Dismal Hba1c levels

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

I keep reading recently abysmal statistics for Type1 diabetics maintaining healthy long term HbA1c., that is only 8%. These statistics are repeated throughout the world in both the United States and Australia. I would love to know how DAFNE users feel and is it just too difficult even with dose adjusting to maintain consistent hba1c over a number of years. Are DAFNE users reflected in the 8% and if not who are they and how do they achieve these levels? The article is below:
Of the 3.8 million people who are currently living with diabetes in the UK, approximately 300,000 people are diagnosed with Type 1 Diabetes Mellitus (T1DM). As the molecular taxonomy for diabetes remains incomplete, current guidelines can only provide generic solutions as the factors that affect blood glucose are not fully understood. As a result, only 8% of this population achieve HbA1c targets with current diabetes management tools and devices.
https://pharmafield.co.uk/healthcare/women-owned-tech-company-to-revolutionise-type-1-diabetes-management/

jh0 DAFNE Graduate
The Queen Elizabeth Hospital, London
16 posts

Achieving control isn't easy. DAFNE isn't perfect either, there are huge gaps in the principles. Equally NHS staff in the UK fall short of quality standards. Like robots they apply the principles and they're the first to blame the patient if things aren't going right. Any monkey can understand the DAFNE principles.

Back to your main question summing up, one needs to practise a certain life style in order to maintain some semblance of control. Dieting plays a very significant role in this I have since found out, aside from DAFNE. Now, the west isn't particularly renowned for healthy eating habits. I think that's why you see this correlation.

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,800 posts

I personally believe to achieve in range, consistent Hb levels you need to possess a pump, libre or CGM and pro actively choose your meals wisely......

if not, then numbers can creep up.......

I personally know what I need to do to achieve good numbers, but thats what makes it hard.....the temptations and distractions of life...

jh0 DAFNE Graduate
The Queen Elizabeth Hospital, London
16 posts

Just one or two basic rules to your diet can go a long way to healthy eating.
1. Eliminate processed foods (the crap in plastic packaging). Focus on naturals, organics, home cooked meals. Don't buy "Simply" or "Essentials" brands from supermarkets - they are a false economy (not to mention very unhealthy albeit low in carbs too) Embarassed
2. Reduce the size of the meals but eat more often Cool
3. Try and avoid having dinner Very Happy
4. Eat (healthy) only when planning to do some exertion such as stepping out of the house, going to work or going out etc. The rest of the time you don't really need to eat. Shocked

sjohno DAFNE Graduate
Royal Derby Hospital
36 posts

I've been a T1 Diabetic for 40 years and became DAFNE educated in 2009. I'm on good old NovoRapid and Levemir.

Since completing DAFNE I have achieved a good level of Hba1c levels i.e. in April 2017 6.5, October 2017 6.3, Jun 2018 6.8 (this was due to being put on a TRUE Result BG meter) September 2018 6.3 (back on my Aviva after DAFNE writing a letter to my GP Practice). My next HBa1C will be in June 2019. Since 2010 I have regularly achieved between 6.3 and 6.5, my lowest was 5.9 in 2015.

I'm on good old insulin injected with a NovoPen, the Levemir is also in pen form.

Any food whether it be Simply, Essentials naturals, organics, home cooked, processed, vegan, low carb, low fat, low sugar etc etc foods will all contain some form of carbohydrate. Eating more often can result in more injections taken, not having true BG readings and not letting the insulin work in time for the pre food you've eaten.

I do try to eat healthily and attend 7 gym classes a week.

I think it all boils down to every T1 is different, how you get to learn your body and the curveballs it throws at you, how you wish to control, maintain and and look after everything. Very Happy

jh0 DAFNE Graduate
The Queen Elizabeth Hospital, London
16 posts

There is no such thing as "true BG" readings. Perhaps you mean idle BG readings during fasting and running on background insulin alone.

If you are concerned about the overlap of carbs and insulin in the system from eating regularly then let me explain. By eating regularly this is not to say that you're munching constantly (like in snacking), but rather you are eating at least every two to three hours or so and eating less. I draw a distinction between this and eating heartily every 6 or more hours (the typical traditional meal times of b/fast, lunch and dinner).

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

Hi sjohno
Your results are remarkable over such a long period of time and must have been a huge effort. Even more, it is both alarming and of utmost concern that your results are statistically better than 92% of Type1 diabetics in Britain!
You may have individualised your “normal eating” and routines over time but I wish you had been at my DAFNE course for advice that works!
Guidance for gaining long term low Hba1c results by what I deem “experts” like yourself would be of great benefit to the 92% of us out of range.

sjohno DAFNE Graduate
Royal Derby Hospital
36 posts

torana said:
Hi sjohno
Your results are remarkable over such a long period of time and must have been a huge effort. Even more, it is both alarming and of utmost concern that your results are statistically better than 92% of Type1 diabetics in Britain!
You may have individualised your “normal eating” and routines over time but I wish you had been at my DAFNE course for advice that works!
Guidance for gaining long term low Hba1c results by what I deem “experts” like yourself would be of great benefit to the 92% of us out of range.



Hi torana

The DAFNE concepts suit my body, thinking, discipline and I like to think that I've streamlined it to suit my everyday life BUT it's not been easy Laughing i.e. in November 2018 I broke my ankle, had to sit on my derriere for 6 weeks!! The battle was trying to sort out the BI and NovoRapid which took nearly 14 days to sort out and settle down Rolling Eyes

sjohno DAFNE Graduate
Royal Derby Hospital
36 posts

torana said:
Hi sjohno
Your results are remarkable over such a long period of time and must have been a huge effort. Even more, it is both alarming and of utmost concern that your results are statistically better than 92% of Type1 diabetics in Britain!
You may have individualised your “normal eating” and routines over time but I wish you had been at my DAFNE course for advice that works!
Guidance for gaining long term low Hba1c results by what I deem “experts” like yourself would be of great benefit to the 92% of us out of range.



Hi torana
Just had the recent Hba1c results back, the last one was 6.3 in Sept 2018, May 2019 is 6.5. I'm happy considering I had 6 weeks just sitting Smile .

Seanyseanuk DAFNE Graduate
Central Middlesex Hospital
10 posts

Well I did my DAFNE in October last year, and did the calorie counting etc. I had previously been having severe hypos throughout the day - and wasn't able to identify the exact causes. However in my recent Hba1c test, my mark had doubled. I was so upset, as I had been doing the calorie counting etc and adjusting dosage on the insulin. I know that during the course, despite following the guidelines in relation to insulin injections my sugars didn't stablise in the course either. So I'm really at a loss and so demotivated right now.