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How to low Hba1c level?

I type 1 diabetes from 2008.i arrived in France in 2011.  Basically I am Indian
Since 2012 my hba1c is still 8.0.. doing sports 3 times a week. I have a very good diet. But I do not know why I can’t lower my blood sugar. It always increases in evening. I take NovoRapid  5 units  in morning, afternoon night and also before bedtime Levemir 10 units and 6 unit in the morning .. And also my weight is still 50kg. My height 1m72. I am unable to increase my weight
i need your advice to increase my weight
my doctors they not respond properly. I have an appointment with a doctor within 2 days.
Your advice helps me a lot to ask questions with doctor
Please give me advice and solutions to lower my blood sugar
Thank you
1 Responses
231441 tn?1333896366

your a1c is too high.  It is best that it is below 7 and even better if it can be below 6.5.  Consider that normal non diabetic hba1c is < 5.0.

Your insulin doses are not high enough.  You need to test your basal rates and also determine your carb to insulin ratio.  This will allow you to properly dose insulin to control your blood sugar.  It sounds like you are just taking a fixed dose of insulin without adjusting it based on what you eat.

Please go to the following U-tube site: Bernstein Diabetes University.  There are about 41 lectures on managing diabetes.

You could also find the books: Think Like a Pancreas, Using Insulin.

basically, to test basal rate (for your levemir), you take your insulin at night.  If your fasting blood sugar is higher than target (ideally is between 70 - 100), then you increase your bed time insulin by 1 - 2 units.  Observe for 3 days.  If your blood sugar is still high in the morning, then increase again.  You do this until your blood sugar is at target.  When you increase your nighttime insulin, you should probably also increase your morning dose of levemir (by say 1 unit for every 2 units increase in the night time dose).

To fine tune your day time dose you have to continue fasting. You take your morning dose of levemir and then test at say 12, and then 4 pm.  If your blood sugar continues to rise during the day (even on fasting), then you need to increase your dose.    You would do this maybe once a week until your blood sugar level during the daytime stays stable.  It is hard to say, but I have found that daytime basal insulin could be about 70 - 80% of the night time dose (maybe lower to account for exercise).

For your eating - novorapid.  You have to calculate a carb to insulin ratio.  Start with assuming that 15 g of carbs requires 1 unit of insulin.  So you eat a meal with 15 g of carb.  Measure your blood sugar 2 hours after eating.  If your blood sugar is higher than target (let's say in increase of more than 30 points from your pre-eating blood sugar) then you need to try a lower ratio.  You would then try say 1 unit of insulin for 12 g of carb.  Adjust over a period of days.  Your insulin: carb requirement could be as low as 1 u for 5 g of carbs, or it could be as high as 1 u of insulin for 50 g of carbs.  Depends on how insulin resistant you are.  but you need to determine this for yourself.

Test frequently.  Particularly you want to see the impact of exercise on your blood sugars.  It may be you have to eat a bit more or take a bit less insulin when you exercise.

the best way to gain weight is with normal blood sugars.  This is because when your blood sugar is high your blood will pee out the carbs you ate instead of converting it to body mass.

Hope this helps.

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231441 tn?1333896366
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