More on Numbers - Type 1

Type 1 and LADA
1

I was looking at the dLife website - and found this:
The American Association of Clinical Endocrinologists (AACE) recommends
A1c (three month blood glucose average) – 6.5% or lower
Two hours postprandial (after the start of a meal) - <140 mg/dl (7.8 mmol/l)

The American Diabetes Association (ADA) suggests slightly different targets
A1c (three month blood glucose average) – 7.0% or lower
Postprandial* (1-2 hours) - <180 mg/dl (<10.0 mmol/l)

When I read these 2 comparisons, it made me wonder what % of Type 1 diabetics really are under 6.5 A1C. I have only attained that a few times in 34 years.

Do any of you really get post meal BS readings under 140 on a regular basis? This is very difficult for me to acheive- 180 is not so bad - but i still go over that several times a week(sometimes several times a day)

sometimes i want to laugh in the AACE face and say - ‘are you kidding me?’

Am I the one that is unrealistic?

Mollie
Type 1 - 34 years
Diagnosed age 4
Pumping and CGM
Last A1C - 6.6

2

There are a bunch of Type 1s posting on Dr. Bernstein’s message board who report A1cs in the high 4s and 5s. They follow his low carb diet.

3

My A1C went down from 7.2 to 5.8 when I followed the strict low carb diet. I haven’t had rice, bread, a whole piece of fruit, peas, corn etc. in 4 months. I weigh all my food and do a bolus if I want to eat more than about 6 g carb. But I only do a small amount of carbs- (about 25- 30g)at a meal, even with insulin. I have had good success in staying under 140 after meals but it has required a huge amount of effort and food preparation. To me, it’s worth it.

4

I go by my doctors A1C’s list… It’s a grade scale… I know that a little different but It work for people who needs to low their blood sugars and get better control of their diabetes…
A is 6.0 to 6.5
B is 7.0 to 7.5
C is 8.0 to 8.5
D is 9.0 to 9.5
F is 10.0 or higher

Befor I got on the pump mine was F all the time. It was terriable… My blood sugars were all over the map but mostly too many lows… Now I have been on the pump for 6 years it’s been between 6.5 or 7.5… This time it’s 7.0… Have a GREAT Day!

5

wow, I don’t think my postprandial numbers have ever been regularly under 140… Maybe under 200?

6

Same with me - if my postprandial is under 140 it usually means I’m going to go low once I start coming back down (unless I’ve had very few carbs during the meal). I’m closer to 180 usually. That’s part of the reason why I’m thinking of going on Symlin - it can get you down in that range.

7

Everybody is different. Since I have a complication (retinopathy that’s currently stable) I’m supposed to strive for under 6.5. The closest I’ve gotten is 6.6 and that took a lot of work.
It is so very hard to know how strict to be, and yet be able to squeeze in a life on the sidelines.

8

My a1cs are generally in the low 6s and I’m aiming for the high 5s. Post meal I’m almost always under 7.5 (135) - I aim to never peak over that (AIM, I said, aim - not always a happening thing!!)

It takes a few little changes, but once you get the hang of it it’s easy enough.

My tricks:
I Bolus early for any meal with more than a slither of carbs. Gives the insulin a chance to start working before I eat, because carbs generally work faster than insulin and insulin takes 10 mins or so (depending on what you’re on) to get started.

Balanced meals where possible - 1/2 veggies, 1/4 carb and 1/4 protein is what was recommended to me (and drummed into me many times lol). This works well enough, but it’s even easier to avoid spikes and insulin-oopsies if I’m having less carb. Doesn’t mean I always do it, but it DOES work for me and I aim for that where possible.

Some carb-counting, at least a little bit, makes me better prepared for most meals. Also figure out if you have to bolus for protein (I do), adjust for fat, or consider your exercise levels for the day etc.

Test lots. If you know where you are you know what to do. Don’t have to worry so much about lows if you’re watching the BGs regularly. No need to fear them if you can fight them!

I believe that lower is better. 6.5 or under sounds right to me. Under 6 would be great, but a lot of hard work (for me anyway). It’s not going to be possible for everyone of course, we are all different and leading different lifestyles. But to me it’s really important to avoid complications and try to hang around long enough to be a grandma to my son’s kids if he ever has them… so I get anal about control sometimes :smiley:

BTW in all of this, I think the best tip is to jab early! I can handle any carbs - even Chinese and desserts - if I jab early enough to avoid the peaks. The only trouble then is that more insulin = more room for error, but I keep an eye on my numbers so I can correct before I get high/low and get myself in a good place :smiley: Watching what I eat really works, but not if I can’t have ‘treats’ and go crazy every now & then!

That’s just what works for me… Hope that’s not seen as unsolicited advice, just sharing my tricks and letting you know that it IS possible to get a lower a1c if you want to.

9

Awesome topic!
I do not get it - Can we avoid complications and life shortening events if we stay below 7? Can I assume that I will not have any complications since I am under 6.5? I sure wonder…
Since going on the pump (about 4 years) I think that I have been below 6.5 every time. This is not bragging as I try to get below 5.8 because this is what the real world says is "normal, and I have never hit it.
My MD says that I should not even try to go lower - she says the risk of too many lows is too great, be happy where I am at.
Before the pump - Oh boy was I headed for trouble. 7 -9 was good for me. I had tried everything and could not feel like I ever had “control”. So, did having those high A1c’s (for 25+ years) shorten my life? My MD tells me that I am adding years back on now.
Used to hate the A1c, now I do not mind taking them-my pump usually tells me what they are going to be anyway. I am frustrated that I can never be “normal”.

10

I aim to be between 100-180 @ 2 hours post meal. I have a problem going hypo @ 3 hrs if the 2 hr reading was lower than 100 (maybe even 120).
Lately I’ve been reading about glycemic index, and trying to think about that when choosing meals. While doing so I’ve found I can meet the 140 level @ 2 hrs post, and do not have the problem of going hypo.
My last two A1c’s were 6.9 and 6.5

11

No Mollie your not the only one who wants to laugh at that! I can’t achive anything under 200 2 hours after meals! I’ve had diabetes for 34 years too. Sorry but I just can’t do it! I guess I done alright on my A1C last time though it was 6.4.

12

My a1c has been below 6 from the time i have been diagnosed, although i am not a big eater and do not eat meats and excercise regularly. so i believe with proper dosage of medication, excercise and strict food may play a major role; however i find as i grow older the more insulin dependent i become and the higher my numbers become… some days are good… some days are bad despite how hard i work… strange thing this disease is.

13

It is believable actually.

I have posted my meal plan. I follow it religiously. I have an A1C of 4.7

I was diagnosed in 1997.

It can be done. It really takes discipline. I am also a pumper.

14

Hi Mollie,

I eat low carb & my post meal readings are under 140.

15

Dear rainbowgoddess. How much total insulin do you use per day?

16

I just got mine down to a 6.7 last time I saw my endo, after years of being around 7.2-7.4. I do MDI (about to go on a pump!) and don’t really follow any diet in particular. I just try to take the appropriate amount of insulin for what I’m eating. Granted, sometimes I over or under compensate but dosing for food isn’t always an exact science.

I’ve been told to keep it under 6 for the past fourteen years so that number isn’t any real shock to me.

17

What Kathy said.

Those are general recommendations, and everyone’s case is different.