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Summary – January -March 2013

28 Mar

Whew, three months of 2013 have already flown by.

I started the year off with a new full-time job. It turned out to be more full-time than I had imagined. At the beginning, I would come home dead tired and still try to continue my usual household workload. I realised very quickly that that wouldn’t work and have since ‘outsourced’ various chores to my family members, to be specific, husband and daughter. That has been a bit of a relief but they can only do so much.

My new job has obviously lead not only to a change in how the household is managed but also to my eating habits. I used to cook low carb meals for lunch and eat leftovers for dinner, cooking a teenager-friendly meal for my daughter in the evening. Everything has gone topsy-turvy now. When I get home, I don’t have time to think about making elaborate meals. Dinner has to be quick and teenager-friendly (not spicy, exotic or meatless!). I only have time to go shopping on Saturday afternoons and when I get to the supermarket, many of the ingredients for meals I had planned to cook for the coming week would be gone! Lunch in the office means eating out at one of the few poor-quality cafes in the office neighborhood. Sigh!

To compensate for the increased carbs in my diet, I have had to inject more insulin. Somehow, the accumulated carbs in my body are leading to higher fasting blood glucose levels (110-140). I also started forgetting my basal insulin injections before going to bed cos I would be so tired, I just flopped into bed. The dismal readings really made me miserable. Sometimes I would over estimate the carbs, inject more insulin than required and end up with hypoglycemia. All in all, these sugar ups and downs are another major set-back for me.

So when I went to my docs for my quarterly blood test last week, I was expecting a huge jump in the figures putting me back into square one. I couldn’t believe it when the nursing assistant said Hb1Ac was 6.3, same as last quarter. This would mean that if I had continued my low carb diet, I would have had an even better reading! So I have managed to maintain the same reading while consuming more carbs by injecting more insulin. Not satisfactory for me but nevertheless, better than an increased Hb1Ac.

Well, I am not sure how to continue. I am now trying to cook meals during weekends to freeze and hope to find more easy low carb stuff to pack for lunch every day. I am not the ‘raw vegetable sticks’ type of person. Once thing is for sure – I’ve got to try my best to keep that Hb1Ac figure down!

But let me enjoy Easter first!!


Summary – October-December 2012

23 Dec

Well, the world did not come to an end, so I am now obliged to write this post …a summary of how I’ve coped with keeping my blood sugar in control from October to December and what I’ve been doing.

Happy to report that my Hb1Ac went down one point to 6.3. I was there before but it went up. ūüė¶ So I’m glad that it went down to this level again. ¬†I discovered something interesting last quarter. In my last summary, I reported that my Hb1Ac value was 6.4. This was measured by my endocrinologist. Four days later, I went to my GP and he did a blood test to check other stuff. I was told that my Hb1Ac was 6.8 and I got a bit of a shock. This time around, I questioned my endocrinologist about it and he said they use a different measuring method! So which is more accurate now? Well I’m going to believe the endocrinologist cos he is the diabetes specialist, and make myself happy. So beware, this may be happening to you too! Different testing methods result in different values!

Another good thing happened recently. I was having pain in my right elbow for a long time (about 2 years) and the doctors have diagnosed this as ‘golf elbow’. I got cortisone injections and went for acupuncture,physiotherapy and chiropractic adjustment but nothing helped. If anything, things got worse and then the pain started in my left arm too. After reading another of those health books, I started taking vitamin supplements – Vitamin E, Magnesium, Zink, Calcium, Vitamin D. Yikes, I’m turning into a hypochondriac! Just noticed the other day that I haven’t noticed the pain in my elbows for some time now. When I press the spot, it doesn’t hurt anymore! I’m sure it’s the vitamins but which one did the trick, I don’t know – although I think it’s the Vitamin E. So a tip if you are having problems which no one can pinpoint. In your next blood test, get your GP to check your vitamin levels. Funny, I’ve been to so many doctors and no doctor even thought about checking this.

I haven’t been experimenting much with new recipes lately cos I’m quite happy with the way things are. I’ve got my staples and work around them. What I did was to buy two low carb bread mixes from a German online shop to see if they were better than mine. I don’t want to mention which products I tried (anyway, I think if you don’t live in Germany you probably won’t come across them). They were a lot worse than my low carb sunflower bread :). The first loaf I baked was ok in texture ¬†– a little less rubbery than mine but it lost out on taste. The second one was like eating rubber. My husband refuses to eat anything so I’m slowly eating my way through the two loaves. Still contemplating dumping the rest in the bin.

To sum up my year, I can say that it has generally been a good year for me – glucose-control wise.¬†¬†Doctors are happy so I’m happy.

On this note, I’d like to end off today and wish everyone a very Merry Christmas and a Happy New Year!


A1c, HbA1c, A1C, or Hb1c

13 May

What do all of the above have in common?

Everything! They are the same thing called differently. People who have diabetes know exactly what their A1c value means for them, people without diabetes, less. However, this is an important figure that everyone in today’s society should at least find out some time or other, better sooner than later. It may tell you a lot more than you expected.

Hb1Ac (as the Germans call it) is glycated hemoglobin. Wikepedia explains it as:

a form of hemoglobin used primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic pathway by hemoglobin’s normal exposure to high plasma levels of glucose. Glycation of hemoglobin has been associated with cardiovascular disease, nephropathy and retinopathy in diabetes mellitus. Monitoring the HbA1c in diabetic patients may improve treatment.

In the normal 120-day life span of the red blood cell, glucose molecules react with hemoglobin, forming glycated hemoglobin. In individuals with poorly controlled diabetes, the quantities of these glycated hemoglobins are much higher than in healthy people.

Once a hemoglobin molecule is glycated, it remains that way. A buildup of glycated hemoglobin within the red cell therefore reflects the average level of glucose to which the cell has been exposed during its life cycle. Measuring glycated hemoglobin assesses the effectiveness of therapy by monitoring long-term serum glucose regulation. The HbA1c level is proportional to average blood glucose concentration over the previous four weeks to three months. Some researchers state that the major proportion of its value is related to a rather shorter period of two to four weeks.

So long-winded explanation aside, that means that the value of your Hb1Ac will tell you whether you have had too much glucose (=sugar) in your blood or not over a period of time.

Someone without diabetes will probably have a Hb1Ac of somewhere around 5.0 (according to the articles I’ve read, this could be anywhere between 4.0 and 5.9). ¬†Diabetics will have a higher Hb1Ac because their bodies aren’t producing enough insulin to carry the glucose out of the blood. However, with the help of medication and a sensible healthy diet or if you have borderline diabetes, just a sensible diet, one should try to strive for a good Hb1Ac reading. And what is a good reading?

Dr Richard K. Bernstein in his book, Diabetes Solution, believes that even those inflicted with diabetes are entitled to Hb1Acs of normal people. He is a Type 1 diabetic and has succeeded in bringing down his Hb1Ac to below 5 and has kept it that way. My doctor does not agree with this.

Many diabetes associations, including those in Germany, believe that those inflicted with diabetes are not able to and should not try to achieve Hb1Acs of normal people. To ensure that diabetes patients do not suffer the medical complications mentioned in the Wikipedia quote above, they advocate a Hb1Ac of under 7! At this level, you are considered quite safe from the above mentioned diseases. If you have your diabetes well under control then you would be in the 6 – 6.5 range. What about a lower value? An article on the Islets of Hope website¬†explains: ‘The risk of loss of consciousness, insulin shock, seizure, coma, and death from hypoglycemia for a person with diabetes increases significantly when an HbA1c falls below 5.0.’ ¬†Ok, so by reasoning, if you want to and can get it to above 5, you should still be ok.

But wait, things get a little more complicated. In Blood Sugar 101, Janet Ruhl cites a study which found that Hb1Ac accurately predicts heart attack risk.

Persons with hemoglobin A1c concentrations less than 5% had the lowest rates of cardiovascular disease and mortality. An increase in hemoglobin A1c of 1 percentage point was associated with a relative risk for death from any cause of 1.24 (95% CI, 1.14 to 1.34; P < 0.001) in men and with a relative risk of 1.28 (CI, 1.06 to 1.32; P < 0.001) in women. These relative risks were independent of age, body mass index, waist-to-hip ratio, systolic blood pressure, serum cholesterol concentration, cigarette smoking, and history of cardiovascular disease.

So on the one hand, a diabetic should not reduce his Hb1Ac to below 5 because it could be dangerous but for every point above 5, you are increasing your risk of cardiovascular disease. You can’t win them all can you. I think the general conclusion to draw from all this is that if you are diabetic, you’ll want to try to ensure that your Hb1Ac is as good as you can get it (but do work with your doctor to achieve this)!

I found this great chart which tells you what kind of blood glucose you are averaging for your Hb1Ac value. This is useful. Now I know in what range I am going to have to keep my blood glucoses in order to achieve a Hb1Ac close to 6. A Hb1Ac of under 6 really seems impossible for me to reach at the moment judging by my blood glucose readings and the stuff I like to eat.

HbA1c (in %) average blood sugar in mg/dl average blood sugar in mmol/l
4,7 70 3,9
5,0 80 4,4
5,3 90 5,0
5,6 100 5,6
5,9 110 6,1
6,2 120 6,7
6,5 130 7,2
6,8 140 7,8
7,4 160 8,9
8,0 180 10
8,6 200 11,1
9,2 220 12,2
9,8 240 13,3
10,4 260 14,4
11,6 300 16,7

Source: Wikipedia – German site

I also found a site with a Hb1Ac tracker. This is a free printable chart which will help you achieve your Hb1Ac goals if you want something simple to record your daily glucose readings.

If you are more into tech-stuff, Sugar Stats offers an online diabetes management program. After you’ve read through the page, click on the link titled ‘See Plans and Pricing‘ (or go straight to it here) which will take you to a page with the free download. I’ve signed on to test it out.

Please note I have nothing to do with either of the above links – just happened to come across them today.

I can only conclude – Hb1Ac is a very important small number!

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