HbA1c news

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torana DAFNE Graduate
Royal North Shore Hospital, St Leonards, NSW
41 posts

I thought it is worthwhile to highlight recent news about dismal HBA1C levels in both the US and Australia which also may be reflective of levels in the UK. “Despite the availability of newer insulin analogs and increased use of insulin pumps and CGMs in the U.S., the mean A1c levels for patients with type 1 diabetes have increased in the past 5 years and only 1 out 5 patients reach ADA target A1c levels," says DTT Editor-in-Chief and co-author of the article, Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver (Aurora). "Above all these data represent 30,000 patients followed at the leading centers in the U.S."
This research is fascinating in terms of the questions the data raises for DAFNE members. For me personally, having up to six needles a day and testing up to 10 times I have high expectations that my HBA1C will be 7 or below. However if these results of only 20% achieving their HBA1C of the American study above, are also reflecting DAFNE members, should we question the efficacy of our routines or on the other hand has there been any studies showing that DAFNE members achieve more consistent and lower Blood Glucose levels than their diabetic counterparts?
It is also interesting that with all the new apps available on Apple and google play there has been a lack of research or scientific analysis of how effective these apps are in reducing HBA1C. This is of great concern for diabetics putting their trust into using
apps that in reality may be ineffective or lead to problems in personal management. “https://www.mja.com.au/system/files/issues/209_10/10.5694mja18.00066.pdf”

jh0 DAFNE Graduate
The Queen Elizabeth Hospital, London
15 posts

If you're testing so much then its possible that you "over control" the levels. This isn't exactly what happens in a normal human body. No one seems to know or be interested in discussing the mapping of diabetic control with that of a normal functioning non-diabetic.

This isn't exactly rocket science. People should understand the problem and consider moulding the app and devices to their specific requirements.

torana DAFNE Graduate
Royal North Shore Hospital, St Leonards, NSW
41 posts

Thanks for your reply jh0. You’re spot on.
It’s critical to understand how to achieve success from those who gain long term stable Hba1c in order to assist and support each other. This is the survey/ study/top tips we really need when 92% of British Type1’s have hba1c outside the normative range. Something ain’t working!
Why do we struggle everyday and go to so much trouble when there is an overwhelming chance of being outside the normative range? For example, if there were a 92% failure rate of students at a school or university, teachers heads would be on the chopping block. If car drivers had only an 8% success rate in getting home safely from work no doubt road rules would be changed. Etc etc…
Why are we then not told by our doctors of the difficulties in maintaining and achieving a satisfactory long term Hba1c level and directed to the best practices to maintain a stable range over many years?
Like jh0, I will take a guess at “best practices” in stating those 8% of Type1 diabetics within range over many years may;

 Be highly structured with their mealtimes and food intake,
 limit the amount of extra insulin taken in dose adjustments over a 24 hour period,
 have regular timing of meals