my doctor doesn't like low A1cs? [Archive]

Subby

05-14-2009, 07:42 PM

It's always worth weighing up the two sides of an argument.

First, the benefits to keeping an A1c at 7 or higher.

1. Some people might be currently getting too many lows to achieve it. (And this should be verifiable, not assumed).
2. .... .... nope, that's all I can think of. And in those cases, no guarantee at all, that such a person con't find better stability AND a lower A1c as well.

Let's look at the benefits of a lower A1c (say a point from 7 to 6)

1. Substantial reduction in risks of all complications such as retinopathy, heart disease, amputation, kidney failure, etc etc.
2. ...yep, that about covers it.

I'd say stand your ground that you are happy with a lower A1c, or get a new doc.

davef

05-15-2009, 06:41 AM

I think Subby has made good points, especially the "origin" of a lower A1c - if you get there with good control and low standard deviation then great, if it's there because of a lot of lows compensating for a lot of highs then is it a good measure to decide on how you are doing.

I guess I take the a variation of "look after the pennies and the pounds/euros/dollars will look after themselves" - I test frequently and aim to keep a low standard deviation and so my A1c should follow and both be good and a reliable marker of how I'm doing. Take an A1c is isolation from day-to-day BG testing, for me is not the best way of looking at things.

I went from 11.6% at DX to 6% at my last test. The time before I was at 5.8%, I want back in the 5's range and will get there through paying attention to my control. My doctor appreciates what I'm doing and encourages me to aim below 6% as he knows how I am going about it.

If you have good control then your A1c is great and your Doctor should be encouraging/supporting you.

xMenace

05-15-2009, 07:06 AM

I am finding my extended healthcare team is indirectly referring to the ACCORD study. "I have to say that it is not recommended that you get your AIC below 6% ...
Some negative outcomes has been associated with lowering the AIC too low." - direct quote from a NP.

Risks Associated With Low A1C Target | Doctors of USC (http://www.doctorsofusc.com/condition/document/330430)

IMO this study is only valid for people with type 2 and have chd. Perhaps risks of hypos in such cases does trigger chd events. The deaths were never linked to anything specific though. It is meaningless for prevention of such conditions.

It's always worth weighing up the two sides of an argument.

First, the benefits to keeping an A1c at 7 or higher.

1. Some people might be currently getting too many lows to achieve it. (And this should be verifiable, not assumed).
2. .... .... nope, that's all I can think of. And in those cases, no guarantee at all, that such a person con't find better stability AND a lower A1c as well.

Let's look at the benefits of a lower A1c (say a point from 7 to 6)

1. Substantial reduction in risks of all complications such as retinopathy, heart disease, amputation, kidney failure, etc etc.
2. ...yep, that about covers it.

I'd say stand your ground that you are happy with a lower A1c, or get a new doc.

There is a risk of eye hemhoraging if the A1C drops fast. Apaprently it's a documented fact, but I've never been able to find it and my optho doesn't acknowledge it.

I recommend you keep a tally on your hypo events to compare at different a1c levels. Im my case, the lower I go, the fewer I get. I firmly believe that better control means better control ;)

fgummett

05-15-2009, 07:16 AM

There is a risk of eye hemhoraging if the A1C drops fast. Apaprently it's a documented fact, but I've never been able to find it and my optho doesn't acknowledge it.I have also read that a too rapid BG reduction can exacerbate eye hemorrhage (I'll try to find a quote) but I don't see that as a valid reason to avoid lower -- or even, dare I say, "normal" -- A1Cs over a longer term.

I agree that ACCORD has been taken out of context... they saw issues in older folks already with established CVD and Type 2 poorly managed over many years, who changed to intensive management... hardly a fair analog for a younger newly diagnosed person willing to do what it takes -- within reason -- to live a long and healthy life.

Subby

05-15-2009, 07:21 AM

There is a risk of eye hemhoraging if the A1C drops fast. Apaprently it's a documented fact, but I've never been able to find it and my optho doesn't acknowledge it. ;)

Sure, and well worth mentioning, whether it's a big risk or not it's worth exploring if going for any freefall A1c records. But just to put this in context though, is it relevant in the drop from 7s or 8s to 6.5, such as the OP is talking about? I'd highly doubt it myself. Still, there's usually a study out there to say just about anything ;)

foxl

05-15-2009, 08:29 AM

Wouldn't you think that there would be a difference between deitary lowering by T2's, and pharmacologic lowering? I do wish this was more explicitly addressed.

Sounds like even MDs who read the study are not distinguishing ... and advising pts accordingly.

Subby

05-15-2009, 08:49 AM

I found this sentence quite fascinating, from John's linked article.

"The intensive glucose control group did benefit from slower progression of diabetic kidney disease but the long-term benefits of this are not known."

Errr..... I wonder what the long term benefits of slowing the progression of kidney disease might possibly be? Maybe at some stage, tap dancing mongooses rain from the sky and dance the nutcracker. They'd better run a study over 60 years to check, before commiting themselves to anything.

foxl

05-15-2009, 08:59 AM

sumi

05-15-2009, 11:05 AM

I have just gone through this with my Dr. I have written her a letter with my reasoning as I was literally speechless at her reaction (see my thread My Fantasy Doctor's Visit ). I think my objections to her reasoning have already been addressed here. First it is only ONE study, no other major study that I can find supports it. Second there was no attempt to observe results mainly from lifestyle changes as opposed to significantly increasing meds. Third the population was older, with poor control for several years (40% had already had a cardiac event). Also, it warns for people with increased risk of CVD - that would be over 80% of all type 2s (at dx). One would think that if a low A1C was dangerous, non diabetics would be in real trouble! And, my guidelines in diabetic Education were: before meals 4.0 to 7.0 mmol; after meals 5.0 to 10.0 mmol. If we take the 2 low range numbers, they indicate an A1C of 4.4. The 2 high range numbers would be indicative of an A1C of 6.7
IMHO

foxl

05-15-2009, 11:13 AM

GOOD FOR YOU, Susan!!! Maybe we can edumacate some of these docs, eh?

Beckernj

05-15-2009, 11:20 AM

6.0 is borderline low, a 6.5-7.5 is usually very good.

sarahspins

05-15-2009, 11:48 AM

6.0 is borderline low, a 6.5-7.5 is usually very good.

I don't think a 6.0 is low at all if someone is having steady blood sugars with good control... but I also don't think it's a realistic goal for everyone... it certainly doesn't seem to be for me.

I acheived a 6.2 once with #'s all over the map from 32-HI. I woudln't have considered myself in "good" control at that level, at all. My doctor was pleased as punch though, and I got a lecture when I started pumping and my a1c went up to 6.9... but I really felt like I was in MUCH better control at that point, I rarely had lows or readings over 200, nearly all were in the 80-140 range, which should suggest a lower a1c than what I normally end up with.

I've only had a1c's under 6 a few times.. and all were during early pregnancy when I was fighting lows ALL the time... it was not fun, and even cutting basal rates down on my pump I really felt like I could just not eat enough to keep up... especially combined with the nausea which made me not want to eat. I would have entire days where I never saw anything higher than an 80.

Now honestly I'm happy to be anywhere from 6.5-7% as long as I'm not having lots of lows or highs. I think steady numbers, even if they're a little higher than "ideal" (I'm talking 120-140, not anything insane) are probably better long term than the ups and downs that can come from trying to keep that a1c at 6 or lower. I want to get on a CGM soon and I am anxious to see if that will help me bring my a1c down a little while maintaining steady #'s and not dealing with frequent lows.

foxl

05-15-2009, 11:58 AM

True -- A1c is an indicator of "average" BG's ... and does not reflect standard deviation or standard error.

sumi

05-15-2009, 12:32 PM

True , Sara,
Maybe this is a difference between T1 and T2? I would imagine T1 is much more difficult to handle. In my case, I had 1 reading of 4.4 (79) and 2 readings of 8.1 (146) over the last 3 months, those are my extremes. Everything else is 4.7 to 7.8.

Timmy Mac

05-15-2009, 03:28 PM

thanks for the info guys, i think my doctor is just weird

art

05-16-2009, 05:18 AM

fgummett

05-16-2009, 05:51 AM

Mine wonderful Doc (I do mean that) has told me he wants me to run about 6.5.
Factored in is my age and my lifestyle.

He flat out told me he does not want to ever see me in the 5's.

If I was in my 20's or 30' he would want my A1C running around 5.8.

Seems reasonable to me.I don't see the reason... can you please explain why you should not be aiming for biologically normal A1C (and by inference, BG) levels?

art

05-16-2009, 06:22 AM

It's more a factor of my age than anything else.
Diabetes is slow.
At my age (63) diabetes has a lot less time to work it's magic on me. Running in the mid 6's is control enough and provides enough protection. Additionally, at my age a major lifestyle change is probably not sustainable.
So, it's a balance.
Cruise comfortably in the 6's and enjoy yourself or try to go down into the 5's and in all likelihood fail in the long run.

Live long and prosper and have a party:D

Art

foxl

05-16-2009, 06:29 AM

Art ... I hope he's right.

sanflan

05-16-2009, 07:34 AM

I have also read that a too rapid BG reduction can exacerbate eye hemorrhage (I'll try to find a quote) but I don't see that as a valid reason to avoid lower -- or even, dare I say, "normal" -- A1Cs over a longer term.

I agree that ACCORD has been taken out of context... they saw issues in older folks already with established CVD and Type 2 poorly managed over many years, who changed to intensive management... hardly a fair analog for a younger newly diagnosed person willing to do what it takes -- within reason -- to live a long and healthy life.

Has anyone compared the Accord Study to the Advance Study? They reached opposite conclusions. One explanation is that the Accord Study allowed patients to use Actos and Avandia, while the Advance Study had more patients using glucotrol and insulin. One thing that impressed me is the fact that those who took an ace inhibitor had fewer heart attacks. The Advance study was a very large study and I think the doctors are ignoring it and concentrating on the Accord Study.
It is a little like the low carb, low fat debate they are opposite theories and yet they both are used to treat diabetics.

TommyC1

05-16-2009, 07:59 AM

I just saw my Endo at Joslin in Boston this past week.
He was quite happy with my A1c of 6.5 and no scary lows.
He was far less happy with my stated intention of bringing my A1c down around 6.
His concern, which I share, is the possiblity of hypos.
He also stated that the benefits of getting below 6.5 "are not that great".
My standard deviation is up around %50 of mean now. I'm pretty sure getting that down to at least %40 is as, if not more, important than further lowering my A1c.
But I'm still going for both.

Tommy

sanflan

05-16-2009, 08:05 AM

Sorry, I need to correct my previous post. The medication used in the Advance study was gliclazide not glucotrol. The advance study had over 11,000 participants.

Dan Gato

05-16-2009, 09:15 AM

Timmy, Art,

It's recommended to keep the BG's below 140 to prevent nerve
damage (Heart,kidneys,eyes, etc) read more on the short time damage done by having high BG's.
Art, you're young, expect to live to 100 & beyond.

Normal A1C is 4.2 to 4.6, -- the lower the better. 7 is too high IMHO.

ccryder19

05-22-2009, 08:58 PM

My doctor doesn't like my low A1c's either and mine are very low: 4.6 and 5.2 were my last ones. Anyway, they assume that we have too many lows. If this is the case we need to work on that, otherwise STILL strive for an A1c under 7...definitely, I mean, who wants a higher risk of complications? Easy for a doctor with diabetes to say...he/she isn't the one under the threat of the disease. When I do research (Oxford, New England, and American Journals of Medicine) I only find support for low A1c's and very tight type 1 diabetes glucose control. I think a doctor makes his or her job easier by letting us have a decent A1c instead of pushing us to have a great one. I don't know. But, I don't trust them.

foxl

05-23-2009, 06:45 AM

Has anyone calculated WHAT KIND OF LOWS would be required to bring your A1c down, say .5 pts over a month. And HOW LONG? I think it would be an interesting exercise ...

And I would think any highs would offset periodic lows, anyhow -- because acylation of hemoglobin would not occur at all below a certain BG concentration .... ? Does anyone follow me, here? Supposedly it measures averages. But that does not take into account the sd and SE, right .... ? Didn't I say this in another argument, recently ... ? Hmmmmmm ... need more coffee, clearly. That or my A1c is runnin low!

DeusXM

05-23-2009, 09:14 AM

Normal A1C is 4.2 to 4.6, -- the lower the better. 7 is too high IMHO.

Query this. 'Normal' A1Cs are between 5-6%. WHO guideline say anything less than 7 is 'acceptable', largely because once you get below 7%, the benefits of reducing your A1C drop dramatically. There is a considerable benefit for someone with an A1c of 7.5 to drop it to 6.5. There's almost no benefit at all for someone with an A1c of 6.5 to drop it to 5.5.

One question that hasn't been asked here is Tommy's age. A lot of doctor prefer to keep prepubescent patients between 6 and 7% largely because of the perceived risk of hypos and the more severe effect they'll have on a body with a smaller liver and supply of glucose.

There's nothing wrong with reducing your A1C from 6.5 to 6 but you should also consider what are the benefits of doing so (minimal) against the difficulty of doing so. People tend to forget that treating diabetes isn't about getting the right number - it's about getting the right life.

Personally I would rather have an A1 of 6.5 and hypothetically die at, I dunno, 75, having not had to significantly deny myself anything, rather than have an A1c of 5.5, live to 90 and spend most of my life worrying about my condition or what I've got to eat.

notme

05-23-2009, 09:29 AM

Query this. 'Normal' A1Cs are between 5-6%. WHO guideline say anything less than 7 is 'acceptable', largely because once you get below 7%, the benefits of reducing your A1C drop dramatically. There is a considerable benefit for someone with an A1c of 7.5 to drop it to 6.5. There's almost no benefit at all for someone with an A1c of 6.5 to drop it to 5.5.

One question that hasn't been asked here is Tommy's age. A lot of doctor prefer to keep prepubescent patients between 6 and 7% largely because of the perceived risk of hypos and the more severe effect they'll have on a body with a smaller liver and supply of glucose.

There's nothing wrong with reducing your A1C from 6.5 to 6 but you should also consider what are the benefits of doing so (minimal) against the difficulty of doing so. People tend to forget that treating diabetes isn't about getting the right number - it's about getting the right life.

Personally I would rather have an A1 of 6.5 and hypothetically die at, I dunno, 75, having not had to significantly deny myself anything, rather than have an A1c of 5.5, live to 90 and spend most of my life worrying about my condition or what I've got to eat.

Once again, the voice of reason! My last A1c was 6.5. I talked to my doctor about lowering that to 6.0 and he told me the benefit was negligible. I tend to agree with him. The past few months as my blood sugar levels have remained in range, I have had lows that I didn't notice. I am getting down into the high 30's and I am not aware. Lowering my A1c much more would make me worry about hypoglycemic unawarness.

I think for type 2 diabetes, there is less of a worry about the hypoglycemic unawareness, but then, the quality of life argument kicks in.

Great post Deus.

foxl

05-23-2009, 09:45 AM

This month's Diabetes Self-Management (pretty conservative) synopsizes an article on HbA1c level predicting kidney risk ... levels of A1c were grouped into < 6, 6 - 7, 7 - 8 and > 8 (!).

Over an 11 year study (for other factors) the authors found that risk of chronic renal disease ... "for each 1% increase in HbA1c, a person had a 31% higher risk of developing chronic renal disease." This was in Archives of Internal Medicine, DEc 8/22, 2008 ... a peer-reviewed journal. Of course there were flaws with it, and it was an analysis of peripheral data from another study. But ... perhaps it is look-it-up-and-cite-to-the-MD worthy ... ? :D

fgummett

05-23-2009, 09:58 AM

Query this. 'Normal' A1Cs are between 5-6%. WHO guideline say anything less than 7 is 'acceptable', largely because once you get below 7%, the benefits of reducing your A1C drop dramatically. There is a considerable benefit for someone with an A1c of 7.5 to drop it to 6.5. There's almost no benefit at all for someone with an A1c of 6.5 to drop it to 5.5.

One question that hasn't been asked here is Tommy's age. A lot of doctor prefer to keep prepubescent patients between 6 and 7% largely because of the perceived risk of hypos and the more severe effect they'll have on a body with a smaller liver and supply of glucose.

There's nothing wrong with reducing your A1C from 6.5 to 6 but you should also consider what are the benefits of doing so (minimal) against the difficulty of doing so. People tend to forget that treating diabetes isn't about getting the right number - it's about getting the right life.

Personally I would rather have an A1 of 6.5 and hypothetically die at, I dunno, 75, having not had to significantly deny myself anything, rather than have an A1c of 5.5, live to 90 and spend most of my life worrying about my condition or what I've got to eat.You are stating all this as if it is hard fact. Is it really? So far as I have read there is constant improvement in risk the closer to normal that you go.
Yes, of course too many hypos just to get a low A1C is a bad idea but if you can get a truly normal A1C (not as the ADA defines) without too much risk, difficulty or compromise why not go for it?

xMenace

05-23-2009, 10:37 AM

So far as I have read there is constant improvement in risk the closer to normal that you go.

In my experience the better control you have, the less risk of hypo you have and the less risk of severe hypo you have. I had for more and far worse hypos when my A1C was over 7 than now. Even last fall when I rose to 6.3 from 6.1 I had more hypos. As I dropped back to 6.0 my hypos decreased.

I do not spend 8 hours a day on my control. I might spend 10 minutes doing d-things. I think I work smarter, not harder. Enjoying life is a priority for me.

foxl

05-23-2009, 11:27 AM

In my experience the better control you have, the less risk of hypo you have and the less risk of severe hypo you have. I had for more and far worse hypos when my A1C was over 7 than now. Even last fall when I rose to 6.3 from 6.1 I had more hypos. As I dropped back to 6.0 my hypos decreased.

I do not spend 8 hours a day on my control. I might spend 10 minutes doing d-things. I think I work smarter, not harder. Enjoying life is a priority for me.

As type 2s we are less-prone to hypos. However I think you present another valid point ... note my statistical comment above, too ... clearly, someone who is aiming for better control is apt to have fewer reactive hypos, and fewer hypos in general as they are self-educated and conscious of correcting with care and eating regularly. (NOTHING against people who have problems with hypos please do not mistake my intent).

DeusXM

05-24-2009, 08:03 AM

So far as I have read there is constant improvement in risk the closer to normal that you go.
Yes, of course too many hypos just to get a low A1C is a bad idea but if you can get a truly normal A1C (not as the ADA defines) without too much risk, difficulty or compromise why not go for it?

Yeah but once you are at 6% or under, you're already normal. And that's not the ADA guidelines, which also never claim to be normal, but just acceptable.

I agree, if you can get your A1c down from 6.5 to 6 without having to make any sacrifices or compromises, but if you can't, there isn't that much point.

It's incredibly disheartening to aim for a lower A1c, work very hard for it, and then miss. We already know that for one reason or another, people with diabetes seem to be more prone to depression. Perhaps it's a result of poor control. Perhaps it's the result of having a chronic medical condition. But psychologically, I'd argue that the last thing any of us need is a sense of failure over something that isn't really important.

Having a good A1c number is not a measure of how well your diabetes is treated. It's a measure of how well your blood sugar is regulated. Obviously yes, the lower you can get your A1c, the better. But I'd say this. I get A1cs regularly around the 6.5 mark. So physically, my diabetes control isn't bad. Psychologically, it's brilliant. I don't worry about what I eat, other than watching my calories. I don't ever feel the need to deny myself anything. Outwardly, no-one would have any idea whatsoever that I have diabetes. That, for me, is treating my diabetes. If I wanted a lower A1c, I'd have to worry a lot more about everything. From a philosophical perspective, I wouldn't be treating my diabetes because my medical condition would be affecting my lifestyle.

I appreciate that it's different for some, indeed many people. We all deal with this condition in different ways. Some feel good about getting the best numbers possible. Some feel good about proving their condition doesn't affect their life. Neither way is necessarily 'better'.

People often sell doctors short and say they don't know what it's like living with diabetes. It's true that a doctor without diabetes will never understand what it's like. But they do see the effect it has on far more people than most of us do. Doctors see people who go into spirals of depression because they're pushing themselves too hard and failing. That's why many of them can be cautious about pushing for 'unnecessarily' low A1Cs, because they've probably seen too many people who've tried, failed and then psychologically lost the battle.

When they warn you against pushing like this, it's not because they don't understand what it's like or they don't take diabetes seriously; it's because they're worried you might 'cure' one set of symptoms but end up with another.

foxl

05-24-2009, 08:29 AM

Penny

05-24-2009, 09:18 AM

From what I read on this forum, I have one very understanding doctor, and I appreciate him more all the time. He is happy if I am around 7, cheers me on when I am under. What bothers me is all my numbers are really good, A1C, cholesterol, blood pressure, everything but my weight.....and I really work at my diet. I would have a hard time believing someone who looked like me, if they reported what they eat and wonder why they don't lose weight. I don't worry about my numbers being good when I see my doctor, except for the weight thing and he really doesn't even bother me about that too much, though my heart doctor really bugs me about it.

DeusXM

05-24-2009, 09:34 AM

I wonder if, since we have to use diet to control our blood glucose, anyhow, getting a lower A1c is less additional psychological effort for type 2's ... ? Since we already are reining in our eating and activity levels, to such an extent ... why not?

I don't dispute this at all; in fact, I'd argue that it's a greater imperative for T2s to maintain lower A1cs, largely because the diagnosis of T2 usually comes some time after having elevated A1cs. It's probably more essential to maintain lower ones since the damage already done is generally higher.

But you'll note that the OP is a T1.....

Eddy

05-24-2009, 10:01 AM

So much worry about the A1c value. What really matters in minimizing "too high" and "too low" time, and being able to enjoy life.

Since DX at 12.9%, I've remained 5.2% - 5.4%. I do run the risk of hypos, which are not fun... and I've done a few glucagon shots when alone and scary low... but my mind (important for my work) works best when I stay below 110 mg/dL or so. Ergo, for me to function as best as possible, my A1c just can't be in 6.5+ territory.

Yes, I have spent -- and still spend -- much effort figuring out various foods, learning what physical activity does, et cetera. This is a choice that I've consciously made. Until some credible study shows that semi-regular excursions into the 50s (another pesky 55 yesterday) have severe risks... I'm comfortable with my decision.

Do A1c values really matter if one is keeping close tabs on spot samples? Is a simple one-dimensional number really appropriate for evaluating all the nuances of our shared nuisance? Or is the A1c sometimes [ab]used by those shirking a duty to give actual, intelligent, thoughtful insight into the subject?

foxl

05-24-2009, 10:23 AM

Nice perspective, Eddy.

I like the poetry of nuance and nuisance, too ...

rcortez002

06-06-2009, 07:46 AM

Hello I am new to the forum. I am glad to have found this sight and I am glad to be able to talk with others on this matter of Diabetes.

I was told last year that I am Pre-Diabetic. I cried so much that day, because I was hoping I would not have this disease, because my Mother is a Diabetic for the last 36 years.

My DR told me that my A1C was at 6.9 and that I am Pre-Diabetic and should of course eat better and exercise more often. So, I have and I feel better and love working out more. But I asked him when will we do another A1C to see where I am in the test." He said not for another year or so ".

Is he right or should I just keep on him to take the test again or should I look for another DR with more experience in this field?

art

06-06-2009, 07:50 AM

He's probably right.
He knows you're doing the right things to keep your A1C down and there's no rush to retest.
Once in a while borrow your mom's meter and test. See what happens there.
We understand the crying part. It's ok

Art

rcortez002

06-06-2009, 07:56 AM

ant hill

06-06-2009, 08:41 AM

My Endo is not too concerned that A1C's go to 7.0MMOL/L They are more concerned about the weight that you have on your mid riff and that would have to be that we should be limiting the carbs that we eat OR!! Exercise. The 21St century is making us FF fat. :eek: I am not suggesting to go a veggie, Just eat less.

We could go on & on about what we should eat, Get out there and take a walk (Don't forget the BG meter and fast carbs. ;))

I am sorry that I say to folk here to take a walk & away from the computer, Just have a stroll after you had a bite of nice carbs. ;):)
However I aim for 6MMOL/L myself, Just eat less. :T

foxl

06-06-2009, 09:06 AM

Hello I am new to this forum and I am glad to have found it.

I was told by my Dr that I am pre-diabetic and that my A1C is 6.9. I of course do not understand any of this stuff and asked him what it all means. He used nothing but a lot of Dr talk again. Don't get me wrong I understood a bit but come on.

Any way I started exercising more often and eating better. I asked when will we do another A1C test to see were I am. He said not for another year or so. Is he right or should I just keep on him?

Hi, and welcome to the forum. Buck up a bit ... you can control this and without that much hardship, really.

Me, even as a pre-D I would like more feedback on how I am doing than just an A1c once a year. You could buy a meter and test strips out of pocket and keep track ... learn what spikes you ... barring that, you could go to WalMart and buy the Relion A1c for 9 bucks, every 3 months, and use THAT to learn how you are doing! It'll be okay -- you have my sympathy -- my diagnosis -- in the hospital -- came as a huge shock to me, but you can learn how to live with this!

Read here, learn, and talk to us all you can!

Doug

06-06-2009, 04:39 PM

DeusXM covered it pretty well

Type 1s perspective

I would add the common sense input that low BG will kill you quick and high BG kills you slow

MANY Drs have similar concerns. I know that if I showed up with a 5.x he would have a B IG problem with it and Im certain he is a good Dr.

Its my opinion that a newly diagnosed person could get mislead by reading the a1c discussions here. Its not the typical diabetic in good control that has an a1c under 6, its the exceptions.

Keep in mind that this is the internet and not everything you read is true and its rare when you get the WHOLE picture in a forum.

If the a1c is true the standard deviation may be really high.

Finally a LOT of what you read about Diabetes is specific to type 2 diabetes, especially in the main stream media. Most of that doesnt apply to type 1s or applies differently

Timmy Mac

06-23-2009, 12:35 PM

alright, sorry i havent been on much. I have had some other things keeping me away from the computer. I tried to find the new doctor, but there is only one endo within 2 hours of where i live and she's not the nicest doctor in the world.

"All of these readings are useless and don't mean anything if you don't log them"
"why do you use this meter? it has no features! change it now!!!" (well what if i LIKE my true test)
"I see within the last 10 readings you've had 2 above 300. you're obviously not taking care of your diabetes as well as you should"

ect...

so (at least until i can drive by myself) im doctorless for a while.

alright, clearing a few things up

im 16
not overweight
generaly active (which is why my a1cs are higher, if i see anything under 100, i know within an hour of doing anything ill be low)
thanks for all the useful advice!