistance and some insulins working better on some people than on others and you have the Giant Flying Spaghetti Monster looking you right in the eye


People in the 7’s and 8’s are trying very hard and are taking care of their bodies. We all are, and we are all different. Some people are much less sensitive to insulin for natural reasons which means instead of taking 6 units for dinner they need 60, that leaves MUCH more room for error. Other people are suffering from severe depression which will cause chaos in your bloodsugar readings no matter how hard you try. Some people have other disorders that also get in the way, things like trouble with digestion, other autoimmune diseases, even cancer.

Also, just as many people in the 7’s are on pumps and continuous glucose monitors, as are the people in the 4’s. To say that it is that simple is just plain naive. In no way does an A1c reading say anything about how well you are “taking care of your body.” Personally i’d rather be a steady 7.5% (constantly at 180mg/dl) than a 5.5 and swinging every day from 30 to 300. I know you didn’t mean to offend anyone but I can’t help but to think you are being quite naive about the subject, and I do feel a bit offended by it. Sorry, I don’t want to upset anyone I just thought I should be honest about how I felt.

I would rather be 180 too…I have had too many 40’s in these 16 years of having diabetes…I am very lucky to have no complications yet and good lab results. I will be happy with 7.5 too. Finally got my basal dose pretty right on and I play with the Humalog, so I WON"T go low.

Cannot but agree with you, Joanie.

I have been in the low 7’s my entire 15 years of diabetes…until 3 days ago with my last result…a 5.9! (i blogged the details here) I don’t think there’s anything wrong with being in the 7’s if you’re moderately stable and fighting with all you’ve got, which most of us are! Keep up the great work! This isn’t an easy disease!

I agree with everything here. It does seem that you are acccusing out-of-control diabetics of personally being responsible for it all. That’s not the case. Each BODY is different as some can be more insulin sensitive/resistant than others; emotions/stress can play a huge role; medications; food sensitivities; and DENIAL play a large role in the scheme of things. It’s not just the type and amount of food. You will find that a good portion of T2 diabetics are in need of weight loss, but not all. So, before you hang the plackard of “out of control fatso” on a person, think of what all is involved in this complicated world of diabetes. Think, also, that we are human … imperfection to the nth degree!! Many of us search for ways to stuff pain and confusion and all sorts of emotions and food is the easiest way to assuage some of these feelings. This is denial in action. Well, one little bagel couldn’t possibly harm me; and then an orange; and then a little old cookie. All within one day!!

I don’t mean to sound defensive, but, actually, someone has to defend the poor, imperfect sucker unfortunate enough to get in line for two doses of disease!!

Have a good one. And, please try to understand … not everyone is blessed with immatculate self-control. :o) Would that we were!!!

Lois La Rose
Milwaukee, WI


Self-control is definitely something to be learned, as I do not believe anyone is born with more than a trace of it (or whatever you mean by “blessed” with it). I realize there are a lot of valid reasons why it may be more difficult for one person to control their diabetes compared to another, but lacking self-control and not eating right or exercising are not good reasons. I have sympathy for someone who can’t walk right due to neuropathy, but that sympathy doesn’t carry over to someone who decides a plate of brownies is the best way to address difficult emotions.

Dolores, may I add another question to your posting ?..I have heard this some time ago : true /not true ???..does night time blood glucose have a larger effect on the total out come of A1C result … and numbers are relatively the same during waking and sleeping hours .
I am living with type 1 diabetes for over 26 years …has always been hard work , try to have the latest gadgets working for me ( pump , sensor …) and it is still hard work …my A1C’s have been in the upper 7 's prior to pumping …the Internist suggested more insulin , that’s when I let go of him …I had far too many lows.
Last night around 11 pm all was well…7 ( x18 ) ; had supper around 6.30 pm, no evening snack …then my glucose went on the rise , ended up at 1.30 am at 13 ( x18 ) , gave a shot by needle , at 2 am .2 u by pump, at 6 am 11.1 ( x 18 ) another shot by needle …at 8.30 am down to 6.5 ( x 18 ) …
Fustration did set in , because I did all the problem solving learned over the years .
The GOOD news …no diabetes related side effects, never been in the Emerge due to diabetes…strong genes ; NO

Well I just ate an orange and my BG went to 210 from something like 100 before. Forgot to inject my 10 units of novorapid 10 minutes before eating it. But after eating the orange I did inject the 10 units. The problem is at some other time I would eat the same size orange and inject the 10 units and then promptly go low. The spike that a given amount of carb will cause is not totally predictable but still you can correct after the fact. The only problem with the feedback control is that one wonders if that makes you fatter. Still pesrsonally I am very unhappy if my HA1c goes above 6.5%. I am all for fanatical control but I wonder if it makes you gain more weight. Any thoughts on this?

I think so.