Doubts with glycosylated hemoglobin?

A glycosylated hemoglobin of 7.3, 7.5, 7.6 is a control.
a) Acceptable but improvable.
b) Bad.
c) nefarious.
(I do not put good because the correct is supposed to be below 7 ...)
It is that for quite some time my hemoglobin levels have staggered around those figures and some people tell me that it is a very bad control (even a nephrologist hinted that in five years I would be on dialysis) (it is supposed to not yet have microalbuminuria)Or it is not so rough.I no longer know whether to get wet or take it as a failure that I have to improve ...: SSS

It is improvable, but not bad.That nephrologist has exaggerated a lot.
Put from now to improve it, but quiet: D

And how could it be improved?I was also thinking about some exercise ... I would like to know a series of guidelines or something to improve the hemo;)

Nenito how many controls are you a day ???????I think that to carry good control you have to measure glucose enough and regular exercise is fundamental: D

It is for my partner, now it is controlling much more, when you need it, and the truth that since the lantus has risen has quite good and stable levels, and that it continues to please.It would be great that the hemo will go down a little, so I also thought about the exercise, but everything possible will be done because it stays well.:)

I am in a similar situation.I can't get out of 7.3 hemoglobin.As healthy, I upload insulin when it touches.I walk and do yoga.But having breakfast the same and waking up more or less equal 89-120 one day I got perfect to food, but another day instead 220. And with the issue of Covid I literally make the same routine.Some doctors told me that it is because I am very emotional and stress or feelings can affect me.But so much ???I envy people that exemplary hemoglobins.All the best.

@marmg

Do you have a continuous glucose monitor?For example of Abbott or even better Dexcom

That would help you go down without a doubt your HBA1C.

I don't have better skills than you.Simply that the sensor warns me when I stay tall.And I avoid being high.There is no more magic or mystery.The sensor in our case is vital and helps us a lot.

Ask your endocrine to give it to you.And if you have financial possibilities, do not hesitate for a second, buy it.Well and if you can, buy dexcom, it's expensive but it works very good.But even if it is Abbott's sensor, it will help you a lot.I assure you that without a doubt your hemoglobin will go down.I have no doubt!

All the best

First what kind of diabetes do you have?What treatment?diet?exercise?They are the basic pillars

As a general rule, the ideal is to be ≤ 7, but being <8 is not so harmful either.

You would have to worry much more if they were hemoglobins ≥ 8.

jldiazdel said:
@marmg

Do you have a continuous glucose monitor?For example of Abbott or even better Dexcom

That would help you go down without a doubt your HBA1C.

I don't have better skills than you.Simply that the sensor warns me when I stay tall.And I avoid being high.There is no more magic or mystery.The sensor in our case is vital and helps us a lot.

Ask your endocrine to give it to you.And if you have financial possibilities, do not hesitate for a second, buy it.Well and if you can, buy dexcom, it's expensive but it works very good.But even if it is Abbott's sensor, it will help you a lot.I assure you that without a doubt your hemoglobin will go down.I have no doubt!

GREETING

Thank you very much for answering.If the thing is that if I use Abbot's for about 10 months and if I have managed to lower the hemoglobin of 8 that I used to be impossible.But for now it does not fall from 7.5.I suppose that when the sensor better controls hemoglobin too.All the best.

@marmg

You should get a little more.Also keep in mind that nights are very important.It is important to have few carbohydrates, avoid fats at night, dinner early and sleep well, around 110 and get up more or less in that figure.More/less.Having well will adjust the basal and the nights are vital for us.Apart from the day.Avoid fast -type bread, juices, paste etc.Eat many vegetables.That will also help you

All the best

There is no trick, once you eat "well", exercise is already a matter of putting the necessary insulin.

With the sensor you learn to know your body and how it reacts with certain foods.With some it is not necessary to replenish insulin and with others at 2 hours you have to put replacement units.

My gluco is 6.1 and my trick is to be below 140, for this I put an extra insulin if at 2 hours of eating I see that blood glucose does not fall.

This is proof and error.

jldiazdel said:
@marmg

You should get a little more.Also keep in mind that nights are very important.It is important to have few carbohydrates, avoid fats at night, dinner early and sleep well, around 110 and get up more or less in that figure.More/less.Having well will adjust the basal and the nights are vital for us.Apart from the day.Avoid fast -type bread, juices, paste etc.Eat many vegetables.That will also help you

GREETING

I take note with the bread, or pasta because that is where they give me those peaks during breakfast.The nights happens to me that I go down and I wake up at 75-90 or with hypoglycemia.I had the toujeo because the lantus gave me hypoglycemia in the middle of the night.But first avoid those peaks.Thank you very much for the tips.
All the best.

@Marmg If at night I get off is that you probably have basal, you will have to adjust to keep you flat at night and then adjust the quick insulin to what you eat.With the free you have the advantage of seeing the graphs and you can correct if necessary, do not wait for the next meal if you are high.
Lowering hydrates and especially certain types of hydrates helps a lot.Prioritize vegetables, legumes and fruits that are slower absorption (there are glycemic index lists on the Internet that tell you how fast a food is absorbed).
And to avoid the peak of meals, sometimes it has been good to make a waiting time since you put the fast until you start eating to give insulin to take time.It also helps start with vegetables, then protein and if you put hydrates at the end of the food, so you give insulin more time to take effect and slow down the absorption with the fiber of vegetables.Fiber and fat make hydrates absorb more slow.
It is a matter of knowing how food affects you and learning to control them in your specific case because each one is different.There are many things that directly do not and so I do not complicate me so much but if you want to eat them you will have to adjust the insulin and the waiting times to control that it does not upload you.

Hi @marmg,
Everything that @yessica_a tells you is what I do, with the freestyle 2 sensor (alarms are very important) + feeding + exercise is able to lower the glycosilada.It is also important the range you have of target is not the same 80-180 as 80-200.

Even so, I would look good if you are doing the basal toujeo because I had it a few months ago and it happened to me that I had brutal change from 8u to 14-15U and it happened to me that during the day I had a lot of resistance that I had to correct quicklyAnd at night I went to Hipo that threw me all night eating.
In the end my solution was to change to Levemir that during the day I have a higher dose and at night only with 3 or 4 basal units it is worth spending the night.

Try to adjust as they say in the forum and do not value change basal in case it does not fit well.

@Yessica_a @belcp thank you very much with your answers.To eat the vegetables first and the last the hydrates the truth that seems great to me, and I had never thought about it.If I see that if I want to have those precious numbers it is to sacrifice if or if certain foods (such as bread, pasta, or cereals) regarding the toujeo I have ever wondered if it is the most correct for me, but my endocrine says that it goesGood for my lifestyle.I still have the Freestyle 1, but if in 180 I have put the limit, but of course it does not warn me XD.I will try all these tips.It's nice to be able to talk to diabetic people and can give you a hand.Thanks a greeting.

@Marmg you don't have to stop eating those foods, I ate pizza and a burger from Burguer King this weekend, you just have to go little by little and with the sensor watching how the glucose goes up or down.I don't like every day but I didn't forbid anything.

What you can do perhaps, is to eat pasta, bread, ... but integral that as it has more fiber the digestion is slower and there is not so much peak but remember that from the 2h almost certainly you will have to put another bolus.I try to eat everything both integral and not because sometimes when I'm going to eat out I can't choose integral things or vegetables, so I'm practicing at home with the swinging and eyelet.

In the end, everything is trying and you will see that the sensor helps you even if you don't have the alarms.What I did was put on the mobile for example every 10 or 15 min more or less to see how it was fluctuating the glucose and so you learn and lower the glyc.

I think it is a mistake to base an insulin according to your lifestyle because I have not modified it and show the endocrine that I was not going well toujeo with the graphs of the freeview.I do not know if you do it but it is also important that you see if patterns are repeated in your meals, I analyze the graphs and for example in this way I realized that sometimes I need almost twice as fast insulin for meals because I went to200.

Much encouragement, surely you get it.

You also have to take into account the quantities.It is not the same to eat 3 pizza units Q 7, or 5 paste units Q 3. Many times to control what I do is eat moderate.But you can eat 2 days in a row and you already eat the same as others but distributed over time

@belcp thanks again.If I will gradually try seeing how he reacted with everything, because now that he does not go out because he is almost all closed (at least in my community) as at home and I can eat healthy food.But the day you can leave ... Well, I can ever enjoy a pizza without being then 280 would be very good !!!And yesterday in the ambulatory I was updated to Freestyle 2, so happy !!!We will see !!!Thanks a greeting.
PS: You listen more than some endocrine who only read hemoglobin and say next.XD
All the best.

Hi @marmg,
I am very happy that you have updated the freestyle, you will see that alarms will help you.

Just remember to put them a little before your objective value, I want to say, for example the low alarm put it in 80 so that you do not get to a hypo and with the high, if your goal is 180 put it in 160 or 170, this dependsof your fast insulin and the action time of insulin in your body.
I have it on 170 with Fiasp and as it acts very fast, I do not usually go from 180-190 approx but when I wore novorapid as the time to start making insulin effect in my case it was 20min to correct it I had to put it when I was 150-160, well you will see it with the days.

And only with respect to pizza and meals that are slow or fat you will see that you will have to put the following bolo past approx 2h (depends on each person) for the UGP.

PS: I don't know if you follow people on Instagram but there are many accounts and help everything they share :)

All the best.