I ask this because here in the Uk they seem to have got fixated on 7%. I even had my T1 husband told by a “Specialist” that 7% is tight control and tight control can be dangerous!!! I think this woman has heard of the ACCORD study and doesn’t know the difference between T1 and T2…
I am aiming for myself to get down to 4.6% I’ve been reading Jenny Ruhl and think on balance it’s about right. Last one was 5.0% and am just due for next one. I hope it’s down, but i’ve had an infection, which caused a bit of upwardss “creep”. I’m usually in the 4s and even got a 7 the other day, but it didn’t last more than an hour or two. However, since i only test about once or twice per day, I hope it didn’t happen too often and get missed.
Hana
Ps I’ve never discussed targets with the doctor. the area health Authoriy’s[PCT’s] Target is 6.5% FAR TOO HIGH.
My endo says anything below 7%. I was 6.9% my last visit and complained because I thought I would be lower. That’s when he said 7%. He said even a few 200+ readings can throw off your A1C. I’ve been working out, on Weight Watchers and my log still has a couple of 200-flukes.
My doc was thrilled when I scored a 6.5 last time I went in. Which, considering how it’d been in the past, is an improvement, but she said that is exactly what they shoot for with diabetics. I guess she bought what the ADA is selling. Personally, I too would like to see it in the 4.6 vicinity but it’s tough going.
There is probably a good percent of the population that are non diabetic that are far above 4.6. Bernstein leads a monastic diet that not all can follow. I would lean with Jenny Ruhl in the lower 5 club and I feel fine about that. Sometimes when I get really low I just feel crappy, and I dont want to go around feeling crappy in life all the time too. There is a balance.
Jenny Ruhl writes about people who have A1cs above 4.6% and are not diagnosed diqabetic. They have a high risk of “diabetic” complications too.
I found a figure of 5.1% as average for non-diabetics. That doesn’t mean it’s ideal.
Bernstein is reaping the reward of careful diet in 60+ years of good health as a T1 diabetic.
Because of the voluntary work I do, I meet dozens of diabetics. T1 and T2 and most have had the condition for less time than me[7 years] and use much more medication and have more problems and complications. I feel that a bit of self restraint is worth it to me. My health is excellent[even though Ihave a cold at the moment] and Ihave no complications and manage on minimal medication. I’m aware that it’s not sufficient incentive for some people, but it is for me.
I’m in the UK too and have been told 7%. I have been T1 for 23 years and for the last 5 years have done everything possible to get it down ( I swear) but frustratingly can’t - when I said that I read on here that lots of people have very low, or low to me A1cs my doctor said that my personal target of 5 or even 6% would mean that I would constantly be hypo. I wonder how true this is? The lowest I have ever been is 7.4 and that was with quite a few hypos…I’ve cut carbs now and think my control could possibly see a 6 in the next couple of months but, yeah, maybe even 6 is too high?
Dee I’m a T2 and would have a hissy-fit if my A1c climbed above 6. My last was a disappointing 5.9, because I’d had a virus, which hung on and I couldn’t keep my Bg down as much as I like to, covering the month before the blood test… I don’t use insulin or sulphonylureas, so personally I’m not much at risk of hypos. However, My husband is a lifelong T1 with multiple complications. I eventually persuaded him a while ago to go reduced carb and reduce his insulin. It worked. His Hb A1c dropped to below 7% and weight stopped climbing[ didn’t drop by much!]
He went to a hospital diabetes clinic where the doctor recommended he change his regime, he decided to try it and the next thing is the renal clinic commenting on the deterioration in his control[Hba1c 8.5%]. He’s gone back to lowered carbs and the previous regime. BGs are better, staying below 7(126] nearly all the time.
Kidneys are stable, retinopathy not getting any worse. Other problems generally stable or better.
One thing we’ve found out is that the doctors taking the diabetic clinic may be newly qualified and know very little. This has been confirmed to me. In this case, they just follow the tick boxes. At least one wasn’t even reading patient notes and assumed husband to be T2.
On reduced carbs and reduced insulin, husband has few hypos[ bg below 4] and NONE have been disabling. Nothing more than a slug of lucozade needed.The key is to reduce the insulin to match the carbs, then it’s unlikely to happen
Doctors get obsessed with hypos. Overall High BGs are killing many more people;by means of complications or DKA… Hypo deaths are VERY rare.
Dee: In the UK, the NHS is pretty much stuck in the 1960s. As I understand it, there are still active debates on whether T1s need to test more than once a day and insulin mixtard is the standard treatment. There was recently an outcry when the UK moved the HbA1c standard target from 7.5% to 7%. There were actually doctors screaming that people were going to die. I realize it can be hard wading through the confusion. One doctor that is a voice of reason in the UK is Katharine Morrison (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570767/). I think you are on the right track, just take things a step at a time. Hopefully, your doctor will have an open mind. Get your HbA1c into the 6s, demonstrate that you are avoiding hypos and most reasonable doctors will give you a pat on the back instead of criticize you for you accomplishments.
Thank you!!
Thanks so much for that link. I found Dr Morrison’s website http://www.dsolve.com/ which echoes everything you have said about the UK. Unfortunately my doctors do not support low carb at all and have insisted I eat more carbs but I have my own research, on me, which says that it is impossible to lower my Hba1c and eat carbs. Soo happy to have this online support to know I am not crazy ( like my hospital think) about all of this. Thanks bsc and Hannah loads!
I’m glad it was helpful. I actually think dsolve is the product of Phishery. Dr. Morrison contributes to the site and has an email there. So thanks go to Phishery.
There have been write-ups in the Scottish daily papers about Katharine Morrison and her"miraculous treatment" of her diabetic patients.The man who was on the list for amputation qnd whose legs recovered in time and the one on the verge of going blind from proliferative retinopathy . How does she do it? A low carb regime.
Diabetes treatment is abysmal in many places in the UK. Most of us T2s who want to test our own BG have to fund our own test strips, because they are seen as a waste of money and the usual monitoring is an annual HbA1c. Of course if the patients deteriorate or develop complications, that’s not because the care is sub-standard, but because they are "non-compliant"
My diabetes care nurse doesn’t like my low carbing, but has accepted I’ll keep doing it. As far as I can find out, I am her ONLY patient with an HbA1c in the 5s, although there are a couple more in the 6s. She of course believes that below 7 is dangerous. I don’t get to see the doctor and have never seen an endocrinologist. The senior specialist nurse at the Hospital diabetes clinic[which doesn’t have me on its books] thinks I’m not really diabetic because of my numbers. I know her from voluntary work which I do, not as a patient.
My doctor said to me “Why do you want to be so low??? I mean, you do know you have all kinds of room for an A1C all the way to 7%, right?” lol
Equally important Hana is not the A1C but the spikes after eating. As you know that is why Dr B is such a stickler for T-2’s and T-1s not to shoot high after a meal. A A1C check once or twice a year doesnt cut it.
Fortunately I have a good Dr that wants my fasting below 100 and my A1C below 6. I twisted his arm to write me a prescription to test one meal/ before and after/ a day as a T-2.
After tackiling the doctor AND the health Authority on the subject of strips, I gave in and now buy them direct from Abbott, who give excellent service at a fair price. I make sure I don’t get spikes above 7 EVER!!
Hana