My diabetes specialist

[DeusXM]

I'm starting to think my diabetes specialist nurse isn't all she's cracked up to be. Not only has she failed to give me an A1c for the last year (I had to ask her specifically for one), she's also slightly clueless as to the results.

It's rather hard to keep a straight face when she declares that as long as the result is under 7% I'm doing fine.

You should have seen her jaw drop when I told her I was aiming for an A1c of between 5 and 6, and no higher than 6.4 at the most.

[Cinnabon]

Nothing frustrates me more than getting that feeling from Professionals, talk about things that make you go Hmmmm, lol. Can you bring it to anyone's attention?

[sparkle9]

If my A1c was consistently under 7, I'd be elated! But I admire your goals. I do agree with you that not doing an A1c for a year is unacceptable. I thought every 3 months was standard procedure. Have you asked your doctor about it?

[DeusXM]

Well, I'm getting one done now. She was also talking about getting me a home A1c kit too, which was kinda cool. However since I'm moving out of the area in the next three months or so, I'll be looking for a new clinic anyway.

[LauRa Lu]

Your lucky, I dont even have a Diabetes Specialist. :o :)

[statdeac]

Deus, I agree with Sparkle about the A1c. As a T1/T1.5, I have one at every visit (4 months).

Are procedures different in the UK??

[DeusXM]

Standard procedure in the UK is to get an A1c done every three months. Unfortunately the people at my clinic don't appear to be very attentative.

Actually I think I probably soured the relationship I have with my specialist now anyway. When she asked me 'so when did you last have a blood test done' I simply replied 'you tell me.'

I'm a surly little turd at times.

[LauRa Lu]

I've been diabetic for a year and a half now but only had two a1c's. Should I really be having one every three months?... blimey I may as well live in the surgery.

[BeadieJay]

I've had an A1c every 3 months since I was diagnosed (last June), but my doctor has now said that as my numbers are generally good, he's going to do it every 6 months. I'm kinda annoyed, cos I like to know how I'm doing!! Fortunately I can twist my doctor round my little finger, so might get him to do one sooner ;)

[Eri's mom]

Eri gets hers done every three months as well(and this last one was HORRID as you all know)...
I do believe that her lowest ever reading(while going through her old med records) was 6.7 :)....aiming for that one again!!!

[Linda57]

My last one was 6.8, and have just been put onto 6 monthly.

I guess I can request one if I feel my control is slipping, but she did advise me to only test once a fornight now (like thats going to happen)! :confused:

I will test however often I feel the need to.......... :mad:

Rant over...........Linda

[buzzborne]

At the moment I am having mine done every 2 months... I am lucky at the moment I have a great nurse and Dr, who correspond with eachother regulary so they both no what is going on. The clinic where I was at school was awful.. felt they didnt have a clue, and I was telling them what should be done when my A1c's started rising.

Deus.. I hope that you find a better nurse than the one that you have at the moment.
The home A1c kits? do you have to get them from your clinic.. i looked and asked in Boots about them but they didnt have a clue what I was on about....

[duck]

I test at home monthly with the Choice Home test kit. I also had a "real" test done by a lab and it basically validated that the Choice tests were accurate.

[DeusXM]

I believe the home A1c kits are really for medical personel only - she was taking about giving me an actual machine like they use in hospitals to do the blood work. I am aware that there are home A1c kits whereby you take a blood sample at home and then post it off, but this is slightly different.

For all my moaning, my nurse has certainly been brilliant but she can be rather forgetful at times. I blame the secretary though, who just keeps sending out appointments but somehow fails to appreciate that everyone going to the clinic will probably need an A1c done, and so never remembers to send me the necessary forms.

[duck]

I believe the home A1c kits are really for medical personel only - she was taking about giving me an actual machine like they use in hospitals to do the blood work. I am aware that there are home A1c kits whereby you take a blood sample at home and then post it off, but this is slightly different.

For all my moaning, my nurse has certainly been brilliant but she can be rather forgetful at times. I blame the secretary though, who just keeps sending out appointments but somehow fails to appreciate that everyone going to the clinic will probably need an A1c done, and so never remembers to send me the necessary forms.

Ugh. You'd better ask for the forms and make copies, maybe...

[Belinda]

mine is checked every 3 months at my visits. I am going to ask about the home test next visit in June.

[duck]

mine is checked every 3 months at my visits. I am going to ask about the home test next visit in June.

I recommend the Choice version of the home kit--It tells you your results in 8 minutes, you don't have to mail away. Like I said, my April 12 reading with Choice was 5.9 and my April 20 reading at the lab was 6.2. My May 11 reading with Choice was 6.3 (uh-oh, going up)...So I think it is accurate. BUT, when I go see my doc next, I'm going to do a home Choice test the SAME DAY to see how the two compare...

Okay, I'll try and stop hijacking this thread.

[KickStart101]

Hey Deus: I totally agree with the Nurse, you got them A1c's sugars below 7, you are doing good. Don't forget Normal people are not Diabetic. Diabetics are not normal people. I have tested many people in family and friends. They have been at highest, 6.7., 7.3. 9.2 9.9. 8.9, and non of these people have been positive in the Test for Diabetes, that was 3 hours after they have eaten. The longer your Metabolism takes to kick in, they just go back to normal in their own time. And yes we checked.
My jaw would drop also for you to expect for you to get a 5-6% A1c. have you ever gotten that low before Luv????? Best Of LucK. Deus!!!! :) Unless, you are on a very strick diet/exercise and maybe Insulin.

[DeusXM]

Well, the way I see it, people without diabetes have A1cs between 4 and 6 and don't get complications for a reason. I work on the principle that the very best way to stop complications from diabetes is to get an A1c equivilant to that of a non-diabetic. Obviously if you can keep your A1c lower than 7 then you reduce the risk of complications. However, I want to prevent them, full stop. I don't fancy going blind or loosing a leg 20 years down the line. I also have the extra incentive given that pretty much every male on my dad's side of the family has had heart trouble and hypertension - I've already got the hypertension and I'm only 21 and I'd rather like to see my 40th birthday. Keeping an A1c of just below 7 isn't therefore really an option if I want my plan to work.

At the moment things seem to be going pretty good too. If my bg testing is anything to go by, I'm estimating an A1c of somewhere between 6 annd 6.5, which is a step in the right direction but I'd like to take that down by another 1%. The best thing is I don't have a restrictive diet at all - I eat a normal diet like everyone else and I don't even count carbs. I'm pretty fortunate in that I can look at food and pretty much guess spot on how much insulin I'll need.

[KickStart101]

Geez, Deus, who are these fanthom normal people with b/s's between
4 and 6. I'm sure they are of the majority, but don't say all. We have tested many people who are not Diabetic and they have lower than 4.0 up to 9.0. Not everyone is the same. In fact my sugar level was lower than a guy friend of ours and that was 2 hours after supper. But he is not a Diabetic. He does have kidney stones occasionally.
OMG, Deus, I didn't know you were only 21, what am I talking about???????
YOU Lucky DAWG!!!!! :D Well, I've had Diabetes For 43 1/2 yrs. , been in a
3 day coma(my stupidity at age 18), been severely over-dosed by a new Nurse------my Spirit left my body, lost some memories----ain't dead yet. :D
my sugars are normally between 5.9 and 7.0. I have no major complications through all the years...so this time I'm saying Knocking On Wood. When it's my Time the Lord Will Take Me Same as everyone else. Meanwhile look after what you eat, exercise, drink lots of water, and make sure your meds. are right and stay as Happy as You can, keeps your sugars better. Stress and grumpyness sucks!!!!!!!!! :mad: :D

[duck]

Geez, Deus, who are these fanthom normal people with b/s's between
4 and 6. I'm sure they are of the majority, but don't say all. We have tested many people who are not Diabetic and they have lower than 4.0 up to 9.0. Not everyone is the same. In fact my sugar level was lower than a guy friend of ours and that was 2 hours after supper. But he is not a Diabetic. He does have kidney stones occasionally.
OMG, Deus, I didn't know you were only 21, what am I talking about???????
YOU Lucky DAWG!!!!! :D Well, I've had Diabetes For 43 1/2 yrs. , been in a
3 day coma(my stupidity at age 18), been severely over-dosed by a new Nurse------my Spirit left my body, lost some memories----ain't dead yet. :D
my sugars are normally between 5.9 and 7.0. I have no major complications through all the years...so this time I'm saying Knocking On Wood. When it's my Time the Lord Will Take Me Same as everyone else. Meanwhile look after what you eat, exercise, drink lots of water, and make sure your meds. are right and stay as Happy as You can, keeps your sugars better. Stress and grumpyness sucks!!!!!!!!! :mad: :D

Wow.

WOW.

Okay...You bring up a good point, where are these studies that say "normal" people have A1c's of "X-Y"? I've just always assumed from the charts we are handed at the endo's office that I am not normal since my A1c's have been in the 6's and 7's typically.

[LauRa Lu]

Well, the way I see it, people without diabetes have A1cs between 4 and 6 and don't get complications for a reason. I work on the principle that the very best way to stop complications from diabetes is to get an A1c equivilant to that of a non-diabetic. Obviously if you can keep your A1c lower than 7 then you reduce the risk of complications. However, I want to prevent them, full stop. I don't fancy going blind or loosing a leg 20 years down the line. I also have the extra incentive given that pretty much every male on my dad's side of the family has had heart trouble and hypertension - I've already got the hypertension and I'm only 21 and I'd rather like to see my 40th birthday. Keeping an A1c of just below 7 isn't therefore really an option if I want my plan to work.


:thumbsup: I totally agree with you on that one, when my doc says he's suprised by my good control I feel like saying well what exactly do you expect!

There's been alot of heart problems in my familly too, so I totally agree with you!

[KickStart101]

Well, good for you Deus, keeping your numbers between 6 - 6.5 is Great. Well, I sure hope you plan on making it way past your 40th Birthday, I'm at my 46th and I haven't done anything Special. Keeping sugars below 7 are
Good for me even though as a teen-ager I was a bit rebellious, so my sugars were way outta whack. Plus since I was dxd. at age 3, the Doc's didn't know much back then so my Mom gave us whatever Insulin she thought we needed which ended mostly in Reactions. All my wasted brain-cells. :D Oh
Well, Whatever, that's Life!!!! ;)
Mick is 40 yrs. with Diabetes, I'm 43 1/2 yrs. with Diabetes, SunniD is 44 yrs. with Diabetes and some other Lad who has popped in occasionally(he uses initials)has had Diabetes since 1940 (WOWOWOW). That's 60 some yrs. and he didn't do nothing Special either. Just keep your
sugars under control best ya can. (With Good Effort). Enjoy Life!!! :)

[DeusXM]

According to http://www.medicinenet.com/hemoglobin_a1c_test/article.htm A1cs in non-diabetics are typically 4-5.9% - so that's what I'm aiming for. Sure, people without diabetes can have higher readings, but typically those highs are less frequent than in people with diabetes and when they do happen, last a shorter time.

I think the effectiveness of lower A1c decreases pretty much once you get below 7 - for instance, dropping your A1c from say, 8.4, to 6.4 is overall going to be more beneficial than dropping from 6.4 to 4.4. However, the lower it is, the better. If I can manage that without having to compromise on my life, then I'll take that route every time.

Funny thing is I'm actually getting far better control with Insulatard and Novorapid than I ever did on Lantus and Novorapid, but that's a different story.

[Dewey]

I'm starting to think my diabetes specialist nurse isn't all she's cracked up to be. Not only has she failed to give me an A1c for the last year (I had to ask her specifically for one), she's also slightly clueless as to the results.

It's rather hard to keep a straight face when she declares that as long as the result is under 7% I'm doing fine.

You should have seen her jaw drop when I told her I was aiming for an A1c of between 5 and 6, and no higher than 6.4 at the most.
Deus, I completely understand where you're coming from here. My current endo believes my A1C should be between 6.0 to 6.5 or so (or thereabouts), and I usually run about 5.6 to 5.9. You'd think he'd be happy, but he believes I'm running too low to get those numbers.....the endo I had before was really cool about my A1C's and felt I was doing great. He even drew the blood and ran some of his own tests (eliminating the need for a nurse). :thumbsup: The first endo Never had a problem with my A1C's, so having another one with a different set of beliefs kinda confuses things a bit...I like my current endo, but not sure why he thinks I'm running so low all the time, cause I'm not. :confused:

[DeusXM]

A lot of doctors are still running on frankly outdated information that doesn't take into account home BG testing or newer insulins. Most still have this crazy belief that post-prandial bgs of 10 or 11 are 'acceptable' or unavoidable, and so therefore the only way you could have an A1c below 6 in those circumstances would be if you were indeed having loads of hypos.

[TAutry]

Deus,

I don't find your desire to maintain A1c's as near the non-diabetic level as possible odd at all. Although we are on different management plans, I strive for the same thing. My most recent was a 5.8.

Is the diabetes specialist a diabetic? If not, all she can offer is theoretical advice. It's kind of like the old joke about major and minor surgery: Minor surgery is what someone else has, but even if it is having a splinter removed on you, it is Major. When a person considers the possible complications that they can face, if they are smart, they want to avoid them at all cost.

Maybe there should be a rule that only a diabetic and be a Diabetes Specialist.

Travis

[Erin]

As a diabetic who's not a "Diabetes Specialist" I cringe when I hear people on these boards striving for A1c's lower than 6. I know from experience that when I have A1c's below 7 it is generally because I've been hitting dangerously low numbers overnight, and not even realizing it. Keep this in mind, and if you are striving for control that tight, you really should be checking your sugar levels in the middle of the night (and at different times each night, like Monday at midnight, Tuesday at 1, Wednesday at 2... you get the point)

I understand the desire to remain complication free, but diabetes is a balancing act in so many ways. You have to balance your food, exercise, insulin levels, but more importantly you have to balance your desire to avoid complications with your desire to avoid dangerous lows. Both are equally bad for your body. You also have to balance your desire to live a normal life, and the tendency to obsess over your sugar levels. It's always a balancing act, and everybody's unique take on what an appropriate balance is different.

-Erin

[DeusXM]

It can be the case that if you're having lower A1cs then you may be having dangerous lows, but it doesn't follow that it's always like that - it's perfectly possible to have a near-normal A1c without that risk.

As a side-note, if you are unable to get an A1c below 7 without having many nighttime lows then I suggest you may need to overhaul your care routine, because you need to be below 7 at the very least.

[LauRa Lu]

As a diabetic who's not a "Diabetes Specialist" I cringe when I hear people on these boards striving for A1c's lower than 6. I know from experience that when I have A1c's below 7 it is generally because I've been hitting dangerously low numbers overnight, and not even realizing it. Keep this in mind, and if you are striving for control that tight, you really should be checking your sugar levels in the middle of the night (and at different times each night, like Monday at midnight, Tuesday at 1, Wednesday at 2... you get the point)


-Erin

I dont agree with that at all. My recent a1c was 5.6 and thats just what I was expecting because i've been keeping good control day and night. It's all about finding a diet and a routine thats suits you best and luckily for now i've found the perfect way for me. I check in the morning I check at lunch, I check in the afternoon and I check with my evening meal, I also regualry check at three O'clock in the morning which is the middle of my night, so i'm basicaly checking my bg every three or four hours and once at night which is about 5 times each day.... every time i check i like to see between 4.0 and 6.7 (mmol) and at the moment i always do!... My A1c is great without have any major lows!!!! I dont have a 'strict' diet or routine and I don't feel like its stopping me from doing anything at the moment because my sugars are perfectly steady 'as they should be', so my energy levels are great. I'm also luckiy that my diet consists of all the things i love right now, mainly salads, fish, chicken, brown bread, brown rice and fruit...and i just love it!!! :D :)

[rzrbks]

I know from experience that when I have A1c's below 7 it is generally because I've been hitting dangerously low numbers overnight, and not even realizing it.

As a side-note, if you are unable to get an A1c below 7 without having many nighttime lows then I suggest you may need to overhaul your care routine, because you need to be below 7 at the very least.


Might I recommend that All of Us keep in mind that each of us is different and what might be a Good thing for One of Us MIGHT be a bad thing for somebody else.

Diabetes, like all health issues, should be taken on a case-by-case basis. What is the best thing for me---could be horrible for LauRa Lu and maybe DeusXM needs to folow a regimine somewhere in between.

Much like a good Answer to an Essay question, that is, there are many Correct answers depending on how your answer is supported.

[Harold]

I believe the home A1c kits are really for medical personel only - she was taking about giving me an actual machine like they use in hospitals to do the blood work. I am aware that there are home A1c kits whereby you take a blood sample at home and then post it off, but this is slightly different.
DeusXM check out the A1c Now (http://metrika.com/) site they have a demo and on the bottom of the page an availability outside the US link. I bought one a couple of months ago and finally used it yesterday after I returned home from the lab. It will be a week before I get the results from the lab to compare the two, but the kit said my A1c was 5.7%. Was expecting to see something around 7%, and my lab result may very well be in the high 6's. The accuracy of the kit is listed as + or - 1%A1c from the true result 95% of the time when used by untrained individuals. The Kits sell for under 20 US dollars so it maybe worthwhile when all you need from a lab is the A1c and don't have a doc lined up.

[DeusXM]

Might be worth a look but the error rate seems right off. The one I was talking about does the result there and then, right in front of you, and is supposed to have an error rate of 0.2%. Still, my result should be back from the hospital next week anyway.

[soremom]

When I had my last a1c test drawn at the hospital, I also did a home test using the Choice brand. The Choice was 5.2, the lab result was 5.3. I was surprised how close it was. Just wanted to let you know my results from comparing the two.

Kim

[Sparkle]

I have my hba1c done every 3 months or 6 months - they say not more often as red blood cells do not change more frequently than every 3 months (?).

A couple of times ago the nurse took 3 attampts to get blood and then when I got result it was 9.2mmol !!! Guess what - she's sent it off and put wrong data on and they tested for what reading was at the time I was sitting in her stupid office!! Real hba1c (had to go back) was 7.5mmol. I nearly had a heart attack when they told me 9.2 - un-neccessary stress or what?!

I find alot of them unknowledgeable and obviously it's all text book stuff to them with advice - unfortunately you have to live it to know it. You're your own dr - my specialist dr even says that.