We all have different ideas about the level of HbA1c we should maintain. For many of us with type 2 diabetes, the ideal A1c is only a dream of days gone bye. The American Diabetes Association (ADA) says that for those of us with diabetes should stay at or slightly below 7.0 (or estimated average blood glucose readings of 154). For few, this is not even attainable.
The American Association of Clinical Endocrinologists (AACE) says that we should be at 6.5 or slightly below for our A1c (or estimated average blood glucose readings of 140). For this I say thank you. At least they are lower than the ADA, which is another reason for my not feeling good about the ADA.
For me they are both still too high. My personal goal is to have an A1c of 6.0 or less (or estimated average blood glucose levels of 125). No, this is not ideal, but if I can maintain this or less, then I will have fewer episodes of hypoglycemia and far fewer episodes of hyperglycemia.
Every person needs to determine where their comfort zone is and strive to maintain it. If it is lower, then good for you. I understand the medical reasons for some people needing to have higher A1c's, but I do take issue with the medical community for discouraging those of us that want to be lower, and are able to maintain the lower levels safely.
I do tell my endocrinologist to forget it when she says I am too low at 6.0 or lower (5.6 has been the most recent lowest). Yes, I have been above 6.5 (A1c), but lower than 7.0 and the endocrinologist was happy. I finally explained to her that her happiness was not that important to me. It was how I felt about my goals and keeping them, that is what makes me a happy person. She does not have diabetes and I told her that a higher level would only serve to increase the arrival of complications sooner and that I did not want that.
I have not have any severe hypoglycemia episodes which have kept me from taking care of the corrective actions. I have been below 50 (BG) three times and below 45 one of those. I don't get concerned about readings above 64 as I want to be in the 70's and 80's when possible, which is not that often. A fasting 80 blood glucose reading is equivalent to an A1c of 4.4 which for me is more on the unattainable side. It has been a goal of mine to be nearer to an A1c of 5.0, but I am slowly realizing that my safe area is between 5.5 and 6.0. A few years ago, I think I should have worked harder to have gotten to 5.0. However, with age, has come the realization that living on the edge is not for me.
This blog also caught my eye as it is another persons opinion of their goal and what it should be. Even if we are different, I still have to respect her views.
21 August 2010
20 August 2010
Diabetic hypoglycemia and its dangers
Hypoglycemia for those with diabetes can be serious, whether the person is type 1, on insulin or person with type 2, on insulin or oral medications as described here. Oral medications in some combinations or by themselves can cause hypoglycemia. Anyone on insulin can have hypoglycemia. See this article here and it refers to the video mentioned below. Your glucose meter needs to by used when hypoglycemia is suspected.
Until your body gets used to the lower levers of blood glucose, generally under a reading of 140 and near to 100, new people diagnosed with diabetes will often experience hypoglycemia symptoms even though they have blood glucose meter readings above 80. This is because their body misses the larger quantities of glucose. Hypoglycemia can be a problem below 70 mg/dl for many people.
Since glucose is the brain's primary fuel, your brain feels the following signs and symptoms of hypoglycemia: Headache, excessive sweating, blurred vision, dizziness, trembling, lack of coordination, depression, anxiety, mental confusion, irritability, heart palpitations, slurred speech, seizures, fatigue, and even coma and/or death. See this source for more on hypoglycemia – it has several pages.
Severe hypoglycemia can and does cause brain damage as shown in the video in this article published April 28, 2010. This is a dramatic example of the damage that can be caused by repeated episodes of hypoglycemia. What makes this so serious is the increase in risk for dementia.
Until your body gets used to the lower levers of blood glucose, generally under a reading of 140 and near to 100, new people diagnosed with diabetes will often experience hypoglycemia symptoms even though they have blood glucose meter readings above 80. This is because their body misses the larger quantities of glucose. Hypoglycemia can be a problem below 70 mg/dl for many people.
Since glucose is the brain's primary fuel, your brain feels the following signs and symptoms of hypoglycemia: Headache, excessive sweating, blurred vision, dizziness, trembling, lack of coordination, depression, anxiety, mental confusion, irritability, heart palpitations, slurred speech, seizures, fatigue, and even coma and/or death. See this source for more on hypoglycemia – it has several pages.
Severe hypoglycemia can and does cause brain damage as shown in the video in this article published April 28, 2010. This is a dramatic example of the damage that can be caused by repeated episodes of hypoglycemia. What makes this so serious is the increase in risk for dementia.
19 August 2010
The health insurance factor – what a bummer!
When you are diagnosed with diabetes, I sincerely hope that you have excellent medical insurance. But at the same time, you may become very frustrated with your medical insurance, medicare, or for that matter any regulatory agency that controls how you treat your diabetes.
It is now foreseen that insurance is becoming much more expensive under the recently passed Obama health care program. Before the year 2014 when most parts of the program will be in full force, our medical health insurance costs are expected to double and possibly more. Many are already seeing a 21 percent or greater increase in medical health insurance premiums. While there are some lesser premium increases, most of these are for less than full coverage plans.
With hefty Medicare and Medicaid planned cuts, plus cuts to the VA budget for health care, we are going to be in a world of poor health care by 2014. Many, if not most employers will opt to pay the small fine per employee for not having health insurance rather that the high costs of medical insurance premiums. Even employers already dipping into employee's pockets to cut their rising medical insurance costs will also cancel their plans.
Insurance companies are funding more studies this year and the next few years looking for anything that they can use to reduce payouts. Those of us with type 2 diabetes that are not on insulin may have testing completely taken off the table. Medicare and medicaid have already limited your testing to two times a day and I have seen insurance companies enforcing this limit as well. While some are finding temporary relief, many will be severely restricted in what diabetes supplies are insurance reimbursed in the coming years.
While insurance companies are reaping larger profits and paying their executives millions in compensation, they are striving to reduce payouts for claims where ever they can find reasons to do so. So for those of us with diabetes, do not be surprised if we are faced with ever increasing costs. This will range from prescriptions, office visits, to medical insurance premiums.
If the above does not motivate you to bring your diabetes under strict control, then expect to pay the price. You know the insurance companies will be looking to cut their expenses at your expense.
While I am not in total agreement with the following blogger, he expresses some views that are well placed and deserve some thought. There is still much that needs exposure in the Obama Health Care program. Not all the program is bad in and of itself, but much still needs to be laid out for the public to measure the good parts and discover some of the horrific parts that will stifle medical care and development of better health care.
It is now foreseen that insurance is becoming much more expensive under the recently passed Obama health care program. Before the year 2014 when most parts of the program will be in full force, our medical health insurance costs are expected to double and possibly more. Many are already seeing a 21 percent or greater increase in medical health insurance premiums. While there are some lesser premium increases, most of these are for less than full coverage plans.
With hefty Medicare and Medicaid planned cuts, plus cuts to the VA budget for health care, we are going to be in a world of poor health care by 2014. Many, if not most employers will opt to pay the small fine per employee for not having health insurance rather that the high costs of medical insurance premiums. Even employers already dipping into employee's pockets to cut their rising medical insurance costs will also cancel their plans.
Insurance companies are funding more studies this year and the next few years looking for anything that they can use to reduce payouts. Those of us with type 2 diabetes that are not on insulin may have testing completely taken off the table. Medicare and medicaid have already limited your testing to two times a day and I have seen insurance companies enforcing this limit as well. While some are finding temporary relief, many will be severely restricted in what diabetes supplies are insurance reimbursed in the coming years.
While insurance companies are reaping larger profits and paying their executives millions in compensation, they are striving to reduce payouts for claims where ever they can find reasons to do so. So for those of us with diabetes, do not be surprised if we are faced with ever increasing costs. This will range from prescriptions, office visits, to medical insurance premiums.
If the above does not motivate you to bring your diabetes under strict control, then expect to pay the price. You know the insurance companies will be looking to cut their expenses at your expense.
While I am not in total agreement with the following blogger, he expresses some views that are well placed and deserve some thought. There is still much that needs exposure in the Obama Health Care program. Not all the program is bad in and of itself, but much still needs to be laid out for the public to measure the good parts and discover some of the horrific parts that will stifle medical care and development of better health care.
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