owlyn
08-12-2007, 08:00 AM
So I go to my PCP yesterday to get my A1C drawn. He asks how much Lantus and Humalog I average a day. Gave him the numbers (28 Lantus/26 Humalog). Then he asks how my FBGs are. Being stupid, and not bringing my meter along (One Touch UltraSmart, which stores the last 90 day's results), I guesstimated that they are usually between 130 and 180 (turns out I was right, they run 149 on average for last 90 days.) He had been to a seminar recently where it was mentioned that FBGs make up 75% of your A1C. I found this hard to believe, as it seems to me they would be 33% of your FBGs, but I let him continue. According to the seminar, you can't get A1Cs under 7.0 until you get your FBGs to between 80 and 120, and then use Humalog (or R) to control PP readings. He asked when I take my Lantus, and I told him one dose in the morning. Of course, he was surprised, as most one doses are in the evening. He asked why I do it that way, and I tell him that's what I worked out with my endo, due to a fear of overnight hypos, which I sometimes get between 3am and 5am now (usually when I exercise later in the evening instead of earlier). He thinks the Lantus is wearing off by morning.
Anyway, he suggests switching over to taking Lantus in the evening, and to adjust the Lantus to my FBGs, and to start with 10u of Lantus. I say okay, thanks.
When I get home, I check my meter, and find that my 90 day overall average is 149 as well (and I tend to test when I expect my BG to be high, or when I am hypo, and when I get up in the morning. This would all skew my meter average toward the high side.) Now, this 90 day average is lower than it has been in the past, and I reckon my A1C will come in around 6.5, where it has always been in the 7s prior.
At my last endo visit (4 months ago or so, my endo was suggesting I might want to consider the pump or switching to Levemir with split doses.
So... I figure to wait to see what my A1C is. If it comes in at 6.5, what should I do? If it comes in in the 7s what should I do? I am leaning towards not going with the pump, as I hate the idea of having something attached to me all the time.
Anyway, he suggests switching over to taking Lantus in the evening, and to adjust the Lantus to my FBGs, and to start with 10u of Lantus. I say okay, thanks.
When I get home, I check my meter, and find that my 90 day overall average is 149 as well (and I tend to test when I expect my BG to be high, or when I am hypo, and when I get up in the morning. This would all skew my meter average toward the high side.) Now, this 90 day average is lower than it has been in the past, and I reckon my A1C will come in around 6.5, where it has always been in the 7s prior.
At my last endo visit (4 months ago or so, my endo was suggesting I might want to consider the pump or switching to Levemir with split doses.
So... I figure to wait to see what my A1C is. If it comes in at 6.5, what should I do? If it comes in in the 7s what should I do? I am leaning towards not going with the pump, as I hate the idea of having something attached to me all the time.