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A1c - Page 2


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Old 12-11-2014, 05:07   #11
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But the real issue is even if the routines available to evaluate the 'average' were entirely reliable, you have to consider what that average implies. For instance, I can get an average of 100 by calculating using a group half of which are 97 and the other half 103. But I get the same result if I average a group of values half at 25 and and the other half 175. Three guesses which represents good control?
I am wondering if this may be why my doctor expressed concern about my having low blood sugar incidents (which for me are extremely rare). He gave me a target of FBS between 5 and 7 mmol/L; my own target is between 4 and 6. He also said he wanted me to keep post-prandial numbers under 10 mmol/L; I usually manage to keep them below 7.5. So I am not getting either the highs or the lows, which he may not be expecting given the parameters he set for me...

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Old 12-11-2014, 05:27   #12
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Docs are inevitably afraid of lows because extreme lows can kill you on their watch. They are much less worried about highs, because highs will kill us, but it will be on our own time & the malpractice is much less obvious.




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Old 12-11-2014, 08:22   #13
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As Shanny says, doctors tend to be paranoid about hypos - for the reason she says. One of my wife's friends was told by her doctor that she should hold her blood sugar above 120 to avoid the risk. (Wonder if the doctor would volunteer her eyes for the retinopathy issues...)

That's why I like to keep track of my fasting figure - despite my doctor's view that as a Type 2 not on medication, "I don't need to test". Given my fasting figure as the floor and my HbA1c as an imperfect average, I can satisfy myself that I fall in the 97/103 group rather than the 25/175 s.

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Old 12-11-2014, 10:15   #14
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At the moment I do not take any medication for the diabetes at all. It is just controlled with diet and exercise. I am not perfect with diet as I know I have had a few indescretions during the last 3 months (but just a couple). Basically I am eating LCHF. As far as exercise goes I do an RPM (indoor cycling - spin classes) usually 6 times a week and walk about 4km 5 or 6 times a week as well. I have to see the Doctor early next week to discuss the A1C result - do you think I should be asking about Metformin to help bring it down further or battle on as is? Thoughts please

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Old 12-11-2014, 10:34   #15
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Difficult one Harry. Metformin should improve your insulin resistance issues but possibly at the price of some 'gastric discomfort' until you get used to it.

But cutting those 6 mmol/L readings down to 5s probably still needs you to keep looking hard at what you are eating. What sneaky carbs are in there that you haven't spotted? (and as the TV programmes used to say - "Answers on a postcard please")

Your exercise regime strikes me as quite adequate. I get the fun of walking the dog (about 6 miles a day) for mine and I do think that the significance of excessive exercise is overstated, but I'm a lazy so and so .

Your progress is in the right direction and that A1c figure is quite respectable and I hope your doctor recognises the work you've done to achieve it. We are on an ultra marathon though, so steady progress is what you want. Stick with it!

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Old 12-11-2014, 15:48   #16
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For me, my FBG tends to be higher than non-post-prandial reads taken later in the day. E.g., yesterday it was 5.2 when I got up, 4.2 when I got home from work. Even my two-hours-after-meal reads are sometimes below what I started with (which makes absolutely no sense to me -- how can I have a 4.8 immediately before lunch and 4.6 two hours later?)

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Old 12-11-2014, 16:20   #17
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- how can I have a 4.8 immediately before lunch and 4.6 two hours later?)
Perhaps your liver thinks you should have eaten sooner - it'll learn (maybe..) and that drop says you've still got a second phase response going. That's good news!

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Old 12-11-2014, 17:06   #18
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Yeah, I would say it's normal for a two-hour test to be back down around your preprandial test. In order to catch a spike, we always recommend testing at the one-hour interval, and again at the two-hour interval. If you aren't testing at one hour, you're missing a possible spike.




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Old 12-11-2014, 17:34   #19
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Thanks JohnInFrance, for your cogent explanation of the a1c. I've been looking for that for years!

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Old 12-11-2014, 18:54   #20
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Thanks JohnInFrance, for your cogent explanation of the a1c. I've been looking for that for years!

Josebud
Please keep in mind that the quick and dirty descriptions that I use duck a lot of significant detail although I try to make sure the important bits are still there The link offered by David in his post A1C test Definition - Tests and Procedures - Mayo Clinic has a bit more science to it and is worth a read.

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