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SoldiersWifey

A1C Question...

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SoldiersWifey

My A1C test came back as 7.3, however the doctor wants it even lower. I'm trying very hard to get it to a 6 but I have to eat!!!

This man never tells me that I'm doing a good job or ask how I'm doing. He just puts me down constantly. His bedside manners are terrible!!!

So we've decided to see a new doctor.

Can some of you please tell me your input on this and what your A1C test has been running?

Thanks.

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Katrina Stovold

I cannot empathise with you more!!! I have been in the same boat since getting my type 1 diabetes! The docs just dont understand our diabeties like we do!!! They just dont get it!!!! They dont understand that if i eat the same thing for a month every day and gave myself the exact same doses that sometimes and lots of times there are fluctuations (highs and lows) beyond our control! To get a low HBA1c results in many many lows and critisism from the docs, but if they want a friggin good hba1c then hypos are much more likely to occur!!! its friggin hard at times and doesnt help if you do your very best then have to listen to the doc tell you you can do better!!! Ofcourse you can eat, just adjust your dose accordingly! my lowest hba1c was 6.8%, hard to do, dont think I can get any lower seriously! Doc was very happy! I did switch docs and there are docs out there that are very encouraging but in a way a strict mean doc makes you try very very hard to be very very strict which results in a good hba1c but i know what you mean.......a bit of praise for all the hard work goes a long way!!! just keep trying and think of changing docs if it really bothers you.........xx

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9903card

My last A1c was 6.5, & I know what you mean, I really can't get it much lower than that. The 2 things that have helped me lower my a1c was getting the CGM with my Minimed pump and looking at the reports. I made some minor adjustments that made a big difference. The other thing that has helped is going to support group meetings through Minimed (there is a list of them online that are held in your own area). Just like you mentioned, who better to learn from and complain to than someone who knows what you're going through. I would highly reccomend them, I'm pretty sure you can go even if you don't have a Minimed pump. Good luck

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belyro

I was around 6.5 for most of my pregnancy. My endo was happy with that. I wanted it to be lower, but I couldn't get it any lower.

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stupidpancreas

My last A1C was 7.4. I went to the doctor on the 29th, and it's gone up to 7.8 during the course of the holidays. I'm not exercising like I know I need to. It's frustrating. When I told my doctor (before I switched to a new one) that I just didn't feel motivated, he replied, "What's there not to be motivated about?" Some doctors focus more on the numbers and things instead of the mental toll diabetes can have on a person. Someone who has a type I sister told me when I was first diagnosed in 2007, "Oh, it'll become second nature..." I don't think it'll ever feel "normal" to constantly think about how many carbs you're eating at every meal or always worry about the cost of meds or doctor visits, or all of the other things you have to think about when it comes to being diabetic.

I'm now on my second doctor, and I still feel like I spend 80 bucks a pop to have my A1C checked and be shoved out the door. I wish I could find an endo who has a small caseload and can really get to know me as a person not just a patient.

I guess we can hang in there together. Surround yourself with friends and family who are willing to listen to you and inform themselves about diabetes.

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Katrina Stovold

Dear stupid pancreas! not sure where you live but here in australia type 1's visit the diabeties centre, which is free (we go every 6 months) and my doc has a fee that I pay each visit (only go twice a year too) which is $50 but I get about $30 back from medicare. Surely the government must subsidise for you! It might sound silly but what motivates me is when my doc is a little unhappy with my result (hba1c), although it makes me feel really sad that I am getting in trouble it also makes me want to improve my hba1c so I dont have to listen to their lecturing, sure enough, my hba1c went down from about 8.3% to 6.8% over the course of 2 years! Now I just get praise from them! Its a great feeling to get praise and motivates me more to prove to them all that I can do it! Try telling your doc how you feel. I found that my doc lacks empathy, but the diabetes centre is just great and very helpful! Some docs just dont get it! They should try living with this disease for a day! We are the ones that deal with it day in day out!This forum is great for support.....ps: I got my hba1c low by doing alot of testing (im pregnant so I have to), I test up to 12 times/day! I totally cut out sugar, eat the same thing every day - yummy food tho, and record all my readings and monitor accordingly, I aim for readings between 4.0 and 6.5. Ofcourse they are out of range too but I JUST correct if I have to, makes a big difference! x

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JJeenn

My last A1c was 6.6, with A LOT of work. All my other A1c results are in my signature. I would really like to get below 6.5 and am willing to work even harder for that, but I'm not sure I will ever get much lower than that, at least not without a CGM.

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SoldiersWifey

Well I've been having a lot of lows in the 40's and 60's. It takes me a long time to feel good again.

Fortunately we go to a new doctor in a few weeks.

Thanks everyone. :o

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genie86333
Surely the government must subsidise for you!

 

Unfortunately, not much, Katrina. I'm not in Indiana, but here in California, if you're not pregnant, a parent with kids still living with you, or disabled, you can't get MedicAid. Some counties have other programs to help out, but not much - where I live they make you spend every cent you make over $600/month (before taxes) before they'll help you at all. I make $1700/month, so unless my medical bills FOR JUST ONE MONTH are $1100.01 or more, they won't pay anything. Even then, I still would have to pay the $1100 first & they'd only take care of the amount over $1100. Since my rent is $600 (after taxes, of course) that doesn't even leave me enough to pay my rent, much less pay for food, utilities, car payments plus gas & insurance so I can get back & forth to work, etc.

 

Now, as to the OP's question...I agree it's time to find a new doctor because of his attitude. However, he is right that your A1C is higher than you should aim for. A 7.3 equals to an average blood glucose of 182, so it IS important to remember you need to try to get it lower for your body's sake. (I know, easier said than done, right?) Of course, you need to eat...but possibly you need to change *what* you are eating or increase insulin usage. Go back to basics & find what foods cause the highest spikes & eliminate them (or cut back the amount...) Avoid the "white" foods - rice, potatoes, bread, pasta, and things with sugar or flour - if you're not already doing so. Others may have good info on adjusting insulin amounts.

 

And finally, remember we're here for you, if you have any questions or just need to vent, talk, etc.

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Katrina Stovold

Genie! some great advise for soldier's wifey! Yes, its true cut out the sugar, makes a difference! I know this might sound boring but try eating the same thing for a week...adjust your insulin accordingly, then add something new to your diet and see the effects, write all your results down in a book along with your insulin dosages, helps alot! Trial and error until you get it right, takes about a week max then fiddle around...x

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SoldiersWifey

I do watch what I eat. I count carbs and eat wheats. There's just days when it's higher than others even if I do the exact samething.

Not trying to use it as an excuse, but I tried telling the doctor that the reason it was high that time is because I've been going through a terrible divorce for the last year or so. So yes, I wasn't as careful as I should have been. But as soon as I even thought that I was pregnant I started measuring everything I ate.

Now he assumes that I always live that way, and he wouldn't even listen to what I do eat or don't. I don't even recall the man ever asking me how I was feeling!

I do feel terrible about not being so careful with my diabetes. Even though I was going through a lot, I should have stayed on track. I'm doing better though. I haven't had a high BG in awhile. I'm actually having bad lows.

Thanks.

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Katrina Stovold

Dont worry! totally normal, I have highs and lows even tho I eat the same thing........us type 1's can aim for perfection but we will never achieve it, just get close maybe! thats the nature of your disease. You do your best and thats it! Dont be so tough on yourself! You are doing fantastic! x

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Keezheekoni

Just a thought... I went to a perinatologist who also was a diabetes specialist, so he knew how to help me adjust my basal rates at any given time, after looking through my trends. Mostly I did the adjusting, but I lived quite nicely within the parameters they set... My last A1c before having Quin was 5.1%. I started the pregnancy at a 6.7%, IIRC.

 

Good luck to you!

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SoldiersWifey

Thanks to everyone. This forum has helped me a lot. I just get so angry when people that don't even know what you're going through jumps down your throat. It's good to be around other diabetics. :o

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Steal

SoldiersWifey,

I agree, I agree. The first time I met with the endo for pre-pregnancy counseling, she asked what my blood sugar readings were post food. I was so nervous and she made me all worked up and I felt like I didn't know what to say. I work really hard and she freaked me out. Apparently what I said was wrong and she said, "You shouldn't get pregnant right now." Little did we all know, but I already was and when I took my A1C it was 6.5 and I wanted to shove it in her face. I have felt really happy about my blood sugars and have been scarily intense about them and I think they are lower now, but I have never had such good numbers in my entire life. My lowest A1C before this was 7.8 and I always felt like I worked really, really hard. I have only had one doctor who was understanding and told me that I deserved a B+/A- and was proud of me and as a Type I Diabetic, our goals are different from other people and we are human. I just keep thinking of that man when I get frustrated by Doctors that study Diabetes as a science and forget that we are people. I always wish that one of these Doctors was a Diabetic! I am on a pump and have been Diabetic for 23 years. I totally get it and I have always felt like the only person I can commiserate with is my sister (also a Type I for 23 years). She always knows how to make it better and reading what you have written, really does make me feel like someone out there gets it, too. It seems like you are angry because you care and you are trying hard. You are doing your best and I hope that they recognize this.

 

Just as a fun side note: When my husband saw how upset I was, he vowed to come with me to the next appointment. I thought he was going to kill her. I had to make him promise not to yell. Luckily, the results of the A1C were positive and no one had to get killed. But, I was so scared for the woman. Maybe bring your husband or an intimidating friend. I found it helpful and almost gave me a little boost.

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MIAMI2009

Hi, everybody, i am new around here,and also in this Type 1 trouble :)

I have been diagnosed Aug 26 2009, while having A1c 12.5 and a was in very bad shape.

Long story short,after refusing for 2 months,i started insulin end Oct,and after only 1 month my A1c was 10.1.

My diet wasn't good either.

 

Now i guess,i got a lot of info,and i am behaving.Hopefully ,end Jan when i plan my next A1c it should be under 8.5.

 

anyways, i really wanted a kid,and this really set me back and scarred me.

It was ovewrwhalming anyways,the whole thing,with finding out,being sick,feeling hopeless,the whole emotional rollercoaster.

i know i haven't said much,but i could really use any advise,i really don't know where to start.

My other issue is that i live both in Miami and Europe.

 

Thank you,and i am very happy i have found this forum.

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Josselyn
Hi, everybody, i am new around here,and also in this Type 1 trouble :)

I have been diagnosed Aug 26 2009, while having A1c 12.5 and a was in very bad shape.

Long story short,after refusing for 2 months,i started insulin end Oct,and after only 1 month my A1c was 10.1.

My diet wasn't good either.

 

Now i guess,i got a lot of info,and i am behaving.Hopefully ,end Jan when i plan my next A1c it should be under 8.5.

 

anyways, i really wanted a kid,and this really set me back and scarred me.

It was ovewrwhalming anyways,the whole thing,with finding out,being sick,feeling hopeless,the whole emotional rollercoaster.

i know i haven't said much,but i could really use any advise,i really don't know where to start.

My other issue is that i live both in Miami and Europe.

 

Thank you,and i am very happy i have found this forum.

 

Hi, and welcome to the Forums, MIAMI2009.

You've found a great resource in us, and please know that you're not alone.

 

I'm a Type 2, no insulin (so far), so my input is limited...but others will be along to help as well.

 

Please tell us a bit more about what you are doing to assist in treating your diabetes (or not). What kind of foods are you eating? What type of meds/insulin are you on? If we have more to go in, we can help you better.

 

If your post were on its own thread, it would get the attention it deserves. I'll see if this can be done.

 

Meanwhile, read and learn. We're here to help one another.

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MIAMI2009

hello,thank you for the warm wellcome,Josselyn.

At the begining,my first dr diagnosed type 2,wasn't so sure,and he just told me "no carbs".

As it was actually type 1,and i had a lot of ketones,i was loosing a lot of weight.So for the first month and a half,and based on the ADS guidlines i was having 8 servings of carbs a day,3 of fruit,etc.

Which was pretty bad.

After i started reading a lot,and found out the reallity,i went to see another dr,which realised i was type 1,i had the whole lab test panel.

Actually the 3rd doc did the right tests,the beta cells,etc,and he decided i need insuline.

I started with 10U Lantus at bedtime and 3 U of Humalog each meal.

Now i am doing 12-15 U of Lantus,and 4 U sometimes in the morning of Humalog, and 3-4 for lunch and dinner based on my meals.

I pretty much behave, i was at 147 30days/average on my monitor(freestyle lite) ,but in the last 2 weeks i ate a bit more,so now my average monthly is 170-180.

But starting this week i plan to restart working out,and cutting completely the bad behavior :)

 

In the little time i have been on insulin,less than 3 months i have noticed that for 2 weeks strating the 1st day of my period the sugars are low,and the body reacts very well to the insulin,and starting with the 15-20 th day,it reacts less to the insulin.

 

The idea is i really want to get pregnant,but i don't have enough info.

I understand from what i read on the forum ,that the A1c should be around 6,5 to start trying to get pregnant.Any confirmation on this?

 

My question is for how long should this be so low,how many months before i can safely start trying?

 

Also about the insulin type.I understand that this Lantus i am on is not at all safe for pregnancy,i've seen a chart with insulin types and classes that are safe or not for pregnancies.

 

Also,for how many months should i be on this so called safe insulin before getting pregnant.

 

And i could go on with the questions forever i guess.

 

I'll try to see another doc in Europe now,anyways and redo all the pancreas and beta cells related tests .

1month and a half after i started insulin,i started Q10 100mg /day and found my BS lowering a lot.

 

I'm curious to get my lab tests done jan 25 th to see the difference.

Thank you.

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Katrina Stovold

I had a hba1c of 6.9 and my doc said I was fine to fall preggas, after 10 mths of trying I gave up and got lazy with being so strict. hba1c was then up to 7.3 then I got pregnant, first 3 months of pregnancy my hba1c was 6.8%. So far, all is fine.....so hard to get it lower but I am sure my next hba1c will be even lower as i rarely get a reading over 7.0%. I tell you, its pretty friggin hard to do, but as long as it is under 7.0 then thats fine I am told. x

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Katrina Stovold

ps: I guess should have a good hba1c for about 3 months before trying to get preggas and I was on Lantus when I found out I was pregnant, switched to protaphane when I found out I was pregnant. Many others have had healthy babies on lantus, I didnt take the risk, dont worry, I'll let you know how my bub turns out.......Im 23 weeks (5.5 mths) preg now..

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MIAMI2009

Thank you so much.

When i am thinking of it,and all this unknown stuff,it all seems terrible,and overwhelming.

And i guess sometimes the internet and too much info does not help either.I read so much about the possible...

I am so happy i found this forum,when i hear this from you,it all seems less terrible.

I am sure your babies will be great,and healthy,and their mommies,too.

Keep in touch,

Thank you

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SoldiersWifey

Sorry it's been a while since I've been online. I haven't been feeling very good.

However, I'm pleased to say that we had our first appointment with our new doctor. We loved him! He was exactly what we were looking for. Very understanding & kind. He said that my BG's were very good. He also helped me get through being scared to death from the last doctor. There's no reason why I can't have this baby normal and at a local hospital. :T

So thanks everyone for helping out. I will keep everyone informed. *hugs*

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LizLuvsMustangs

My husband and I just saw a fertility specialist because we wanted to make sure I didn't get pregnant until everything was in the best shape it could be for me (I have more than just type 1 diabetes). My HBA1C was 6.1, but the doctor said he didn't want me to get pregnant until I was at a 5.5. He said that lots of doctors are fine with anything under a 7, but he said anything that is above a non-diabetic HBA1C has potential problems. I kind of feel like he's knit-picking. I have CGM, but I also have delayed digestion, kidney stones, brittle diabetes, and hypothyroidism, so even with the CGM I have some high swings (and some scary low swings that at least I get woken up for now before I have siezures). I'm really afraid that if I try to drop below a 5.5 I'm going to have waaaaay too many bad lows. I mean, to have a 6.1 is huge for me. Before I was on my pump the brittle diabetes was killing me, literally. My HBA1Cs were always in the 8's, but that doesn't tell the whole story. Rarely did I have blood sugars in the 100's at all; they were always between 25 to 60 or above 200, so the average made my HBA1cs seem better than they were. I want to make sure if I get pregnant I'm in the absolute best shape I could be in, but wouldn't having a lot of lows from keeping my blood sugars so low all the time be dangerous while pregnant for the fetus? My problem is that one day my blood sugars will be stable, the next they're not, and nothing is different. Plus, I'll just be level for hours, then all of a sudden at random times every day I'll just plumit...fast. Sometimes (often-times actually) I'll even drop so fast that my CGM doesn't warn me until I'm almost blacking out. Unfortunately I've had T1 for almost 20-years, and I have lost my hypoglycemic awareness.

 

I dunno, maybe I should just stop seeing this fertility doc. He's not my OB/GYN, he's just trying to help me get healthy for pregnancy. He really, really seems to care, so it's hard to leave that. However, I really do think it would be dangerous for me to adjust my insulin down much more. I already just added metformin to the mix to try to decrease the amount of insulin I need to keep my blood sugars low. One thing he said makes me question his knowledge a little. I'm on pain medication for a different condition, and I have been tapering off of it with my other doctor's help before I get pregnant. He wasn't aware of this and only saw that I was on them. Before I could say anything he told me he wanted me to get off of them. However, he didn't want me to get off of them for the pregnancy like you'd normally think. He wanted me to get off of them because he said pregnancy can be really painful and especially if I already have pain it will be worse. He said that I should go off of all pain meds now so when I'm pregnant they will have a strong effect on me if I need to take them. What he doesn't realize is that the pain medications I'm on don't have a ceiling as long as they are increased in steps. It just seemed weird and made me question how much he really knows.

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Steal

LizLuvsMustangs,

 

I think that you being 6.1 is awesome and you should see someone that gives you some realistic numbers. It sounds like you are working really hard and are in good control. Doctors go by numbers for non-diabetics and our bodies are different. In an ideal world, we would never have lows and highs. This is not humanly possible and lows and highs are going to happen. Even if your basil rate and food are perfect, we still are people with emotions and all of this can and does have an effect. I think that you want to see someone that helps give you hope for possibility. I think that fetility specialists want to eliminate all of the other possible hinderances. I have found that I love seeing my regular Gyno. I have to see the perinatologists, but they are just so clinical and number driven. It is their job and they are happy with my progress, but my Gyno is like a kind Aunt that is so excited for the Joy of Life. When you begin to try, you want all the positivity you can have. It seems like you have a good amount of stuff going on in your body, but I always feel like this gives you an awareness. I think you will know when you are at your best and that is all that you can do.

 

I have found that since lowing my AIC, my recognition of low blood sugar doesn't happen until I am in the 30s/40s. I used to feel it in the 60s. I have been a diabetic for almost 24 years. So, I have just been more diligent about testing, testing, testing and have started to notice small clues that it is dropping.

 

Good luck with the pregnancy and finding someone that can be supportive of your journey.

 

-Steph

12 weeks and counting

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