Blog Entries With Tag: A1C


Posted: Jul 7, 2013
Image of high 5 cat from reallyfunnypictures.co.uk

I had attempted an overnight basal test on Friday - but that was a failure with going low (3.2/57) - but last night - with having tweaked basal rates abit was SUCCESSFUL!!  I went to bed at 6.2/112 and woke up to 5.4/97.  During the night around 5 AM I had gone to 4.2/75 - but according to Gary Scheiner's book 'Think Like a Pancreas' - he says staying within a 1.7/30 up/down range from your original starting BG (blood sugar) - I was in the good zone. 


I have to admit - I'd like to be abit higher overnight with my BG - more in the 6-7/108-126- - so will tweak basals eventually - but am so looking forward to having a solid sleep tonight - as last few nights have been very broken with getting up every hour.

I guess this would be where a Continuous Glucose Monitoring System (CGMS) would come in handy - I know of some US health centers loaning them out to patients - but when I asked my endo about whether this was possible here in Montreal - he said no.  Anyway, the good "old fashioned" way of testing with the blood meter went well.

So much more precise than the urine testing in my earlier days of diabets control as I'm sure many of you will agree on!

Curious - how often do you test your basal rates (pumper or MDI)?  I have to admit - I blog about it "how to do it" - but have never really done a full night one before until having had difficulties the past month with low BG's since starting back on the pump after my break from George Michael.

I know that due to not having a Certified Diabetic Educator (CDE) or endocrinologist (endo)  to show/tell me how to do these sort of tests - I've pretty well had to go with what I read in books that others have recommended within the DOC (diabeties online community).  I have to admit - this time I was using Gary Scheiner's book I mentioned above instead of the John Walsh book - 'Pumping Insulin'.  I actually found Gary's book abit easier to understand - he writes more from the heart with being a Type 1 diabetic (T1D) like myself - and a pumper as well.  Both books though are very good - so they have many dog earred pages!

Picture courtesy of Fiction Writers Review
                                                 Picture courtesy of Fiction Writers Review

There's a few more tests I'm going to be doing over the next few months - to get more use out of my pumps programming (e.g. I have a feeling due to my sensitivity to my insulin - that perhaps my carb ratio is set too low - there are tests in both books that talk you thru' how to perform this).  The pump as some people think doesn't mean you'll have better control of your diabetes if you DON'T use it properly.  The same applies to multiple dosage injections (MDI).  You are the brains behind these devices we use - they can only help - if you know how to use them - along with help from your health care team (provided they are up on all the latest and greatest).

I know some of you may think it's dangerous for me to be doing this on my own - but sadly - not all of us have the resources / services available to us - and this is the only route we can go.  I would LOVE to be able to have a CDE or endo that understood the fine tuning of the pump - but alas - I've not lucked in as of yet.  A few years ago my GP had referred me to an endo here in Montreal that does research in the diabetes field and works with pump patients.  Sadly, when I saw her (Dr. Natasha Garfield) - she told me that my A1C of 5.9% at the time was dangerouosly low if she was to take me on as a patient.  I had hoped due to her having a team of CDE's trained in the pump area - that I'd be able to go to them for help when I needed it.  So, I walked away with my tail inbetween my legs and carried on the way I always do.

The Cat that Walked by Himself - by Rudyard Kipling
The Cat That Walked By Himself - by Rudyard Kipling - picture courtesy of  -http://www.mainlesson.com

So, this is why I do my own thing - and again - some of you maybe in the same boat as I am.  So far though, I seem to be on the right track - despite the little roller coaster ride from time to time that we all have with this disease!
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Posted: Apr 14, 2013
I had my birthday last week, and the way I celebrated it was to attend a JDRF Symposium a few hours drive away from my home here in Quebec in the province next door, Ontario.
 
What a blast – being with others that are wishing  to find a CURE* for T1D's (Type 1 Diabetics). What I found the most interesting, that at this symposium they were discussing research aimed at older T1D’s  –  not just the younger ones which has always seemed to be the research topic discussions in the past at the symposiums I have attended over the years.  They are looking ahead – at those of us who were young T1D’s at some point in our life (I was diagnosed in the 60’s) – and living our lives to the fullest with all the new research and innovations – while we wait for that CURE.

Doctor Irene Hramiak from the University of Western Ontario (UWO) was the research doctor that night who presented her role in a  project called REducing With MetfOrmin Vascular Adverse Lesions in Type 1 Diabetes (REMOVAL).  The aim is to test whether 3 years treatment with metformin added to insulin therapy to reduce thickening of the arteries and prevent cardiovascular disease in T1 diabetics.  Heart disease is one of the many problems that diabetics can develop over the years due to the ups and downs of our blood sugar and diabetes control – not all of us can attain a purrfect  4.5-6% A1C that a non-diabetic has.

The study will be monitoring the thickness of the arteries in the neck, which is a marker used to predict the risk of future heart attacks and strokes (and yes, while she was talking about this, I was touching my fingers around my neck).  Also, the study will test the drug’s effects on the control of diabetes and treatment.  One of the small drawbacks of the recepient being on the actual Metformin maybe stomach discomfort and/or diarrhea (which one of my Ottawa friends who is going on this project says might help them lose weight as well as get better control of their A1C).

For those that do partake, of course they'll either be on the drug or they won't, and will be clossely monitored to ensure that they stay in good control (that would be my greatest concern as a test guinea pig).  The criteria fo taking part in this tudy is that you have to be over 40 years of age, had diabetes for more than 5 years or more, with an A1C above 7% but under 10%.  There is other criteria in order to take part in this trial which you can find at this link.  Note that this trial is being conducted in the UK, Australia, Denmark, and the Netherlands and they maybe recruiting as we speak (for Canadians - the deadline is rapidly approaching for participants as they hope to start in the next few months). 

Art made of syringes by Dana Heffern
*
When I posted about attending this symposium last week on Facebook a few long time T1D's like myself got their feathers a wee bit ruffled (very attractive to a bird loving cat like myself I might add). They were disillusioned by JDRF's  promise of “a cure will be found in 5 years”.  That is perhaps an old statement they used many moons ago but so far over the years I've attended JDRF symposiums there are no longer make promises made like that.  JDRF's goal all along has been to, and I quote - " improve the lifes of every person affected by T1D by accelerating progress on the most promising opportunities for curing, better treating, and preventing the disease.
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Posted: Jul 5, 2012

Well, I was expecting what my endo told me a few hours ago when I had my 6 month check up – my A1C was 7.2% - usually it’s 6% - has been for past 4 years ever since going onto the pump.  That was one discussion we had – as usual – he’s not keen on the pump – except in children – where he said that less hypos are shown in children (if only I could tell him some of the stories that I’ve heard from D-Mum’s about that – but we could have been debating for hours – while his other patients were waiting).  He was not keen on my going onto the pump back in 2008 – when I decided to give it a try – but eventually I proved to him – that for me – it works ….. as well as MDI (multiple dosage injections) do for me.  I am lucky that I can do both – but as long as I can afford to pump – as it is a luxury if you do not have insurance coverage / provincial coverage / Sugar Daddy – the regular routine of MDI does work – with abit more effort – but it does work as I’m sure some of you reading this will agree. 

The result of my higher A1C is mainly due to being in the menopause stage of my life (oh joy) – and learning to readjust my insulin needs – weight (I have gained 11 lbs / 5 kg).  I didn’t need to step onto the scale to know that – rubbing thighs making music to my ears lately (NOT) have been making me wince.  Either I learn to take charge, get out of my potato couch mode – or change jobs (what I do now is basically a desk job – prior to this I was much more active) – so I’ve got to get out and just DO IT – rather than write about it – and suffer the consequences.  What didn’t help was problems with an elbow and drugs to help it and to top it all off last month’s threats made to my personal life – very unpleasant to say the least – were a test of my sanity – my parents / my bosses / friends / neighbours – all came to my help keep me sane thru’ the days that followed.  Hopefully the threats do not occur - if they do – we’re prepared.

The other reason for my visit to my endo – was to finally have him sign the Disability Tax Credit (DTC) forms that I’ve been wanting to give to him since I learned about this earlier in the year (see forum discussion link here) – that will either be accepted by the federal government as being legit or not.  He sadly does not like the word “disability” – and in a way – I agree – but heck – if I can get some sort of monies back – to help maintain my health as long as I can without going into the dog cat house – then call me disabled!!!   Like I told him, one of the form questions ask – “Does your patient meet the conditions for life sustaining therapy as described above? “ - the answer is a resounding “YES”!!  Without it, I’d be not only disabled but most likely dead in a short time.  So forms, along with printed up pages from Diabetes Advocacy – will hopefully help him understand what I am trying to attain.

So, as I left the office, into the stinking heat wave outside (a balmy 30C / 86F) – I almost felt like crying believe it or not.  Yes, I know an A1C of 7.1% isn’t bad – I know why it is occurring – but I hate having my diabetes control be a victim of it.  So, what does this D-gal do to handle the latest result ?  She goes shopping – finds herself a really nice blue TIGHT shimmery skirt from H&M (only $10) to be worn at hopefully a future D-OC (diabetes online community) meet up – and driving back home – windows open in the car with music from Caliente (tropical latin music) blasting away.  Yes, I am back in my happy place as I plan how to get my diabetes back in control!!! Ole!

Oh – and guess what - when I got home – my blood sugar (BG) was 4.1 mmol/l / 74 mg/dl – right on (this warmer weather keeps my BG’s in good control). 

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Posted: Jan 4, 2012
I don't usually set NY goals - but this year - I've decided to give it a go - promising myself to eat breakfast in the AM - and hope that by doing this - it aids in losing that belly fat I have ( though it comes in handy for my infusion sets ).  I know - bad excuse to stay plump!!! 

One thing I've discovered with some of my fav shows I caught over the holidays since I had time to actually watch what I miss as a working stiff - is that missing out on meals does not help in losing weight.  Your body goes into panic mode and decides to hang onto those fat reserves when you don't eat on a regular basis.  Something I secretly have known all these years, but I hid it in the far regions of my sponge brain. 

I am like many of my friends, diabetic or not, that find consuming breakfast in the AM to be a chore at times.  It's been something that was always difficult for me and as a child I did eat breakfast, but leaving home, that all disappeared. 

So, my goal this year, is to try my best to eat something in the AM, rather then just a cup of coffee until I "find" the time to eat later in the afternoon (bad, bad, bad).  Take for exampe yesterday, I didn't have much of an appetite, but I managed to get 1/2 cup of cottage cheese into me, besides my regular java.  Amazingly enough, with grazing every 2-3 hours - my blood glucose (BG) averaged 5.0 (90).  That was even with eating a blonde brownie in the afternoon at break time.  Of course, giving the correct amount of insulin to cover the carbs as well as my basal rate I have set up on my insulin pump helps out alot.

I'm also trying out an "at home" A1C test and posting the results on my Facebook page called the Roller Coaster Ride of Diabetes and also Twitter .  I lucked in on getting the 10th edition of the book entitled "Diabetes Mellitus - A Practical Handbook" by Sue K. Milchovich and Barbara Dunn-Long.  In the chapter on Labratory Tests - they tell you to do an at home eAG (or A1c).  Not that I'm not going to have a lab test done anymore, but the instructions which I'm following by testing my BG before and 2 hours after a meal using your glucose meter will give me a bit of a heads up I feel.  I always thought that by averaging out ALL your BG results from your glucose meter would reveal similar lab results - but apparently not according to the authors of this book.  The main thing is, I really recommend this book for any newly diagnosed diabetic - or old fart one like myself - since I always am learning new ways to improve the control of my diabetes.  Check out your library - you never know - they might have it - if not - ask them!

Happy New Year!!!!

My healthy breakfast
NB: If the picture above doesn't show up on your screen -
you can view the picture at this link
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Posted: Jul 19, 2011

Yesterday on Facebook -  Diabetes Daily had a poll going about the amount of carbs we consume a day.  Going back to it today – the one that seems to be winning out is 50-100 grams of carbs a day – which I personally think I cannot do.  I then decided to go over my past few days (this is after I’d put down my choice of 100-150 grams per day) – and was amazed to see that the last 3 days my average amount of carbs is actually on 90 grams.   I may have to go back to the poll and change my answer.  One of the other higher totals (same as the 50-100 totals) was “I don’t count carbs”.  Either they were folks like myself that just eat based on what they think is alright for them and semi-shoot in the dark for the amount of insulin to cover the carbs I used to be that way and managed to stay in an A1C of 7% - but my blood sugars did yo-yo a lot back then on multiple dosage injections (MDI) – which probably led to the lower number for my A1C. – The other thing is that those that answered perhaps were not on meds at all – but just diet and exercise.  All I know is that when preparing to go onto an insulin pump, I started to look at food labels more closely, not just for the carb count, but for other things like fat/sodium count that I felt was important for me to monitor as well.  I guess I reeducated myself after 40 years of being a diabetic – and just following the guidelines I was brought up on by my Mum and CDA with eye balling the amount of rice I had on my plate, etc.  It did work, but I just wasn’t being as precise with carb counting as I am now.

That’s one thing that I noticed the other day when going grocery shopping with a friend.  I picked up a bag of Bing cherries that are affordable at this time of the year.  They told me that they had bought a bag the other day (about 2 kg) and had consumed it practically in one go.  On top of that she was buying another bag as I picked out the darkest cherries I could find to share with my DH over the week!!  The first thing that went through my head was the amount of carbs they had consumed in that one bag of cherries –it boggled my mind.  Next we stopped by the bread area.  I swear those places pipe out smells of fresh baked bread just to draw you in – resistance is futile to most – but in my case – the constant walking wanna-be-dietician - I resisted the urge to a loaf of cheese bread my friend was buying.  As they teased me with the comment of, “There is one loaf left – buy it!!!”  They then told me … that they would be consuming this WHOLE loaf probably that afternoon.  I just had these flashes of potential diabetes or not being able to fit thru’ the bathroom door in the making.  On top of that they are already have been diagnosed with hypoglycemia – yikes!   All I could say was – “In my next life I come back with a pancreas that doesn’t pack in on me” – and almost added – “and a bank account that can pay for all the clothing / medical bills I may get from becoming overweight”. 

For some of you who are newly diagnosed with diabetes – carb counting is a chore – along with watching the quantity/quality of food you consume.  Trust me, it gets better over the time, and in the end you’ll be doing the calculations without even thinking about it.  For long term diabetics like myself, it’s just something I’ve always done; looking at food with a critical eye and pondering what it’s after effects will be to my health.  I really rarely think about what I doing except when faced with a food that I can’t really access properly – then I just wing it the best I can!

Off to munch on some cherries (not the WHOLE bag!!!!).

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