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sweetstar

A1C at 7.0

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sweetstar

I have been seeing an ad on TV for a diabetic med.  I am sorry I don't know which one.

It implies that any A1C 7.0 or under is good/ok.  I was doubtful until I saw my Primary Physician today.

Mine came in at 7.0 and she was pleased.  She indicated that the guidelines are changing, especially for us old folks.

So, I don't feel so bad about all of the cheating I did over the holidays.  And, if I cheat a little now and then, it is okay. I still want to get under 6. but I do believe that may be a lost cause.

Now I must combine a low carb diet with anti-acid reflux diet.  It never ends.

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don1942

I am an insulin dependent T2. My endocrinologist advised once that I should not try to get my A1c below 7 because I would be at increased risk of suffering with hypoglycemia.

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sweetstar

Don1942, that is some of what my doctor's explanation was as well.  It's interesting to me that the A1C goal has changed so much in the 20 years I have been at this.  I still think 6.0 is a good goal.  Just so much harder to maintain as I get older.

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stevenal

Doctors are scared of hypoglycemia, so they keep the standard high. I have found that with the HFLC way of eating along with Metformin, low just doesn't happen with me. I stay about 5.7. My highest was 7.2, which caused complications such as cataracts and neuropathy. My holiday cheat was a single bite of pie.

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steel
18 hours ago, sweetstar said:

Don1942, that is some of what my doctor's explanation was as well.  It's interesting to me that the A1C goal has changed so much in the 20 years I have been at this.  I still think 6.0 is a good goal.  Just so much harder to maintain as I get older.

Hi sweetstar, could you tell me which A1C goals have been set for you in the past 20 years? I was only aware of the 7, but I imagine they used to be even higher than that.

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adiantum

This is the first time I've seen  diabetes  implicated with  cataracts.

Googled causes... Beside advancing age....

  • Ultraviolet radiation from sunlight and other sources
  • Diabetes
  • Hypertension
  • Obesity
  • Smoking
  • Prolonged use of corticosteroid medications
  • statin  medicines used to reduce cholesterol
  • Previous eye injury or inflammation
  • Previous eye surgery
  • Hormone replacement therapy
  • Significant alcohol consumption
  • High myopia
  • Family history

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sweetstar

Steel, when I started on this journey, my doctor wanted my A1C in the 5's.  And I was able to do that with meds, exercise and a strict LCHF diet.

I was able to accomlish that for awhile but then as I got older it was much harder to be so disciplined.

 

Adiantum, my eye doctor has diagnosed me with cataracts in both eyes.  My right eye is slow growing and not near ready to be removed.  My left eye is fast growing and the doctor says it is definitely related to my diabetes.  I see cataract surgery in my future this year.

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Fraser

One thing I was taught early on 10 years ago, is that diabetes goals are not set to the benefit of the patient. But what is easier or more functional for the medical community.  It is much easier to presribe the standard diet of 150 carbs, because patients dont complain as much and you know it is really hard for a t2 to count carbs and actually manage diabetes, And the a PC has to make sure their patient is following plan.  I understand there are way more diabetics than competent PC or endos.
When I see any goal be it 8 or 6, to me it is a compromise of expediency. 

 

I set my goal for what hopefully will keep me healthy.   6.0 or less, less is better, diabetics should have normal BG levels too.  I have heard that before. ))) 

Edited by Fraser

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steel

@sweetstar I can only imagine the burnout at 20 years of managing t2d with diet, exercise and metformin.  Low carbing consistently gets easier but is never easy peasy. Wishing you the best with getting back on a LCHF diet. You're doing very well. An A1C below 6 is ideal and what most of us aim for, but 7 isn't awfully high either. With LCHF, it'll come down to 6 and below for sure. :)

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sweetstar

Steel, thank you so much for the encouraging words.  I keep trying so that helps in the long run.

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Type 2 Fighter

I agree that industry sets goals dangerously high. 

 

It serves their needs more than ours. 

 

I also wonder if its easier, motivation wise, for overweight Type 2 than for a normal weight type 2. 

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Fraser

I am not sure on the motivation question.  I am a normal weight T2, I would not wish to have the extra challenge of loosing  a large amount of weight.

 

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Type 2 Fighter

Vanity can be a powerful motivation, not to be under-estimated, in both men and women. 

 

Both heavy and lean wish to control BG. 

 

If one has the added motivation of dropping pounds, looking better, feeling better, getting new clothes, fitting into clothes that no longer fit, seeing weekly progress on the scale, tape measure etc, I think this is sometimes an increase in resolve. 

Edited by Type 2 Fighter

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meyery2k

I used to be strongly in the camp of the, "They want to keep us ill so they can all make money" camp.  I can't deny that is not motivation for many.

 

As I got to know my PCP better and he observed that I was serious about turning things around, we had a discussion.  He admitted that so many patients simply don't listen or don't try that he gets discouraged.  He tries to set goals that his patients can hit so they can at least put off some of the complications vs. if they did nothing.  I remember the first goal he set for me was to lose 15 pounds.  He later admitted, he doubted I would even do that based on the apathy he has observed over the years.

 

This is backed by my own experiences.  I get asked how I do it, I answer, get told that is way too hard or way too much bother, and they carry on going downhill doing nothing different while complaining about it the whole time.  Harsh, but true...

 

I can empathize with my PCP much better.  I see my own friends and family struggle with obesity, diabetes, and other conditions.  I have presented an example that they can turn things around.  Not only do they not try, they get MORE obese.  It is very frustrating to see the ones I love in this mindset.  I also know they won't change until they choose to change.

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Ela

My doctor didn't set any A1C goals for me, she just told me what is the normal oh and it's also written on the lab report btw WITH THE GOAL of 7 - it was there 8 and 10 and 15 years ago and still is, so I don't know what if something really changed... 

She also didn't tell me to lose weight - which EVERY DOCTOR BEFORE HER DID!  However she told me to avoid carbs as much as possible INCLUDING fruit that I love and back then consumed in large quantities as was RECOMMENDED by all medical profession as SOOOOO healthy!  I am grateful for her approach as it works for me.  I didn't try to lose weight but did lose 30 lbs and still keep it off.

 

Anyway, I think the recommendations are just simplified for all involved: it's easier to bunch us up as all the same diabetics and set the goal that is easier to achieve, also the medical community is afraid of lows as they could be deadly.  High BG wouldn't kill you on a spot, but will do slowly, and then doctors are not responsible.  

There IS such danger in people with Type 1 or Type 2 with certain medications. However there is very little if at all danger of harmful lows if the person doesn't take insulin or drugs that stimulate production of insulin in your own body.  In other words if you are Type 2 and control your diabetes with diet/exercise and Metformin only, I wouldn't worry about lows.  Personally I have an occasional one once in a while BUT it resolves itself pretty quickly!  No need to treat it or do anything. 

 

In any case, Sweetstar, don't feel bad, but try to do the best you can.  Maybe you need to increase your Metformin? 

Good luck and hugs!

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Kit
2 hours ago, meyery2k said:

I used to be strongly in the camp of the, "They want to keep us ill so they can all make money" camp.  I can't deny that is not motivation for many.

 

As I got to know my PCP better and he observed that I was serious about turning things around, we had a discussion.  He admitted that so many patients simply don't listen or don't try that he gets discouraged.  He tries to set goals that his patients can hit so they can at least put off some of the complications vs. if they did nothing.  I remember the first goal he set for me was to lose 15 pounds.  He later admitted, he doubted I would even do that based on the apathy he has observed over the years.

 

This is backed by my own experiences.  I get asked how I do it, I answer, get told that is way too hard or way too much bother, and they carry on going downhill doing nothing different while complaining about it the whole time.  Harsh, but true...

 

I can empathize with my PCP much better.  I see my own friends and family struggle with obesity, diabetes, and other conditions.  I have presented an example that they can turn things around.  Not only do they not try, they get MORE obese.  It is very frustrating to see the ones I love in this mindset.  I also know they won't change until they choose to change.

 

I actually used to be more along the same lines that doctors just get discouraged and similar.

But 6 months ago I got to sit there and be berated by a doctor because my A1C was under 7.  Over and over and over "there's no reason to have an A1C under 7" and when I started (let along got a chance to finish) explaining my goals all she would do was yell "who told you that" and then would not even give me the opportunity to answer the question.

 

Next bloods draw is Tuesday and needless to say, a new doctor and office.  I wonder if that previous one enjoys murdering her diabetic patients in a slow and agonizing manner.

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sweetstar

I am encouraged by so many kind words.  Your stories are truly an example of how we all deal differently with our diabetes.  Ultimately we have to do what we are comfortable with and what    is best not only for our  physical health but our mental health.

 

I have resolved to reduce carbs but it will take a while.  My breakfast and lunch choices are the easiest.  Dinner is far more difficult.  I find if eat too little carbs at dinner I will be hungry later.  And , the what do I want?  CARBS!

It is a struggle and I will succeed. It will just take some time and more exercise.  But, right now we have had snow all weekend, the schools are closed tomorrow and both the football teams I rooted for today lost.

 

As Scarlett said, "tomorrow is another day".  

Thanks for listening, I really appreciate it. 

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Hammer

As a type 2 on insulin, I will say this...any doctor that tells me that an A1C of 7.0 is good, I will tell them that they are an idiot, and I would find another doctor.  I think that the reason that doctors feel this way is because they have so many type 2 diabetic patients that don't do what is necessary to control their diabetes, so the doctor sets a higher A1C goal, which will eventually harm the patient.  An A1C of 7.0 is way too high, but the doctor doesn't care....he/she won't have any problems since a patient with an A1C of 7.0 will eventually suffer complications, many years from now.....they just won't have any complications today.

 

Look at it like this....a non-diabetic person will NEVER have an A1C of 7.0, so why do doctors think that a diabetic having an A1C of 7.0 is okay?  As a diabetic, we need to try to get our glucose levels down to the levels that a non-diabetic person has, otherwise, we are damaging our bodies.  I use insulin to control my diabetes, and because of that, I can eat foods that are high in carbs, then take the appropriate amount of insulin, and my glucose levels won't spike too high.  I know that doing that is not a good thing to do, because eating high carb foods, then taking the appropriate amount of insulin, can lead to severe lows, and can cause me to gain weight, so I usually avoid high carb foods.

 

My last A1C, which was done in December, was 5.8, and that was up from my last A1C of 5.7.  I know that's not much of an increase, but considering that I had a craving for things that I don't usually eat (pizza, broken pretzel pieces, subs, etc.), using insulin, I was able to eat those foods without having huge spikes in my glucose readings.  Had I not had insulin, I would have spiked to over 400....not a place that I want to be, but to a lot of doctors, those 400 readings might have resulted in an A1C result of 7.0.  It takes a lot of high BG results to get an A1C reading of 7.0.  Is that something that we diabetics want to do?  NO!!

 

If you can get your A1C down to a 6.0 or less, then an A1C of 6.0 has no higher mortality rate than a diabetic who has an A1C of 5.0.  Knowing this, we should all try to strive for an A1C of 6.0 or less....anything higher than that can cause complications.

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dowling gram

I watched the Nature of Things show a while back. It was on the brain and eating and it confirmed what I have seen here so often. They took a people who had a poor diet and fed them a good diet for a month. After that their tastes changed and they preferred the good diet. What they did was reprogram their brain. The brain did not forget the old diet and occasionally they remembered the pleasures of it but if ignored those thoughts soon disappeared. It seems the brain has more to do with how we eat than food or will power although it does take well power to ignore those sudden urges.

 

When I was first diagnosed I determined to change my lifestyle so I went with a diet that keeps my A1C under 6. I have never had a low and never got flack from a doctor for keeping it there.

 

 

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don1942

It is my opinion that some insulin dependent t2s have to work a delicate balancing act taking into account insulin resistance, carb intake, insulin infusion, and exercise. If you don’t do the same of each everyday, hypos and spikes can be excessive. I know if I miscalculate  my carb intake by even a little  I can easily go high or low, with highs taking sometimes hours to get back under control. Also, if I delay a Bolus even by 15 minutes. I can go high.

 

That being said, I believe some T2s have a hard time keeping their A1cs under 7 without experiencing excessive hypos and, accordingly, their doc knows their patient well enough to advise them to aim for 7 and should not be considered idiots for doing so. Once the patient has succeeded in lowering their A1c to 7, the next step is to slowly work on getting it lower.

 

 

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