Tag: Glycated hemoglobin

D related disappointment!

On Saturday, I had a routine eye check at the Eye hospital. As a type 1 diabetic having regular eye tests and making sure your eyes are in tip top shape is the best way to Printavoid any complications which might occur.

Side note: I never miss an appointment I usually have my eyes checked every 6 months to a year with the optician. Then every year since I had my son I usually attend the eye hospital for a routine check-up.

So I made my way to my appointment, the doctor checked my eyes thoroughly and proceeded to tell me that I have “*small changes” in my eyes.

WHAT?? was my initial response ( in my head ) I wanted to shout it at the top of my voice, but me being me I remained calm and maintained my compose. I mean how could this even be happening? My HbA1c is good, well 7.5 is good right? I suppose I can definitely get it tighter and I’m all over my blood sugars day and night. What more could I be doing?

He then proceeded to tell me that it was nothing to worry about and that the changes were too small to be a concern.

“Oh is that supposed to make me feel better!” Well it didn’t!

For me any change is a bad one, especially when those changes are occurring in my eyes. Well this shocking news pretty much set the tone for the rest of the day. I felt disappointed in myself that this was the result I was hearing.

Side note: I’ve had small changes before just after I had my son, but they corrected themselves plus my HbA1c was at 6.4, so I’m hoping and praying that this time they will correct themselves one again.

Being able to connect and talk to others type 1 diabetics (T1D) is something I feel that has been lacking throughout my 19 years with diabetes. I can only say I know less than a handful of other T1D’s in my town, which is really sad.

My family have always been great with trying to understand my diabetes and make me feel better when I’m having a bad D moment. However I sometimes feel that they could never really fully understand it.  I love them very much and will always appreciate all the advice and the help they can give me.

Recently twitter has become a place where I can go to and vent about D related issues and non D issues too. It has helped me immensely and I’ve been able to connect with so many other T1D who are going through similar things to me. They just get it and can relate to the highs and lows that diabetes brings.

Yes I’m worried, I’d be lying if I said I wasn’t, but  I have to stay positive. I’ve had some great advice from my family and other T1D which I’m planning to implement. I know that these changes aren’t my fault and that I’ve been diabetic now for a very long time. The most important thing is that I continue to try my best and maintain as good a BGL as possible.

My Plan of action

  • Keep on checking my BGL throughout the day. I recently started using an app called mySugr (https://twitter.com/mysugr) and it has really helped me keep a closer eye on my blood glucose levels. It has some great features and I can take it with me wherever I go. Also I had the opportunity to use a CGM sensor recently and I’m hoping to get one on a more permanent basis. I believe it will help me a great deal.
  • Hopefully getting a tighter grip on my BGL will also reduce my HbA1c. I’m aiming to get it down to 7 and then after that I’ll try to get it back in the 6’s again.
  • Some great advice I got from https://twitter.com/nrycroft was when I count the carbs I eat, I should try to calculate how much insulin I need based on my experience with that carb rather than depending solely on what the text books might say. If I’m able to generate almost like a map of the portions of carbs I eat, using the trial and error method I will hopefully be able to figure out how much insulin I’ll need to take every time I eat that carb.
  • Continue to work out. Working out definitely helps my BGL.
  • Try to connect with more T1D in my town.
  • Stay positive

If anyone else has any other advice I would really appreciate it.

Thanks for stopping by Amina xx

 

*Please refer to my previous post: https://sugarhighsugarlow.com/2013/04/24/diabetic-complications/

*Small changes or background – This is the most common type of diabetic retinopathy and many people who have had diabetes for some time will have this early type. The blood vessels in the retina are only very mildly affected, they may bulge slightly (microaneurysm) and may leak blood (haemorrhages) or fluid (exudates). As long as the macula is not affected, vision is normal and you will not be aware that anything is wrong. Your retinal screening test will keep a close check on these early changes and ensure that any signs of progression to more serious stages of retinopathy are detected early.

HbA1c!!!

HbA1c WHAT'S YOURS

HbA1C! When I first became diabetic I had no idea what this even meant. I just knew that every 3 to 6 months I would have blood taken from my arm. This blood sample, which seemed like gallons of blood, would then come back to me, a few weeks later in a percentage format. The doctors and my parents seemed happy and that made me happy. “I felt a sense of achievement.”

Let’s start with a few basics!

The blood stream is made up of red blood cells these red blood cells contain haemoglobin or Hb. Red cells can live for 8 – 12 weeks before they are replaced. Hb carries oxygen in the blood from the lungs and then to the rest of the body.

“So what did it all mean?”

As I developed a better concept of science and my diabetes, I began to understand, that this HbA1c was an average measurement used to identify the level of control I had maintained over a prolonged period of time.

HbA1c occurs when haemoglobin binds (Hb) with glucose in the blood stream. The glucose and the haemoglobin molecule form a glycated haemoglobin molecule.  This is known as A1c or HbA1c.

 

Hb + Glucose = HbA1c

 

Someone without diabetes produces normal levels of glucose and therefore produces a normal level of glycated haemoglobin (HbA1c). The more glucose in the blood stream, the more haemoglobin A1c or HbA1c in the blood. Higher levels of glycated haemoglobin in diabetics would suggest poor blood glucose level control.

These high levels of HbA1c are associated with diabetic complications such as retinopathy (eye complications)  and neuropathy (nerve damage). There are many other complications, which I will touch on in my next post. HbA1c levels do not ensure that complications will develop or will not develop. However it has been proven, that having good control and a good HbA1c will reduce the chances of these complications arising.

What should your HbA1c be??

  HbA1c in mmol/mol (new unit) % HbA1c (old unit)
Non diabetic  30 mmol/mol 4.90%
Diabetic 48 mmol/mol 6.50%
Diabetic prone to hypoglycaemia 58 mmol/mol 7.50%

HbA1c testing in diabetics depends on the individual and how well they control their blood glucose levels.  A diabetic prone to hypos, but is trying their best to achieve tighter control on their diabetes, HbA1c test is carried out every 3 months.Once the individual is able to control and retain good control, HbA1c testing should then be carried out every 6 months. Since I had my son, I’ve suffered a great deal with low blood glucose levels. Currently I have my HbA1c tested every 3 months, due to my nocturnal hypoglycaemia. This is something I’m working hard to get rid of and maintain a good level of control, as I always have.

 

My current HbA1c = 7.4%  57mmol/mol

My dream HbA1c = 5.0%   31mmol/mol

Pregnancy HbA1c = 6.4%  46mmol/mol

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Amina xx

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If you have bad control, or perhaps your HbA1c wasn’t so great the last time.Its not the end of the world. Stay positive and please don’t give up. Keep on striving for a better HbA1c. Use your diabetes team and get them to help you. However you must help yourself first by, taking regular notes of your sugars and create a picture of what is happening with them. The only way to make changes and achieve a good HbA1c is to take the steps to control your blood glucose levels.