Woo-hoo! A1C=5.5. And hypo talks with doc.

With a lot of effort, my A1C from my bloodwork last week showed an A1C
of 5.5. At least a little bit of payoff from switching to Lantus +
Humalog and tuning it for a number of months!

With an A1C that low my doc got real heavy on me about hypos and the
risk of hypos with such tight control. This mostly contradicts what
everyone here was telling me about how they maintain exceptionally
tight control with a claimed zero risk of hypos. I pushed the doc on
the subject and he whipped out a DCCT slide showing that the very
lowest A1C's studied there had markedly higher risks of hypos. I
pressed him on whether more modern insulin therapies (after all, the
DCCT was done more than a decade ago) would eliminate the risk of
hypos. He pulled out some stats showing that indeed using humalog and
lantus can result in slightly less risk of hypos than more traditional
(my doc calls them "20th century" in a denigrating sort of way! And
he's younger than me!) regimes of R+N. Some of the studies he had in
the folder in his office were the same ones referenced in the
literature that comes with humalog lantus etc. BUT he emphasized that
the reduction in hypos with the more modern insulins was not profound,
there's still a lot of risk.

We talked about target bg numbers for driving, and he said that my 140
target may be a bit aggressive, and that I should test every half hour
while driving and eat to make sure I'm always above 140.

Sounds easier for me to just avoid driving except for weekends! A bad
traffic jam here can result in a 5-mile trip taking hours (really is
quicker to walk!)

Tim.

On 12 Oct 2006 15:17:56 -0700, shoppa@trailing-edge.com
wrote:

>With a lot of effort, my A1C from my bloodwork last week showed an A1C
>of 5.5. At least a little bit of payoff from switching to Lantus +
>Humalog and tuning it for a number of months!
>
>With an A1C that low my doc got real heavy on me about hypos and the
>risk of hypos with such tight control. This mostly contradicts what
>everyone here was telling me about how they maintain exceptionally
>tight control with a claimed zero risk of hypos. I pushed the doc on
>the subject and he whipped out a DCCT slide showing that the very
>lowest A1C's studied there had markedly higher risks of hypos. I
>pressed him on whether more modern insulin therapies (after all, the
>DCCT was done more than a decade ago) would eliminate the risk of
>hypos. He pulled out some stats showing that indeed using humalog and
>lantus can result in slightly less risk of hypos than more traditional
>(my doc calls them "20th century" in a denigrating sort of way! And
>he's younger than me!) regimes of R+N. Some of the studies he had in
>the folder in his office were the same ones referenced in the
>literature that comes with humalog lantus etc. BUT he emphasized that
>the reduction in hypos with the more modern insulins was not profound,
>there's still a lot of risk.
>
>We talked about target bg numbers for driving, and he said that my 140
>target may be a bit aggressive, and that I should test every half hour
>while driving and eat to make sure I'm always above 140.
>
>Sounds easier for me to just avoid driving except for weekends! A bad
>traffic jam here can result in a 5-mile trip taking hours (really is
>quicker to walk!)
>
>Tim.

Hi Tim

Congratulations on the A1c - great news.

Studies, papers and statistics are all guides for the
doctors, and us, to learn from. But the reality is that only
one study matters to you - the study on Tim.

So, are you suffering from any more hypos, or any deeper
hypos, or any "without warning" hypos?

If not, I'd be aware of what the doc said, keep taking the
sensible precautions you've always taken - and keep doing
what you're doing. It seems to work:-)

Cheers, Alan, T2, Australia.
d&e, metformin 1000mg, ezetrol 10mg
http://loraltravel.blogspot.com/
--
Everything in Moderation - Except Laughter.

On 12 Oct 2006 15:17:56 -0700, shoppa@trailing-edge.com wrote:

>With a lot of effort, my A1C from my bloodwork last week showed an A1C
>of 5.5. At least a little bit of payoff from switching to Lantus +
>Humalog and tuning it for a number of months!
>
>With an A1C that low my doc got real heavy on me about hypos and the
>risk of hypos with such tight control. This mostly contradicts what
>everyone here was telling me about how they maintain exceptionally
>tight control with a claimed zero risk of hypos. I pushed the doc on
>the subject and he whipped out a DCCT slide showing that the very
>lowest A1C's studied there had markedly higher risks of hypos. I
>pressed him on whether more modern insulin therapies (after all, the
>DCCT was done more than a decade ago) would eliminate the risk of
>hypos. He pulled out some stats showing that indeed using humalog and
>lantus can result in slightly less risk of hypos than more traditional
>(my doc calls them "20th century" in a denigrating sort of way! And
>he's younger than me!) regimes of R+N. Some of the studies he had in
>the folder in his office were the same ones referenced in the
>literature that comes with humalog lantus etc. BUT he emphasized that
>the reduction in hypos with the more modern insulins was not profound,
>there's still a lot of risk.
>
>We talked about target bg numbers for driving, and he said that my 140
>target may be a bit aggressive, and that I should test every half hour
>while driving and eat to make sure I'm always above 140.
>
>Sounds easier for me to just avoid driving except for weekends! A bad
>traffic jam here can result in a 5-mile trip taking hours (really is
>quicker to walk!)
>
>Tim.

Congrates to you Tim! Good work!
danl/Greybeard now Remove the x for e-mail reply
08/28/2006 5.7

congrats on the excellent A1c report

i'm aiming on a 6.5 for my next A1c using Levemir
and Humalog :-)

kate
--
Join us in the Diabetic-Talk Chatroom on UnderNet
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http://www.diabetic-talk.org/freeveggies.htm
I have no medical qualifications beyond my own
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Choose your advisers carefully, because experience
can be
an expensive teacher.

<shoppa@trailing-edge.com> wrote in message
news:1160691476.284647.31010@i42g2000cwa.googlegro ups.com...
> With a lot of effort, my A1C from my bloodwork
last week showed an A1C
> of 5.5. At least a little bit of payoff from
switching to Lantus +
> Humalog and tuning it for a number of months!
>
> With an A1C that low my doc got real heavy on me
about hypos and the
> risk of hypos with such tight control. This
mostly contradicts what
> everyone here was telling me about how they
maintain exceptionally
> tight control with a claimed zero risk of hypos.
I pushed the doc on
> the subject and he whipped out a DCCT slide
showing that the very
> lowest A1C's studied there had markedly higher
risks of hypos. I
> pressed him on whether more modern insulin
therapies (after all, the
> DCCT was done more than a decade ago) would
eliminate the risk of
> hypos. He pulled out some stats showing that
indeed using humalog and
> lantus can result in slightly less risk of hypos
than more traditional
> (my doc calls them "20th century" in a
denigrating sort of way! And
> he's younger than me!) regimes of R+N. Some of
the studies he had in
> the folder in his office were the same ones
referenced in the
> literature that comes with humalog lantus etc.
BUT he emphasized that
> the reduction in hypos with the more modern
insulins was not profound,
> there's still a lot of risk.
>
> We talked about target bg numbers for driving,
and he said that my 140
> target may be a bit aggressive, and that I
should test every half hour
> while driving and eat to make sure I'm always
above 140.
>
> Sounds easier for me to just avoid driving
except for weekends! A bad
> traffic jam here can result in a 5-mile trip
taking hours (really is
> quicker to walk!)
>
> Tim.
>

shoppa@trailing-edge.com wrote in news:1160691476.284647.31010
@i42g2000cwa.googlegroups.com:

> With a lot of effort, my A1C from my bloodwork last week showed an A1C
> of 5.5. At least a little bit of payoff from switching to Lantus +
> Humalog and tuning it for a number of months!
>
> With an A1C that low my doc got real heavy on me about hypos and the
> risk of hypos with such tight control. This mostly contradicts what
> everyone here was telling me about how they maintain exceptionally
> tight control with a claimed zero risk of hypos. I pushed the doc on
> the subject and he whipped out a DCCT slide showing that the very
> lowest A1C's studied there had markedly higher risks of hypos. I
> pressed him on whether more modern insulin therapies (after all, the
> DCCT was done more than a decade ago) would eliminate the risk of
> hypos. He pulled out some stats showing that indeed using humalog and
> lantus can result in slightly less risk of hypos than more traditional
> (my doc calls them "20th century" in a denigrating sort of way! And
> he's younger than me!) regimes of R+N. Some of the studies he had in
> the folder in his office were the same ones referenced in the
> literature that comes with humalog lantus etc. BUT he emphasized that
> the reduction in hypos with the more modern insulins was not profound,
> there's still a lot of risk.
>
> We talked about target bg numbers for driving, and he said that my 140
> target may be a bit aggressive, and that I should test every half hour
> while driving and eat to make sure I'm always above 140.
>
> Sounds easier for me to just avoid driving except for weekends! A bad
> traffic jam here can result in a 5-mile trip taking hours (really is
> quicker to walk!)
>
> Tim.
>

I have pretty much the same regime. Lantus with Novolog and I have been
in the low 5.0-5.3 A1C's using it.

Just my opinion, I've found that my lowest Bg's with just Lantus use
always occurs at night. I found out that when I got my average Bg
approaching 110 on my meter (All tests at Meals), I woke up around 3am
with a really bad headache and a Bg below 80.

I ended up adjusting my Lantus down until the 3am readings were
consistantly normal or above normal. That meant I had to start using
Novolog for meals more often.

By the way, Congrads on the A1C.

Good job on the A1c, Tim!

Hypos are indeed the worst, and I can certainly understand being VERY
careful to avoid them at all costs since you are a T1. However, I would
suggest that if you have not suffered any hypos (or no more than you have
before) with what you've been doing to attain the 5.5 A1c, then keep it up.
That's a might respectable number. :-)
--
Michelle, T2
diet & exercise


<shoppa@trailing-edge.com> wrote in message
news:1160691476.284647.31010@i42g2000cwa.googlegro ups.com...
> With a lot of effort, my A1C from my bloodwork last week showed an A1C
> of 5.5. At least a little bit of payoff from switching to Lantus +
> Humalog and tuning it for a number of months!
>
> With an A1C that low my doc got real heavy on me about hypos and the
> risk of hypos with such tight control. This mostly contradicts what
> everyone here was telling me about how they maintain exceptionally
> tight control with a claimed zero risk of hypos. I pushed the doc on
> the subject and he whipped out a DCCT slide showing that the very
> lowest A1C's studied there had markedly higher risks of hypos. I
> pressed him on whether more modern insulin therapies (after all, the
> DCCT was done more than a decade ago) would eliminate the risk of
> hypos. He pulled out some stats showing that indeed using humalog and
> lantus can result in slightly less risk of hypos than more traditional
> (my doc calls them "20th century" in a denigrating sort of way! And
> he's younger than me!) regimes of R+N. Some of the studies he had in
> the folder in his office were the same ones referenced in the
> literature that comes with humalog lantus etc. BUT he emphasized that
> the reduction in hypos with the more modern insulins was not profound,
> there's still a lot of risk.
>
> We talked about target bg numbers for driving, and he said that my 140
> target may be a bit aggressive, and that I should test every half hour
> while driving and eat to make sure I'm always above 140.
>
> Sounds easier for me to just avoid driving except for weekends! A bad
> traffic jam here can result in a 5-mile trip taking hours (really is
> quicker to walk!)
>
> Tim.
>