I’m with you Nic! Even if it’s not fine it’s hardly like you’re the unmotivated type.

I’ve got some mace you can borrow for the appointment if the Dr give you too much of a hard time? You just let me know…

Thanks Aaron (I think?!!) – but I have a lovely specialist who won’t be rude about it…. it’s more the disappointment I’ll personally feel given that I’m still trying pretty hard to keep things under control. No mind, I will try to remember that I have a six month old baby and to give myself a break

I had an appointment with the clinic last week, and after ALOT of work trying to get my levels down – carb counting, testing and recording like crazy, my HBA1C had dropped from 8.6 to 7.7.

Although not exactly where I would like to be, I was still pretty happy with that progress…that was until the Dr (after talking AT me for a good 30 mins instead of WITH me) mentioned that she found that level hard to believe because of the numbers she saw in my recordings in front of her..

1) Nice way to make me feel proud – NOT,
2) I already told her the numbers I gave her were for the last 3 weeks since I had been having high readings in the morning again – not at all a representation of the last 3 months

Much appreciated…hmmm!

Good luck with you results Nic!

Only a T1 can understand just HOW MUCH work goes into getting an HbA1c down by nearly 1 percent – awesome work NB, don’t let the haters get you down!!

Nic darlin … I bet it won’t be as bad as you think it is… Infact, I guarantee it!!! I always get edgey about it too … but just remember all those nights that you don’t test and I bet you wake up on a really good number … it’s the nights that we rarely see on our test meters but they are a huge part of our HbA1c tests. So take some solace in that!

Know the feeling Nic – heading off to get tests tomorrow myself and know from my own records that my figures have been the worst that they’ve been in 6 months. I console myself with the fact that even though that might be the case they’ll still come out 3 times better than they would have a year ago and 10 times better than they would have when I was in my teens!

Totally agree Nic and that’s the whole point – you care and that’s all they can ask for.

NB – like Nic said, don’t let the haters get you down. It is SUCH hard work and getting the HbA1c down and 1% is no small feat. It’s a reduction in BG of 2.0mmol/L on average which is awesome!

Good luck Ali! I’ll let you know how I get on, we can compare notes. Thanks Ruthie and Aaron x

Not sure who you guys have as a specialist but I have Rick Cutfield and find him great, my last HbA1c was 7.4% down from 7.8% the previous 3 months and he was happy enough, they should always be pleased to see any improvement we make as managing diabetes and kids and work and household and life aint easy xxxxx

Good luck Nic. Its my turn for the Type 1 check up in a few weeks. My levels are so erratic!

Can I ask you all, if you are given an A1C target figure?

Ruthie is right Nic, I think you will be surprised and anyway, it ain’t worth the worry and the stress. Give baby a cuddle and his dad a hug and look to the next day of better control.

You’re right as always, Roy! And it’s my wedding anniversary today so I’ve more important things to celebrate.

The target depends on who you talk to. I’ve read <7 lots of places, but the IDF recommends <6.5%, which is pretty hard to achieve without a lot of work on it.

Certainly if you are planning a pregnancy they advise you to be <6.5%.

I am so with you. I hate getting my Hba1c done. It is stressful both in the lead up to the actual test and then waiting for the result. I am naughty and check mine at work (so usually every hour until I get the result (knowing that it will take at least a day so regardless of how often I look the result won’t be there!))
If ever I am given the form to do before next time, I keep leaving it and leaving it till the last possible minute in the hope that I will have had a period that I am happy with before the test. This never happens.
Don’t woryy (so easy to say , so hard to do). It is almost certainly going to be better than you are expecting. If not what does it matter. An occasionally high Hba1c is not going to lead to complications. They reckon that if you are consistently <8 that is enough to generally prevent complications.

Nic, I notice you said you do a fasting test – my doc never asks me to do that and I imagine it would be a bit tricky to do without sending my figures haywire and risking a morning hypo. How do you manage? Do others out there do fasting or non-fasting tests?

When I was pregnant they never made me do a fasting test but I’ve often been asked to do fasting tests in the past (the ‘fasting’ box is ticked on the form). I’m actually not really sure why they’d make T1s do a fasting test, because if you’ve had a hypo or a hyper you’d have to take insulin or glucose to fix it anyway…. it makes much more sense to do one on a T2, surely?

On a pump you are not so regimented as to when you eat etc so it doesn’t affect me, Ali. In fact I didn’t get my test done til nearly 9am today due to now having to feed, change a baby etc.

HbA1c is only a small part of the big picture in my opinion
(tho if its perfect then by all means take a pat on the back.)There should also be a QAL test that goes alongside an HbA1c where YOU get to rate just how much time and energy you put into getting your result on a 1-10 scale, with 10 being no effort or stress at all. So you may well have an HbA1c that’s less than the magic 6.5% but if your Quality of Life rating ( ie how bloody miserable it is trying to get that result) is under 5 then maybe its time to reassess things.
As the parent of a teenager with Type 1,( and HbA1c in double figures), I love that you guys are all striving to get such great results now and that you have come through those teenage years unscathed.

Actually just a as matter of interest, what would your QAL diabetes score be??? to what extent does achieving good control impact negatively on your life?

For me, Chris, I’d say that my quality of life relative to the amount of effort I make to get a good HbA1c is about 8/10 – so pretty good! The thing is, the most effort you put in the easier it gets and your tend to get into the swing of things. Every now and again it all turns to proverbial but you know that you are putting in the yards and I don’t tend to feel so guilty about it anymore. Your standards also change so that ‘high’ for me is now anything above say 10mmol/L whereas before…..well, never mind. My point is that once you have a feel for it, it really doesn’t impact your life as much as you think – I CERTAINLY have plenty of ‘adventures’ shall we say and diabetes CERTAINLY doesn’t stop then happening.

It also got a lot better as I got older. As a teenager by levels were atrocious!

I’m really pleased with the way my results are going at the moment (I was 9.2 in Dec, and got it down to 7.5 by March), but a few years ago I knew my results were going to be terrible, so I just didn’t get the tests done for about a year! Not the best way to manage diabetes, I was totally in denial, at least I feel like I’m on the right track now!

Wow guys – look at all the comments on HbA1c’s!!! haha

As much as we don’t like to admit it, it really does play on our minds, huh …

Chris – truth be told, all the hard work of logging it all and learning my own patterns paid off ten-fold but it took me a fair few years before I really put the effort in when I started pumping for pregnancy. Now, I know if my HbA1c is in the 6’s and I’m only having 2 or so hypos a week and maybe a handful >10mmols, I’m doing pretty bloody brilliantly and I’m at the best level that is achievable and sustainable for me so it is very very worth all the hard work!

Does anyone out there maintain HbA1c’s in the 5’s???? I’d just be interested to hear if it is doable or is that just silly because you’d be having a million hypos?!

Hi Ruthie, my last HBA1c was 5.9 but that is only because I am pregnant and am having a huge number of hypos. That has required a massive amount of effort and monitoring as you would know. My Dr also told me that it is the swings that can cause complications not just highs, e.g. your retinas dont like hypos as much as they dont like highs and the drops in between. I wouldnt really want to stay in the 5s unless you are super human and can do it with out the hypos. I have just found out I have retinopathy and have to go see a specialist, I really do think that even though I have always had an HBA1c under 8 it is because I swing and have had T1 for 20 years now.
I did see a registrar recently who told me that 5.9 isnt good enough for pregnancy and it should be 5.5. Needless to say I had muderous thoughts towards her and was somewhat feisty in my reply. She has no idea how hard it is to get a 5.9 and the blood sweat and tears it took to get there!!!!!! Needless to say my Dr confrimed she is completely unrealistic. Humpf.

Thanks Nic. I was not aware that the IDF set <6.5. <7 is what I am hearing, but I agree who you talk too has an input. Ah! I can make <6.5 no bother, but as I have said before, I am not considered fit to drive. Err! The only thing I can say about pregnancy at any level is that I have been called a girl plenty of times, but that is not enough, aye?

Hi Ali. I have only ever had a hand full of non fasting tests. The last one was in 2000 so I could qualify for a cholesterol tablet, it is always fasting.

Hi Chris. I would shiver at the thought of another test with A1C and I could see it joining the who you talk to club.

I made 5.9 for a while Ruthie, but yeah the hypos. I had lost the plot on what was a hypo and I only had one when I couldn't treat it. I can still function okay below 2 and as I have been painting my roof I had been checking the BG every two hours and I was surprised to get one at 1.8 and not notice anything.
You are so right on how it plays on us and it doesn't matter a toss how long you have had it.

I got to 5.8 by the end of my pregnancy but i wasn’t eating anything risky at all, nothing I didn’t know the carb content of etc etc – and still having hypos, it was way too restrictive. I reckon it’s doable to get late sixes and have a good life balance, but lower than that (for me personally) means diabetes takes way too much of a front seat in my life.

Roy – I too have had BGs in the high 1s and not noticed until I did a test, but once I started making my way up to 4+ with hypo treatment I’d really start to feel it.

People – my result was 6.7%…. I think they may have switched my blood for someone else’s, I honestly thought I was heading for something in the 8s. Very relieved!

Well done Nic! I got my tests done this morning only to get a letter this afternoon telling me my appointment has been postponed for 2 months so I’ll probably have to get the tests done again then! *Sigh*. Ah well, at least that gives me 8 weeks to tighten up my control a bit!

Oh, Ali, booooo! Well – you’re right, you can totally dig it in over the next couple of months and get a really good one! Let us know how you get on. Nic

Nic – I sooooo told you! You owe me a drink. I don’t think we made a bet but let’s pretend we did, just for fun.

PS It’s those untested nights when you’re busy in slumber! I swear by them because your basals can be easily perfected when you aren’t eating!

That has to be a celebration Nic.