[gettingby]

Well, we got the results back from my CGMS trial and bloodwork.
Total Cholesterol is down to 184 (from 209)
A1C still the same. This is the confusing part. Bear with me while I get it all out.
He said that according to my readings and the CGMS reports and graphs, my average over the 3 days was 125. Now, here's the kicker, my A1C does not coincide with these results or with my own bg readings. He thinks it may be caused by one of 2 things:
1. My meter is off. He doesn't think this is the case as my readings were practically spot on with the CGMS.
2. He doesn't think my red blood cells are repairing/regenerating (whatever it is they do) in the normal amount of time. He thinks my red blood cells are taking longer. (Does that make sense??)
I'm still confused by what all of this means but he did make some changes to my I:C ratios and added another correction factor. The additional correction factor is due to the fact that a 3u correction brought me down over 200 points at night.
He did leave my target bg where I set it (did this on my own but he didn't complain).
Any thoughts? Ideas? Suggestions?
Wanted to add something else. The CDE told me that they have been in contact with Smiths Medical to get the software and everything they need to download my pump info. Now, that's a good endo for ya.

[Eddy]

Hey Cin,

I've also wondered how long RBCs hang around for some people. e.g., even with spikes and all, Eri's A1c seemed higher than I'd have expected.

Do you mind sharing what your A1c was, and when you had your last one?

Also: Can you provide any more details on I:C and I:BG ratios?

[gettingby]

Sorry Eddy.
My A1C was 8 (not great but I expected worse).
I:C ratios he changed to 1:15 instead of the 1:12 I was on.
Correction ratios: 1:40 except that he had me add another one which is 1:60 at 10:00pm.
Make sense?
Also, I do agree with you on Eri. I thought about her when he was telling me my results today. He said that my averages do not go with the 8 A1C. I think she's got the same thing going on, too.

[Eddy]

Originally Posted by gettingby

Sorry Eddy.
My A1C was 8 (not great but I expected worse).

Odd. If you were holding 125 over the entire A1c window, I'd have expected you to come in substantially lower.

Originally Posted by gettingby

I:C ratios he changed to 1:15 instead of the 1:12 I was on.

Were you more hypo-prone after large meals?

Originally Posted by gettingby

Correction ratios: 1:40 except that he had me add another one which is 1:60 at 10:00pm.

Now I'm curious: How does your nighttime basal compare with daytime? i.e., the corrections are significantly different, so I'm wondering about the basal as well.

Originally Posted by gettingby

Make sense?

So far, so good.

Originally Posted by gettingby

Also, I do agree with you on Eri. I thought about her when he was telling me my results today. He said that my averages do not go with the 8 A1C. I think she's got the same thing going on, too.

That's sort of what I'd theorized at the time, but had no proof or expert opinion to corroborate. It's interesting to know that others have thought the same... although I'm sorry it had to come at the expense of your A1c.

Now I'm curious what cofactors might be present. Cholesterol levels? Erythropoietin levels? Hemoglobin levels?

I keep wondering if there may be some cytokine-related factor...

[lilituc]

Originally Posted by gettingby

2. He doesn't think my red blood cells are repairing/regenerating (whatever it is they do) in the normal amount of time. He thinks my red blood cells are taking longer. (Does that make sense??)

I've heard of this. Here's my totally unscientific explanation. Basically, the A1c test is measuring something that's known - we know that hemoglobin is glycolating at a certain rate, so testing the A1c gives you a weighted average of blood sugar over the past three months. You run into a problem when the glycolation is happening differently. If your red blood cells live longer than expected, they will be more glycolated, giving you an artificially higher A1c when it is tested. I have the opposite problem - my A1c is artificially low, so probably my red blood cells are not living long enough. In either case, the A1c is not actually reflecting the average bg.

[xMenace]

When one wears such a device for three days, one tends to cheat. They become very compliant. It is quite possible you've been "bad" prior to this at times your testing did not catch. Only you can say for sure whether you always test 6+ times a day and keep on top of it all.

[gettingby]

He did say that I am hypoing quite a bit after meals.
He said also that even though I do have a few highs, I'm having more lows than I should.
I have the same basal rate the entire day and night(0.65u/hr). He wants to try the carb ratios and correction factors before making any more changes. Will keep you updated on what I see happening.

[gettingby]

Originally Posted by xMenace

When one wears such a device for three days, one tends to cheat. They become very compliant. It is quite possible you've been "bad" prior to this at times your testing did not catch. Only you can say for sure whether you always test 6+ times a day and keep on top of it all.

You are right, John. I will admit that during the month of May, I did not test as often as I should. I went through a very depressive time (Dew can attest to this) and I got to a point that I just didn't care about anything.
Throughout June though, I was testing like I always do(8+ times a day) and correcting very quickly to stay on top of it.