DIABETICS!!: whats your HBA1c???

Zaph · 24-01-2011 07:43PM

Just got my latest HbA1c, and from a starting point of 10 last June, to 6.4 in September it's now down to 5.6. I'm off to have a Mars Bar to celebrate. In fact I'm going to have two.

eilo1 · 24-01-2011 07:50PM

Hi Grindlewald,

Im really curious about her special needs assistant, does she have any other conditions?
I was 11 when i was diagnosed and there was never any talk of a special needs assistant. Is this a new thing for all diabetic children?

On the blood side of things, I would stop loading the insulin, she is always have bad weeks and pumping in the insulin could make it worse, as pointed out she may be rebounding.

Is she active? I always find exercise the best way to bring my sugars down when im unusually high for a number of days.

When I was her age I used to have treats and then go skipping, it seems silly now but it did the trick!

cynder · 24-01-2011 08:58PM

She was 14 at tea time, gave her carb ratio of 1:5. Total units 13. Just checked her bloods and they are 27.

Hits head against wall

.

To answer some of the questions, she was diagnosed at age 7 within 4 months the school was awarded an sna for her and she had a full time one till last week. She has a shared one now. She is really active more so than anyone in her class. The sna keeps an eye on her we've put an end to her being shadowed. She was out cycling for an hour today, she was horse riding Saturday for 2 hours aswell as mucking out stables.

As for her growth spurts she is 5 foot 1 (she is in between the 90th and 95th percentile) . And her percentile has fluctuated From birth she was at the 90th but over the years it be be anything from the 75 th to the 90th, last week she measured up to my nose she is now up at my eyes approx 1/2 an inch she seems to grow overnight. Her cousin my nephew grew over a foot in less than 4 months he is now 6 foot 2 at the same age she is now. He was 6 foot 2 at the age of 12. I don't think she is going to be that tall, I wouldn't have really noticed until I mentioned earlier about growth spurts, she's either grown or I've shrunk because when she thought she had grown last week she hadn't.

I checked her sites and some are not great so will keep an eye on that, her sites are usually very very good but there are a couple of bruises. Thanks for reminding me of that

eilo1 · 24-01-2011 09:29PM

Sounds tough Grindlewald!!

Thats is great you got so much support from the school, it must have been a great relief to you to know she was being monitored like that!

The only other thing I think of is change your insulin pens, they may be a bad batch or possibly gone off/out of the fridge too long.

My diabetic nurse told me she had a lot of patients with high bloods this summer and could only assume it was a bad batch of insulin.

ps remember to leave it at least 2-3 hours before testing the sugars after eating!

cynder · 24-01-2011 09:46PM

eilo1 wrote: »

The only other thing I think of is change your insulin pens, they may be a bad batch or possibly gone off/out of the fridge too long.

My diabetic nurse told me she had a lot of patients with high bloods this summer and could only assume it was a bad batch of insulin.

ps remember to leave it at least 2-3 hours before testing the sugars after eating!

Did that at 9pm today, got rid of all her insulin and got new ones out, We had a problem with her back in october and november where bloods went high but she had ketones with it aswell. I wonder if it is a bad batch?

eilo1 · 24-01-2011 10:15PM

I suppose it could have been, I had never heard of it before I was with my nurse and she had a call from a patient running high for a few days.
When she got off the phone she told me she had dozens of patients running high for no obvious reason over the summer months.

I hope the morning bloods are better!!

robinph · 24-01-2011 11:00PM

Zaph wrote: »

Just got my latest HbA1c, and from a starting point of 10 last June, to 6.4 in September it's now down to 5.6. I'm off to have a Mars Bar to celebrate. In fact I'm going to have two.

Hope those are diet Mars bars your tucking into?

Congrats on the numbers Zaph.

tbh · 25-01-2011 01:53AM

grindelwald wrote: »

It would explain it but no shes not eating all around her (she is gettign quite good and if she does eat she tells us). last night she was 14 before her evening tea she has 8 units which should have worked on an insulin carb ratio of 1:10 but 3 hours later they we HI (over 30) so gave her an extra 6 units of novo rapid and 20 lantus and no food, this morning they were 17 and she had nothing to eat all night.

Introduced a insulin carb ratio of 1:5 today.

The only thing i can think of that is making it go haywire is puberty & growth spurts, she is feeling a little sick she did have a tummy bug last week but that should have gone by now.

OK, GW, that's a massive leap, and If I were you, I'd contact my clinic. The advice is that you should never change Lantus by more that 2% per day, except in the case of a hypo. N/R dose should never be greater than 1:2, if it needs to be higher than that, there's an external problem.
I had an issue myself with Lantus being off, I guess it was too cold in the fridge or something.
Remember that changes in your lantus dose takes two days to wash through. What I took away from DAFNE was that controlling diabetes isn't like driving a car, where you make constant small adjustments, but more like steering an oil tanker where you try to anticipate problems in advance and make careful changes.
At a guess, I'd say it's more likely to be a problem with either the insulin or the injection site, or else she's snacking in secret - I know if I'd been diabetic when I was a kid, I would have definately manipulated my sugars from time to time to get some attention - it's just how kids are - or anyway how I was.
Be careful about making such an extreme adjustment, having said all that tho, I know its easier for me to say that than it is for you to actually do it, given its the love of your life we're talking about.
the other alternative is that she's actually going low, and then her liver is dumping glucagon which will raise her bloods through the roof.

If you don't have one, get a ketone meter asap, the optium one is the one I use. You can use it for bloods and ketones, you need two different types of strips, but of course they are all free. If she does have ketones you'll need to monitor more frequently and increase the dose, but only by 20%.

Zaph wrote: »

Just got my latest HbA1c, and from a starting point of 10 last June, to 6.4 in September it's now down to 5.6. I'm off to have a Mars Bar to celebrate. In fact I'm going to have two.

woah! I don't think you're actually diabetic. I reckon you're just pretending cause you want to be cool like us

thats amazing zaph, well done.

cynder · 25-01-2011 09:42AM

Thanks for all your replys,

Bloods came in at 6.7 this morning. Hope were on the right track again, reduced the lantus last night in case she was having hidden hypos during the night and then having rebound highs. I did give her a shot af novorapid at 9pm as her bloods were 27.

We have a ketone machine and most times they are 0.0, over the last few days they peeked at 0.5, way better than the 5.6 we had back in november.

tbh · 25-01-2011 10:15AM

grindelwald wrote: »

Thanks for all your replys,

Bloods came in at 6.7 this morning. Hope were on the right track again, reduced the lantus last night in case she was having hidden hypos during the night and then having rebound highs. I did give her a shot af novorapid at 9pm as her bloods were 27.

We have a ketone machine and most times they are 0.0, over the last few days they peeked at 0.5, way better than the 5.6 we had back in november.

If the bloods were 27 last night and she was 6.7 this morning, her lantus dose is too high. how much n/rapid did you give her? Lantus dose last night won't affect her until tonight

tbh · 25-01-2011 10:35AM

grindelwald wrote: »

Thanks for all your replys,

Bloods came in at 6.7 this morning. Hope were on the right track again, reduced the lantus last night in case she was having hidden hypos during the night and then having rebound highs. I did give her a shot af novorapid at 9pm as her bloods were 27.

We have a ketone machine and most times they are 0.0, over the last few days they peeked at 0.5, way better than the 5.6 we had back in november.

ok, so just to clarify:

*the bloods this morning aren't really relevant unless we compare them to the bloods last night and the amount of insulin taken.

*if you think she's having hidden hypos, you should do a 3am blood sugar check, as reducing the lantus won't have any effect until tomorrow night.

I'm very conscious I might sound like I'm lecturing you - I'd rather not post than give you that impression. I think you're doing a wonderful job, and you deserve more help with it than you're getting. I'm lucky that I've been given a lot of help recently with this condition and if you can benefit from that, fantastic - if you would prefer that I said nothing I will totally respect that, but I think the diabetic nurse will just tell you what I'm telling you.

Remember - the trick is to get the lantus dose right and then account for carbs with the n/rapid. If you need to constantly correct, or use a ratio of more than 1:2, you need to rethink the lantus level.
You should only adjust if you see the same pattern over two days, and only by 2% each day (lantus). The exception to this is if you have a hypo overnight, in which case you reduce the lantus straight away.

Remember - When you take change a lantus dose, it takes 24hrs to come into effect. Increasing your lantus today won't affect you today, it'll affect you tomorrow. If you have any questions, ask away. If I can answer based on direct experience, I will, and if I can't, I'll tell you - I promise you I won't guess or pretend.

cynder · 25-01-2011 10:55AM

cheers,

I always thought the lantus kicked in straight away for 24 hours, but yeh i think i should leave things settle for two days then have a look back and see what can be done,

We got off and a good start today so im going to document everything down and then on thursay see where we can improve (adjust insulin)

I dont think your lecturing me and i welcome any input anyone has. Thats why i come on this site

cynder · 25-01-2011 11:02AM

Just wondering if anyone had the flu / swineflu jab ? did it have any effect on your blood sugar readings?

CathyMoran · 25-01-2011 11:05AM

grindelwald wrote: »

Just wondering if anyone had the flu / swineflu jab ? did it have any effect on your blood sugar readings?

I had one of the flu's at the begining of the flu season and had the flu jab later on - the former had a really bad effect on my bloods but the jab was fine for me.

The_Conductor · 25-01-2011 11:18AM

grindelwald- just a thought- do you keep the Lantus out at room temperature, once its opened? Once you open it- it should not be refrigerated again- as it can act differently to how its designed to if you do. Prior to use- it should be refrigerated at above 4 degrees- but then kept at room temperature (below 24 degrees) thereafter, once you open it.

Lantus works by forming granules subcutaneously once injected. These granules are absorbed at a constant rate in the body over a 24 hour period- which is why Lantus is described as basal in nature- it is replicating the background insulin a pancreas would normally produce. It can take a while to form granules under the skin (typically less than an hour)- however this will vary depending on the person.

You really need to talk to your diabetic team regarding large changes in doses of Lantus- while a young teenager may need up to 20% more Lantus than an older person, and it may vary during growth spurts- any modification larger than 1.5-2% in nature really should only be done under medical supervision.

S.

tbh · 25-01-2011 11:18AM

CathyMoran wrote: »

I had one of the flu's at the begining of the flu season and had the flu jab later on - the former had a really bad effect on my bloods but the jab was fine for me.

+1 - jab was fine for me, any type of infection - even one you're unaware of, will raise levels

yungwan · 25-01-2011 11:20AM

grindelwald wrote: »

Just wondering if anyone had the flu / swineflu jab ? did it have any effect on your blood sugar readings?

My son had it about 3 months ago and had no effect on his sugars. I would definately recommend it

cynder · 25-01-2011 12:24PM

smccarrick wrote: »

grindelwald- just a thought- do you keep the Lantus out at room temperature, once its opened? Once you open it- it should not be refrigerated again- as it can act differently to how its designed to if you do. Prior to use- it should be refrigerated at above 4 degrees- but then kept at room temperature (below 24 degrees) thereafter, once you open it.

Lantus works by forming granules subcutaneously once injected. These granules are absorbed at a constant rate in the body over a 24 hour period- which is why Lantus is described as basal in nature- it is replicating the background insulin a pancreas would normally produce. It can take a while to form granules under the skin (typically less than an hour)- however this will vary depending on the person.

You really need to talk to your diabetic team regarding large changes in doses of Lantus- while a young teenager may need up to 20% more Lantus than an older person, and it may vary during growth spurts- any modification larger than 1.5-2% in nature really should only be done under medical supervision.

S.

Yep we keep the lanus out of the fridge once opened,

no one has explained lantus to me before like that, thanks. we've been told we can increase her lantus ourselves and they did give us a percentage to work with (cant remember what that was) I think i upped it a bit too much:o.

At least i have a clean slate to work with today. It was going well for a few weeks (around 6 weeks), i'll try not to jump the gun the next time.

thanks,

I am a bit reluctant to talk to her diabetic nurse in dublin, last time she accused my lady of not taking her insulin and that was the only reason her bloods were high, but she was and is taking her insulin. to go through the whole rigmarole again im not up for it. The diabetic nurse in limerick is way better but the consultant in dublin is better than the one in limerick, i cant win.... I find the diabetic nurse in dublin doesn't really listen and is abrupt where as the one in limerick will talk it through, help and advise. Ill give it 2 days if i don't see any improvement i will phone the nurse in limerick.

I also know ye cant give out medical advice and the only option is to talk to the diabetic team, but its hard talking to a brick wall.... also i feel that when i have to phone them because things have gone bad that im useless at managing her diabetes, i am trying. i sort of see it as high blood sugars means more insulin. We got on great for 3.5 years but its not working now... feel so demotivated

CramCycle · 25-01-2011 12:34PM

grindelwald wrote: »

Just wondering if anyone had the flu / swineflu jab ? did it have any effect on your blood sugar readings?

Same as Cathy, I had a dose of one of the flus(or something very similar) at the beginning of the season and my bloods ran slightly high for all that week.

Had the flu jab a few weeks ago and it didn't seem to affect my bloods at all.

CramCycle · 25-01-2011 12:47PM

smccarrick wrote: »

grindelwald- just a thought- do you keep the Lantus out at room temperature, once its opened? Once you open it- it should not be refrigerated again- as it can act differently to how its designed to if you do. Prior to use- it should be refrigerated at above 4 degrees- but then kept at room temperature (below 24 degrees) thereafter, once you open it.

I never knew this. Admittedly I knew they could be kept at room temperature after opening if wanted but not that you shouldn't refrigerate them again. Anyone know the science behind it as i would be interested. Cheers.

cynder · 25-01-2011 03:11PM

She is just back from school, bloods have been spot on all day so far (not going above 10).

Modified-IRL · 05-02-2011 09:48PM

I was 10.2% about 12 months ag0, down to 9.6% during the summer to last week 9%

I think im making progress, im 26 yrs old diagnosed since late 2004 and i guess as good a Diabetic as most folk here from reading posts :pac:

eilo1 · 05-02-2011 09:51PM

Well done!!

What have you changed to bring on this improvement?

Heuston14 · 07-02-2011 05:27PM

Hello all, will jump aboard this thread. New to boards.ie, am Type 1 for 21 years. Preparing to try and make our first baby is my big issue right now. Latest HBA1c 8% so working on getting that down. For anyone who has taken the 5mg folic acid - did you have any side effects at all. Wondering because I feel as sick as a pig today and have been getting quite bad headaches lately. Am hoping it's just a coincidence. We'll see I suppose!

tbh · 07-02-2011 06:48PM

Welcome along!

CathyMoran · 07-02-2011 11:26PM

Heuston14 wrote: »

Hello all, will jump aboard this thread. New to boards.ie, am Type 1 for 21 years. Preparing to try and make our first baby is my big issue right now. Latest HBA1c 8% so working on getting that down. For anyone who has taken the 5mg folic acid - did you have any side effects at all. Wondering because I feel as sick as a pig today and have been getting quite bad headaches lately. Am hoping it's just a coincidence. We'll see I suppose!

I have other health issues which complicate things but I did not have any issues with the folic acid. I know that at least one of the hospitals have assistance for diabetics that are trying for a baby. I had my HbA1c down at 5.8 at the begining for our son, lower for our daughter (am pregnant at the moment), they are supportive through it though it may feel that the doctors take over your life for the pregnancy but the results are worth it. Being a type 1 diabetic and being pregnant is not easy but the result is worth it all, the only thing is that (at least for me) I wondered why I had been so scared of it as a young adult as being a parent is wonderful.

I am coming up to 26 years since I was diagnosed with type 1 diabetes. Good luck and have fun!

Heuston14 · 08-02-2011 11:30AM

Thanks CathyMoran for the reply. I know what you mean - it aint easy. I've put it off for a long time, the thought of getting pregnant frightens the knickers of me - no pun intended:D

CathyMoran · 08-02-2011 11:46AM

They do more eye tests on you when you are pregnant, you will be visiting the hospital a lot. You will be very well cared for. From my experience the main public maternity hospitals were better. As soon as you find out about the pregnancy after going to your gp it is better to get an appointment with the maternity hospital. It is worth it in the end. Our son was born ar 37 weeks at 4lb 11oz - people may think that diabetic's have huge babies - that is not always the case. Personally I have had a lot of problems with hypos in pregnancy. You will be constantly monitored - just think of your child at the end of it. It is worth it - our 10 month old son sat up in his cot just the other night as he wanted his parents. It is very easy to get pregnant in the few months after having a baby - our daugher was planned but if you do not want a wonderful suprise soon afterwards take care. Once our daughter is OK and out with us we will be stopping. Having higher blood sugars will be a change.

robinph · 08-02-2011 12:15PM

Heuston14 wrote: »

...the thought of getting pregnant frightens the knickers of me - no pun intended:D

Now I'm no expert in matters regarding pregnancy, but I think that might help with the getting pregnant.

yungwan · 08-02-2011 01:19PM

My sons sugar is all over the place the last week. [Sigh]

Maybe he is going through a growth spurt or something as they are constantly high. Or perhaps he is just coming out of the honeymoon phase he has been in. (Diagnosed Aug)

He is only on small does of novomix as of yet. Up until recently this was 5 in am and 2/3 in pm. However it has been very high at times over the last week - 10 days (sometimes going as high as 30s for no apparent reason).

Have been increasing insulin gradually and it is now at 7 in am and 4 in pm. It was better yesterday (11, 15, 13, 5, 12, 12) and then 8.9 this morning. Obviously still not optimum but hopefully it will settle again. Its hard work!

Left a message for nurse there. Its so stressful some times. You cant take your eye of the ball at all!

DIABETICS!!: whats your HBA1c???

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