Tag Archives: blood glucose

Summary: March 2011

31 Mar

I find that I am constantly doing something different each month. I have ups and downs in keeping control over my sugar, I try out new recipes, stumble across new information, etc, etc, etc… So I have decided to do a monthly summary. At the end of each month, I will write what happened in that month. This will also allow me to better keep track of my progress or non-progress.

Before I start for March, since this is the first summary I am doing, I want to go back about three months and start with Christmas just to document how I fared. Why Christmas? – because  that’s the time of the year when you are bombarded left and right with carbs and sugar – Christmas cake, Christmas cookies galore, Christmas Punch, heavy, comfort food to bring you through the cold winter months. The Christmas before (ie. 2009), I baked quite a bit and my Hb1AC for the first quarter of 2010 was worse than I wanted it to be. This past Christmas I didn’t bake anything. I only made some coconut candy to give away and actually didn’t receive any Christmas cookies from any friends or neighbours. Germans love their Christmas cookies and bake a lot during the Christmas season. I don’t blame them – there are so many attractive and delicious tasting morsels to be had. Of course, people bake a few different types of cookies and then give away some. We are usually the lucky recipients of Christmas cookies. Well, hurrah, we didn’t get any this time around. I did however, buy about 3 packets of Lebkuchen (gingerbread) during the whole season and ate about 3 pieces in total.

My last two Hb1AC results were stable at 6.8. My doctor says it’s good but I’m not pleased. Even though I did not pig out over Christmas, I had been having morning coffee and afternoon tea, accompanied by a croissant or something similar. The rest of the time, I was eating mostly low carb but not consistent. At the end of February, when the pediatrician said my daughter’s cholesterol was too high, I decided I had to be even more strict – not only for her sake but also for mine. It was time to revamp our eating style.

That was when I started surfing for low carb stuff again. I ordered erythritol, coconut flour, guar gum, gluten and tested some other low carb bread mixes, spreads and cookies. With my new ingredients, I started testing out new bread and cake recipes. That was how I discovered low carb cakes made with beans. You will find some of these recipes or reviews of recipes I tried in the March 2011 posts here, here and here. The bread review is here. I am still experimenting with different ingredient combinations to get my perfect bread.

My after-meal blood glucose values for March are more stable now. There were a few occasions where I had difficult-to-control peaks. These occured when we dined out and I was not able to gauge my carbohydrate intake accurately. And I guess this will continue to happen unless I eat only salads from now on in restaurants. My new low-carb cake recipes have really been marvellous. When I am hungry, I can reach out for a slice of cake without having any problems. Of course, I do take the appropriate amount of insulin but it is a very small amount.

Sports – my spunky Polar FT60 watch decided to increase the number of hours I should train per week from 7 to 8 hrs. I was already having a hard time fitting in 7 hours of gym workout into my week. When it got to 8 hrs, I kind of gave up and decided not to make myself go crazy and complete the training if I couldn’t. I’ve since got a new programme recalculated and am back to 6 hours plus – that’s more reasonable.

I did get a scare at the end of February when I had a sharp pain to the right of my navel. After all kinds of tests were done by various doctors, there was nothing to be found and I was pronounced super fit. However, after this first pain disappeared (took 3 weeks), another pain started on the left side of my waist. It wasn’t exactly a pain but more a taut feeling like your skin being stretched. Since an array of tests was carried out in early March and nothing was found, the GP then said that perhaps the pain came from the spine. Well, I don’t want to run to another doctor for more tests. Feb 19 was when this taut feeling started and it’s been 1 1/2 months now. It’s still there. I sometimes feel a slight lower back ache so I have reduced my visits to the gym to 3 a week for the time being.

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!

My new toy

8 May

A new USB storage stick?

Yes, you’re half right! It is my new blood sugar meter – Bayer Contour USB with plug and play diabetes management software! I had a check-up and I mentioned to my doctor that I would like to buy a new meter as mine was already 7 years old. I said I wanted something with a computer software programme and he recommended the Bayer Contour USB as simple and easy to use. Even gave me one!

After having tested this little piece of equipment which looks like a bigger version of a USB storage stick, I was amazed at what it can do and am thrilled to possess it.

Here are the plus points:

* no changing of batteries. There is a re-chargeable battery inside and you charge it just like your MP player. Connect it to your computer and in about two hours, it is charged.

* there is no on/off button. Once you insert a test strip into the meter, it goes on automatically. No need to shut it off either. Pull out the strip and it goes off.

* tiny amount of blood required. The test strips require about 1/5th or even less of blood compared to my last meter. The strips are also half the size of my previous strips from another company. Could be perhaps too small for those with big hands but are perfect for my small hands.

* Autolog feature lets you mark your blood sugar measurement with notations such as ‘before meal’, ‘after meal’ or ‘no mark’. There is also the possibility to make notes using pre-defined remarks such as  ‘activity’ or ‘sick’.

* there is a reminder feature which can be activated and an alarm will go off after a set time which you can define. This is great in reminding you to measure post-priandal blood sugar.

* ability to set your own target range. If your value is higher or lower than your targets, they appear in orange to get your attention.

* summary – you can get a 7-day, 14-day or 30-day summary and it tells you how many times you were over or under your target!

* easy transfer of data to your computer to analyse and study your results further using Bayer’s Glucofacts Deluxe Diabetes Management Software.

* for those who want to measure their blood in the dark (can’t imagine why anyone would do this), you can put on a little light which will show you where you should insert your strip.

Whoopee! No more writing down everything on a piece of paper! No more remembering to set the alarm clock! No more squeezing my fingers like crazy to get out enough blood.

The Bayer Contour USB has been on the market since October 2009.  The price on the package was €44.95 but I’ve seen it on the Internet being sold for €39.98 plus postage.

This is a really good piece of equipment and if you are looking for a new meter, read all about it on Bayer’s website.

Thumbs up!

 

Update 3 Jan 2011 : I was quite upbeat when I got my new Bayer Contour meter but I now find that it is not all that accurate. Sometimes I get high readings and when I measure again immediately after, there is a difference of between 20-50 points in the readings. I mentioned this to my doctor (I mentioned a 20 point difference) and he said this was normal. I don’t feel this is acceptable. My last meter, an Accucheck Comfort, also sometimes showed differences between two consecutive readings but I don’t remember them differing by more than 20 points.

Great figures!

22 Apr

Today could be the beginning of results – am I being too optimistic? I got up with a low fasting blood glucose of 86 – and that was without any basal insulin. For the last week, I have been experimenting with zero basal insulin and have gotten readings above 100 but below 120. Then I went for my biking session (one hour, interval training) – started with a BG of 100 and it was 52 after biking. Was my meter wrong? It is a bit wonky and I will be getting a new one as soon as I can. I didn’t feel too bad. So far, sports has not had any great effect on my BG. I have tested before and after BG for 1 week. Anyway, it went up to 90 again one hour later without my eating anything. Maybe my body needed some time to recognise and accept this low carb diet!

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