Maybe its also your fear of hypos that keeps your hba1c high. Ive never had a big fear of them, but try to work on it so you can aim for a bit lower bgs and arent keeping them above 100 all the time. Cause then when your bgs spike they always spike 10 higher. If you know what i mean. Sorry my english is not the best. Someone also suggested writing down. There are also some good apps you can put on your smartphone to note your bgs and reactions down. I use the ibgstar app to write my bgs down. Dont get too frustrated, 7.8 is still a relatively good hba1c. Wishing you luck!!
since an A1C is a measure of control over the last ~ 3 months using glycosylation as the measure. It would seem to me that if you completely replace a fairly reasonable volume of blood that has already been glycosylated with blood that has not been around long enough to become glycosylated your A1C would go down as a result.
It is also one of the reasons pwd and with anemia cannot use A1C as a measure they do not have enough blood to get an accurate result.
I agree with Terry that writing stuff down can help show what I refer to as "opportunity areas." I'm totally lazy (although I recall you aren't, from your "three-a-days" on the exercise bike...) so I don't actually write stuff down but upload pump data. The "pie charts" are very useful to me, a way to see the forest of results amalgamated, instead of looking at this test or that test. The pie charts will show where you have concentrated off results.
Looking at my sensor daily overlay by meal report, which I'll see if I can stick on here to illustrate what I do, I can see that for the last two weeks, my BG has been up a bit from where I usually like to run. This may very likely be a result of seeing if I could cut basals down to .775U/hour from .8 and it seems as if, particularly at night and on into morning, it's resulted in more elevated BG than I usually get. I've noticed this meterwise too and finally gave up on it, just yesterday and cranked things back up during the day.
I woke up in the middle of the night and it seemed to be running up so I said "%$#& it" and gave it an extra basal nudge there too, along with correcting the direction it seemed to be going on the sensor (woke up but didn't get up, I'm in a good sensor spot so I'll roll with that in those situations...). It's "cleaned out" tactically but that's also an inconvenience as I'm getting ready to work out and am at 87, a shade lower than I'd like to be. I'll give it a couple of days. I just had an A1C drawn Sunday which may be odd. Before I had turned the pump down, I had some days on ***rails*** really tight and low, as I started a new AM workout thing and moderated my food or a bit (down 8 lbs in 3 weeks though, which is part of it! It's fun too...). I was concerned about running too low so I tried the basal. It seems not to work (perhaps if I lose 8 more lbs?) but it's just an example of how to use the charts. The A1C may be odd with several "high" days right before it, chasing about a 2 week period of very flat lines. Maybe it will work out to the usual, I certainly hope so but, if it doesn't, I'll just blame it on the adjustment process and keep on tweaking!
Also, I mentioned earlier goals and Lil Mama mentions not going < 100 b/c of lowphobia. I run up about 40 points from meals as a goal but like to start around 80 so I don't go too much > 120 when I'm "on". This has led to about A1Cs in the 5s all the time. I run low sometimes but don't eat enormous meals so they are very manageable. If you aim for a minimum of 100, your post meal will run up to 140, which is kind of right in the wheelhouse of a 7ish A1C. Any "oopses" can push it higher. I got lows when I ran up and down, way more of the serious ones, getting all pale and sweaty and staggering to the fridge and all that. I get them now still but am pretty engaged and see them coming and treat a lot of them very conservatively and I think this helps avoid post-low highs and leads to a more mellow psychology without all the low crazies I'd get, really bleak feelings, with the steeper dive-bombing.
1539-080613sensoroverlaybymeal.pdf (34.6 KB)it seems to me that this method of lowering a1c would be more cosmetic. to get a pretty number we donate blood, but it really wouldn't be an accurate view of control over the past 8-12 weeks.
I don't know, I would prefer to monitor my control more accurately-well as accurately as a blood test allows.
saying that, it might be a nice way of starting over with a lower a1c and working from there to get better control. and wouldn't it be nice if we could just donate blood every month and then wed have low a1cs and not have to worry about complications?!? that would be great!
I don't see how "cooking" your number is really that useful. Your BG is what it is. An A1C isn't an end in itself, it's a tool to get to the end or, specifically for me, it's a tool to help push the end back farther and into and beyond the "normal" range by beating the life tables.
Yes as I said, the original poster wanted to "lower her A1C fast". This is the only way I know how to do that.
I certainly would prefer to do it the "old fashioned way" by counting carbs and being accurate. But a "reset" every once in a while to me seems like a viable option, especially if it might help someone else as well.
And I will quintuple what Terry said. You already told us that when you don't have breakfast you noticed your blood sugar spiked. Does this happen all the time? Does having breakfast stop it? Writing it down reveals the pattern which can lead to an AHA! moment.
My thyroid is a huge factor and is in full on attack mode. It will swing from very high to very low within weeks. Had it checked 4 weeks ago my TSH was 13 so my thyroid was very low, had it checked two days ago and my TSH was .011 indicating my thyroid now only 4 weeks later is very high. Its so frustrating! Going to see my endo today reguarding my blood sugar and thyroid issues.
I currently am so busy with my kids that I have stopped working out this past year. I think this is a huge part in my A1C spike.
Good work, Acid!!I too use the pie charts, because I do not like to log either. But I think I will go back to more manual with a pen logging as my overnight and morning basals do need tweaking.....Love your comment: "leads to a "more mellow psychology without all the low crazies" I'd get, really bleak feelings, with the steeper dive-bombing. I and my shrink thought I was bi-polar until I started testing more and stopped that trend ( the "low crazies").
LIL MAMA, I feel for you and your pain. Take a deep breath and realize you are not failing. You are NOT the sum total of a number. You are intelligent and strong. KNOW THAT. I have had to start over and do the basal/bolus/ISF/ carb ratio over again from time to time. Had a a1c of 7.6 last time myself, due to stress: this was in June 2013, almost 3 months after my brother died in March o). Stress and not accurate enough dosing for the greater carb ( comfort food) consumption.
It is hard, but I to not take the a1c result as a judgment of me. An old late 60's British TV drama was called "The Prisoner". My brother and I were young teenagers and loved it. A spy ,"number 6", was imprisoned in an alternate universe type world where he was observed big-brother like by a group of judges who evaluated his comings and goings and choices. At the beginning of each show, during the theme music they would show a clip of him screaming to his judgers/evaluators/ tormentors, who insisted on calling him "Number 6: and never his real name: " I am NOT a number, I am a FREE man.!!
Same for us all :"/we are not numbers we are free diabetics.
An a1c is just a check so we can use the data as a basis for changes, not a formulary that is a harbinger of doom and gloom.
God bless,
Brunetta
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Feeling defeated, huh? I have been there before too and it's the worst feeling.Don't beat yourself up about it. You have obviously done an amazing job taking care of yourself and these past 3 A1Cs don't overshadow all of your hard work and exceptional care.
I think we have all had times when we feel at a loss and can't seem to figure out what is causing us to be higher than we would like, especially when we are doing everything we can think of to try and lower our numbers.
As others have mentioned, so much other stuff impacts our #s. I would take a deep breath and give myself a pat on the back for simply managing a disease that can be so frustrating. Try to think about other things going on in your life that could be causing these higher numbers, and maybe check more frequently and you'll possibly find that you need some corrective units throughtout the day. I would also make sure my supplies have been kept at the right temperature, etc.
My Dr. Appt a few months ago didn't go as I had hoped, so I logged onto sparkpeople.com.
There you can track your food, fitness, A1C, etc. and it has a lot of diabetic info. This was helpful for me because it really opened my eyes to just how many carbs I was eating (even though I thought I had carb counting down pat). After joining this website, i was able to drop my A1C by .8, which made a big difference.
Fine tuning and being patient is key. you will get there.. keep your head up!!
well, working out is great..but it's transient, really. what if you got really sick, broke your leg, etc..and couldn't work out, it's providing, really, a false sense of blood sugars. you need more insulin, jenn. use your CGM as your guide. I set my low at 90 when I bolus, that way..when I see a 90 with side arrow down I know I'm probably about 70 and dropping and treat it, considering lag time. 1.5 meal bolus seems to me wouldn't cover any of your meals, 1 - 2 cups of veggies, even w/a bunch of lettuce could be 30 carbs right there, plus you're not bolusing for protein, which hits and spikes the body later (are you using any of the extended bolus features on your pump). Please try eating more, upping your basal, if needed, it will help with your bolus too. try basal testing. yeah, hypos suck but so do high A1C's and bouncing from 100 to 245, that does damage. I also find stress does little to my numbers, certainly not a total increase of my A1C, if my BG's go up...I need more insulin and there's no way around it. Also, just to be clear, more insulin doesn't cause weight gain - we need what we need and our bodies tell us this with our numbers, not taking the correct amount of insulin to effeciently move and allow the excess damaging glucose out of our bodies does.
Maybe I missed it in all the advice offered, but your insulin sensitivity can and does change. Might be worth recalibrating?
An a1c of 7.8 translates to an average blood glucose of 177 mg/dl. To me it is obvious that something must be wrong with your basal coverage. I also question low carb solutions because most likely they will reduce your metabolic rate. But the metabolic rate is important for the burn rate of glucose (in muscle tissue and so forth). With a sufficient burn rate you can consume excessive blood glucose more easily. This makes it easier to handle the typical deviations of blood glucose we all experience. In my opinion a restriction of carbs is fine but make it 100g of carbs not 30g. This way you will permanently learn new things about food and their carb content. The more you have learned the better you can utilize this knowledge to cover the carbs correctly. To me this approach is better than trying to take the carbs out of the equation. The big unknown might be the thyroid here. With fluctuating activity it will greatly influence the metabolic rate.
My experience is that low carb leads to a lot more BG stability and is easier to manage with much slower increases and decreases in BG. For me I've probably been covering a lot of the protein/fats with basal, and I do a lot of grazing. At night things might change a bit, but you can change basal rates overnight to cover it. It seems to make it easier to stay in the 90-130 range, and avoid the highs (200s) and lows (50s-60s).
HOWEVER, skipping breakfast would be a game changer and might be problematic. Is it possible to get a stronger dawn phenomenon if there is no food/glucose in the body?
she's eating only 30 grams of carbs per day already! i wish, sometimes, people would stop over endorsing low carbs, especially for skinny type 1's who need to eat...thus, eat what you want and what works for you but many type 1's eat carbs. it's learning what one can and cannot eat and one's I:CR and basal rates - it's not always linear either.
My perspective is that anyone should be capable to master the mechanics of insulin dosing. With around 100g of carbohydrates it should be possible to reach an A1c of 6 - of course if the circumstances allow that and other factors like the menstrual cycle or the thyroid are not interfering. At this stage I am fine when someone decides to strive for even more. Statistically it will most likely not pay out though. But that is another discussion with much speculation. The statistical long term data for people in the A1c range of 5 will be sparse I suppose.
In my experience skipping breakfast is always problematic. Most likely the I:C in the morning is also covering the dawn phenomenon. Thus you will need a small dosage of insulin to cover the DP if you want to skip breakfast. But skipping might also influence the dosage for lunch. This really depends on how the activity of the insulin will unfold. For some people even the fast acting analog insulins have a long tail that will influence the following 5 hours after the injection. For me this has the effect that a skipped breakfast leads to a dosage increase for lunch by the factor 1.5.
yes, or people on pumps just turn up their basal rates to cover the DP.
You may want to work on your stress levels. It seems you are very stressed out about the numbers and where you should be from an a1c point of view. I went through a period where I could not control my numbers and work was crazy. Stress is a big factor on numbers. If the stressor is constant then your body is in a constant fight or flee response mode. If you donât take your body out of that stress mode then you wonât be able to stabilize. It took me years to accept that stress was doing a number on my numbers. Relax a bit. And I mean find a real way to relax about things. Your body is trying to prepare your body to deal with the stressor by feeding you more glucose from internal resources where ever it can find it. Google the topic âstress effects on glucose levelsâ. You will find tons of information. Take care and please relax.
looks like you're a type 2 not on insulin. type 1 is an entirely different ball game. i can be stressed out as all hell and my blood sugars will drop if i take too much insulin. stress effects us all differently, and it has very little effect on my BG's...hell, i'm basically stressed everytime I bolus. having type 1 diabetes alone, having to take analog insulin all day long is, in itself, stressful.