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New T1D

Discussion in 'Introductions' started by AliciaM, Jul 23, 2013.

  1. C6H12O6

    C6H12O6 Approved members

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    What did the endo say about your A1C being so low? Did the endo recommend the fructosamine test like Meg suggested. 5.7 is diagnostic for pre diabetes according to the American diabetes association, but CDA has not adopted this standard.

    I am not sure about how it usually works with splitting the lantus dose. If you split the original dose 50/50 or something else. You might want to post a thread about this. There are a lot of people here who are quite savvy with insulin algorithm (as general guidelines.)

    Think Like a Pancreas and Using Insulin are also supposed to be great books

    It seems like levemir is the more logical choice if you need two shots of basal a day. For one it does not burn (although a shot of 2-4 units will burn much less than a larger dose). Secondly levemir is shown to be weight neutral and there is a stronger correlation with weight gain with lantus.
     
  2. ChristineJ

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    According to the AACE (American Association of Clinical Endocrinologists), "A1C should be used to screen for, but not to diagnose, glucose abnormalities. Any value of ≥5.5% calls for further testing with an FPG test or OGTT."

    They further state "A1C represents an average of blood glucose over the lifetime of an erythrocyte, which is approximately 2-3 months. However, differences in erythrocyte turnover, cell membrane permeability to glucose, and hemoglobin glycation and deglycation, among other processes, may all lead to an altered relationship between A1C and mean glycemia in any given individual."

    Bottom line, A1C is not necessarily the best indicator of whether or not someone has diabetes. There are other members here who have had diagnoses with A1C in the 5's, and they very clearly have diabetes. :cwds:

    Christine
     
  3. C6H12O6

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    Thanks for this info. My bf has been experiencing A1Cs higher than 5.5 for a few years now, but he also has high RBCs and hematocrit. I have read a few resources that say an a1c of 5.7 can be considered diagnostic for pre diabetes, but also read that other testing is also advisable.
     
  4. AliciaM

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    Thanks Christine :) I've also read a few studies that a1c can be skewed also if other lab values are not within range. One of those is b12 and up until this month my b12 was REALLY low.

    I asked about the a1c and she said that's why she's ordering antibodies and c-peptide. I asked originally for levemir but she said they prescribe lantus usually. I will ask when I go next tho about the levemir vs lantus. I didn't know that lantus could make you gain weight...I don't need that issue right now since I'm dealing with another med that makes me weight fluctuate...

    I've had a few fasting bg's and all have been "diabetic range" but no OGTT was ever mentioned I don't think they do them much anymore but I'll ask about it.
     
  5. ChristineJ

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    OGTT's are a useful tool for diagnostic purposes, especially since fasting blood sugars are often the last to become elevated. (People often spike after meals well before their fasting blood sugar shows a change.) If you've already gotten a diagnosis, they may not feel an OGTT is necessary at this point.

    I'm glad to hear they put you on basal insulin. Hope you're feeling better! :)

    Christine
     
  6. C6H12O6

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    Most labs do ogtt's every day. It is a recommended test at a certain stage in pregnancy to rule out GDM you have to drink this orange drink that is apparently really gross and wait there while they draw blood at certain intervals.

    And my mom had one done recently bc she had some elevated fasting bgs.

    I think they put a cannula in (antecubital) so they do not have to poke you more than once bc they draw blood at more than one interval.
     

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