Did the A1C target shift back to 7? My NP said my A1C was too low today, at 6.3. She wanted it to be over 6.5. I thought under 6.5 was ideal, but maybe that risks too much hypoglycemia? I asked my sister because she did a nutrition internship at Harold Hamm Diabetes Center in OKC last year and she confirmed, the target was 7 at HHDC.
So my in range time was 74%, my low time was 4%, and my time above was 22%. She wanted me to shift to an active insulin time of 3 hours and increase my insulin to carb ratio by 2g. From 1:8 to 1:10. Ok, that’s fine, I don’t want to have hypoglycemia.
However, I think the time below range is not an accurate number because of the lag time on the interstitial blood glucose readings with the sensors. I went slightly low this morning. I tested and was 65, ate some Easter candy. Waited 15 minutes, still felt dizzy, ate a bit more candy… drove to the drs office. At that point, it had been nearly an hour since the initial low. I tested and my blood glucose was 168, but my CGM still said, 72. It finally started climbing while we were changing rates. I was’t low for an hour though, only 15-20 minutes. So if that extrapolates accurately, I’m really only experiencing mild hypoglycemia (nothing below 65) for about 1% of the time.
Based on my initial settings from this fall, the 1:10 carb ratio and 3 hour active insulin time gave me no lows, but only 60% time in range and 30% above, 10% extremely above. I’m not okay with the time above range. I shouldn’t spend 40% of my time feeling sick while using automode on a 670G.
I’m just going to watch it carefully and download data reports weekly. I’ll adjust on my own if I think it’s necessary and sneak it back to the NPs settings before my next appointment.
I mentioned the lag time for my sensor catching up after lows and she said it was because I wasn’t eating fast enough sugar… but I think that will make my rates not aggressive enough.
Thoughts? I’m thinking aloud and would love confirmation or negative feedback if I’m incorrect. I want consensus from DOC because we are the on-top of it crew!