[clauawagner]

Hi,
I just discovered this forum since I strolled through the app-store. I am a type 1 for 34 years now. My last HBA1C was 5.2, my best ever. I managed to keep it in the 5s for several years now and I think most Type 1s could do the same once they learn more and more about their condition. I developed Type 1 when I was 16 and I am now 50, so I had plenty of trials and errors. I am on Lantus and Humalog, test at least 8 times a day and inject as many times as it is necessary, depending on the day and how many times I eat.

It is actually funny that a lot of my friends are jealous about my healthy lifestyle and the shape I am in! Easy to do for a diabetic.

I opened this threat with the intention to collect experiences from peoples that know how to manage their conditions really well. I know things are slightly different for everyone but it can't hurt to raise awareness and encourage people.

Could I suggest we share what worked for us to bring HBA1Cs down? Lots of little things can make a difference. Although I believe the biggies are doctors being overly cautious about low blood sugars and the recommended HBA1C are way to high to ensure a complication free longevity. The diabetes association is taking the same stand and I feel it is misguiding a lot of juvenile diabetics.

I learned so much a doctor will never tell you. Either they don't know or they too afraid of the big "H". Obviously we are all different, so we are just sharing our experiences and everyone is free to learn for themselves. You are the only master of your Type1. Please take whatever experience is shared here from someone else as an inspiration, not as a medical advice. We are no healthcare professionals and don't want to get in trouble sharing our experiences. Keep in mind everyone is different! but maybe not that much?

Let me start a list and maybe one of the administrators can keep a consolidated list going, or keep this threat on top?

Please take this list as individual's experiences that are in no way advice from a medical authority.

1. Fast carbs are the biggest evil. (best is to completely avoid them)
I can't tell you how many times I regretted them. Practically every time I had the likes of white bread, sushi or any type of sweets, I got in trouble.

2. High highs are followed by Low lows and vis versa
Plays in to number 1 above but the large swings are the start of all my evils. All large swings start with a bad diet!

3. Don't overmedicate the lows.
I only need 1 or 2 sips!!! of orange juice (not glasses or containers) to bring my BS from 40 to 80. Many times I have ended up with a BS of 250 after a BS of 40? By over medicating, I just encourage the next Hypo since I have to take more insulin again.

4. Low blood sugar levels not always make me feel the same.
In my experience the rate of change in BS levels has a greater impact than the BS level itself. A radical change in BS will make me feel hypoglycemic at 65, where a very slow drop over several hours from 90 to 40, I might not notice.

5. Test often (before and after meals)
The problem with BS testing is still that it is only a snapshot. I am happy to see 80 on the meter but I have no idea if I am on my way to 40 quickly or if I am stable or even heading to the sky. (A complex and low carb diet can help greatly with that)

6. Sensitivity to Insulin (elasticity)
My sensitivity to insulin is vastly different depending on the level of BS and time of day. In the morning I usually need more insulin for the same amount of carbs. Humalog for me works only instantly if my BS is below 90. The elasticity of my BS is vastly increased the higher my BS is before I eat.
For Example, the same meal and insulin intake can have very different effects: starting at 80, 1 hour 130, 2 hours 85, or starting at 130, 1 hour 210, 2 hours 170 (even with extra units taken for the 130 BS).

7. BS level before you eat.
Related to above, it is very important for me to control my BS before I eat. If I can avoid eating carbs as long as my BS is above 100, I am golden.

8. Small increments make a difference
I take my long term complication threats very seriously. Call me crazy, but if I test my BS during the day after a meal (2 hours) and it is at 105, I will take Humalog to bring it down to 75. In the long run that will make a huge difference, in particular it will allow me to have a meal later with others without experiencing unnecessary high BS levels.

9. Don't always trust the labels
Many of the carbs or sugars are misleading on packaging. For example, I couldn't figure out why my BS was rising after I had coffee in the morning until I tested it (again trial and error). I use Splenda since I like the taste of it but it has way more carbs than what it says on the packaging. One pack, I reckon, is about 3-4 grams of carbs (fairly fast acting too, additional problem is that the packages are not equally filled). Funny enough the content only weighs 1 gram?

Ok, I admit the problem would have been not as severe if I didn't drink 4 cups in the morning.

On this funny note I will close my thoughts. Hopefully the list will grow quickly and help many. Please share your experiences and comment on mine.

Thanks

Claus

[dano]

clauawagner;

Welcome to the Forum! Congratulations on your accomplishment.

I have not reached the highly sought after "5" club, but I am working on it. I agree with many things that you have said. Especially #3, "Don't overmedicate the lows." I have found that if you count carbs, for your bolus insulin injections, that you can "back calculate" the number of carbs needed to raise your blood sugar to the target range. It works well for me, I hope others try it.

[leeard]

I've been diabetic for going on 30 years this year. Believe it or not i had my 1st ever A1C test yesterday. It was 7.9

I had been taking humulin N and humulin R since i was diagnosed and that was also changed yesterday to Lantus once a day and Novalog before meals. Dr was pretty conservative with the doses so my sugars are high today, but I'm adjusting as I go so should be sorted out soon. Then maybe I'll be in that "5 club"

[gsteele11]

Thank you so much for this post. As a mom to a young type 1 I am highly concerned on long lasting effects and need any tips I can get my hands on from people living with the everyday. Look forward to reading any other posts.

[timmyr]

Hi Claus,

What a fantastic post,. It is really inspiring to hear about how well you have controlled your diabetes for such a long period and that you are in fantastic shape, congratulations!

I am 34 years old and have been type 1 just over 7 years now. Fortunately I was living a very healthy lifestyle before it hit me and so I have continued in this vein with a real focus on my diet and insulin regime, this in turn has ensured that I consistently keep my HBA1C in the 6s year on year.

For me the condition has brought me considerably more 'in tune' with my body...sounds strange but over the years I have become much more aware of the impact that certain foods or even external factors can have on my blood sugars. Alot of this comes with experience and one of the greatest tests for any diabetic is the steep learning curve of those first few years with the condition. There is so much to think about and so much to learn in the respect of your own body and how best to apply insulin in order
to keep things in check.

I agree with your comment about the big "H", however this is a personal thing as I believe that some diabetics can suffer much more than others. For me personally I sense a hypo pretty much immediately at a sugar of <4mmol and as such they cause me no issue atall other than a light head. They are an inconvenience though and it is essential to carry glucose when on the move as there is nothing worse than being without something to treat with!

There is no doubt that being a type 1 promotes a healthy lifestyle. I am fitter and in better physical shape than any of my friends of a similar age and this is testament to the fact that armed with the correct knowledge and a relatively strict regime a diabetic can live a long a healthy life.

So a few top tips from me and my own personal journey, again this is by no means advice from a medical authority...

Try a diabetic pump. I moved to mine 2 years ago and have never looked back. Don't be put off my the fact that you have something attached (I was initially), it's like wearing a watch and can be removed in seconds for day to day activities such a showering/swimming etc.. I have two little boys who constantly jump all over me and the pump and cannular are as robust as anything, no pain and a hell of a lot more convenient than multiple daily injections (mdi's). The pump is so much more effective for me at controlling my sugars as different carb ratios & doses of Bolus/Basal insulin (patterns) can be defined throughout the day or even specific to day of week. Also you can quickly adjust up/down insulin dosage as required (something that injecting does not allow for) which is great for managing anomalies in sugars i.e during illness. There is even a specific way of managing those dreaded buffet situations or fast carbs such as pizza, the pump can 'drip feed' insulin over a defined period in order to manage those post meal highs which are the biggest associated risks.
NB. I'm not suggesting that a pump is for everyone and clearly people such as Claus are testament to the fact that mdi's can produce great control, however for me personally it has been a win win in terms of my control and also the associated lifestyle change of not having to inject anymore.

Keep a strict diet at breakfast. The most important meal of the day for any diabetic and for me a key way to control morning sugars when I am generally rushing about in commute or at the office. Oats are your friend here and I eat them religiously, slow releasing carb that will not spike your sugars and keep you full for longer. If you do not like eating them throw them in a smoothie as I do, great way to start the day. Go for wholemeal everything including pasta as it really makes a difference.

Don't overmedicate the highs! Again one of the benefits of a pump is that it tells you exactly how much insulin you need when correcting for highs (taking into account the insulin already in your system too.) When I wasn't using a pump I found that I sometimes got a little over enthusiastic when correcting highs which resulted in hypos soon after. Remember to consider when you last injected when applying a correction otherwise it can end up in a swing effect as stated by Claus.

Treat your sweet tooth with sensible low carb alternatives. Dark chocolate is a great way of doing this as it contains little sugar and is actually good for you in sensible quantities. I also eat tinned fruit and muller yoghurts mixed which are a great way of gaining a sweet fix with minimal impact. If you decide to go for a 'proper' dessert it is best done during the day.I find that
I can control the post meal highs better whilst awake and active whereas through the night my sugars will climb 3-4 hours post meal and remain high for a long period through sleep which is obviously not good.

Exercise. Very obvious but I have previously gone a few weeks without and the jump in my sugars was noticeable. I vary my exercise with a mixture of resistance training and cardio to keep things interesting. Like all things with this condition consistency is key and it is equally important to understand the impact that working out can have on your sugars in order to minimise the risk of hypo's. I have a specific pattern for my pump which reduces my basal rate by 40% during gym time ensuring that I do not go low, the pump gets removed completely for swimming and running as the intensity of exercising naturally controls my sugars.

Stress and illness will throw you out. I find that at stressful times my sugars can play up with unexplained highs. The key here is to obviously not get stressed and exercise is a great relief from the day to day things that can cause it. Equally illness will have a considerable impact and my tip here would be to try to not get too down on yourself during these periods. I'm not used to seeing consistent double figures and when I do it can leave e feeling anxious which compounds the issue, remember that these are short term blips and if you are generally well controlled will not impact on your overall targets. It is equally important to address them as quickly as possible and again this is where the use of a diabetic pump can come in handy
as the Bolus rate can be adjusted at any stage to compensate.

Lot's more to share but I am intersted to hear other thoughts and views, looking forward to reading the posts!

[samandjen]

Thats just awesome. 5.2 A1C is good. My lowest is 6.4 but was just recently 7.1. My goal is just to stay in the 6 range but 5 would be nice

[klaw99]

Thanks for this.. I have had T1 for going on 9 years and have never been below 7.0.. I just had one yesterday and it was 7.2.. I strive for 5.0.. Your points 1-5 ,I know for me are also the same.. And today is free bagel day at work.. I was thinking of having one .. cause I have been so good and havent had any grains really for like 3 weeks but reading this post just stopped me!
The past month I have been trying to just eat whatever is <55 on the GI index and thats why I could bring my A1C down I know.. and a bagel is not on that list!

Thanks,
Kristen

[nocturnalracing005]

Hello all
I went from a 7.9 to a 6.3 by using cinnamon tablets. They do help sugar metabolism and also helps with cholesterol

Was diagnosed in nov of 07 with t1. I have came a long way since then. My low I start feeling round 65. It really doesn't affect me til lik the 40' s tho kinda scary. I deal the best round 120 bs

[redrevis]

5.2 is very low. Have a read of this thread where I post about seeing my consultant when I got my HbA1c of 5.9%

[ehb]

To the parents out there of newly diagnosed T1's. I've been a T1 for 27 years, am female and have 2 beautiful children, my proudest achievement as a diabetic! I grew up thinking I would not be able to have kids! Now my main task is to get my HbA1c to a more acceptable level which is hard to do when you have small children, but I'm getting there. Truth is while I was pregnant I had the best control ever, but I also had Dr's breathing down my neck nearly everyday! I think the most difficult thing about being a T1 Diabetic is accepting the importance of looking after your own health and even occasionally having to help your family realise that too!