Shoot Up or Put Up

You are browsing the archive for blood glucose.

Avatar of Alison

by Alison

A morsel about non stop nibbling

4 April, 2012 in Food & diet, Living with diabetes

Eating three square meals a day will give better glucose control than munching away hour after hour. I don’t think I’ve ever been told this, but deep down I know that this works for me.

It makes sense. If I eat a meal my blood sugar rises and takes a while to fall. If I snack a couple of hours after the meal my blood sugar still hasn’t returned to normal from the meal before I start eating again, so the snack hits my bloodstream when my blood sugar is raised, and just raises it even higher for longer. In brief, this is why despite meticulous carb guestimating, buffets often result in diabetic armageddon.

This isn’t life changing news. But somehow reading the piece on it in the latest issue of diaTribe complete with handy graphs by real life diabetic and diabetes educator extrordianaire Gary Scheiner made me think about it properly for the first time in years. Interesting that you can know something, but not feel like it’s really sunk in until someone else reminds you of it.

Avatar of Alison

by Alison

HbA1c: converting old to new

12 March, 2012 in Living with diabetes

Having had to resort to Dr Google to translate my latest HbA1c result into something meaningful, I thought it might be useful to publish a conversion table for new HbA1c measurements. Since October 2011 the way HbA1c results are expressed has changed – from % to mmol/mol. Mostly this has been done to mess with your head, but there is also a secondary reason about trying to standardise measures all around the world to make it easier to compare results from different laboratories and research trials.

Given the UK has been trying to shift from imperial to metric measurement since 1965 yet many people still repond to the question “how many metres is that?” with “about 3 feet” I’m thinking these changes may take a little while to sink in. So ShootUp has a handy guide.

Ye olde HbA1c measurement (%)       Shiny new IFCC HbA1c measurement (mmol/mol)
6.0                                                                           42
6.5                                                                           48
7.0                                                                           53
7.5                                                                           58
8.0                                                                           64
9.0                                                                           75

If you have a calculator to hand, you might want this handy formula to convert your own numbers:

New mmol/mol = [Old % - 2.15] x 10.929
Old % = [New mmol/mol divided by 10.929] + 2.15

So if your new number is 53, divide it by 10.929, then add 2.15 and round up a bit to discover that’s roughly 7% in old money.

And if your old number was 8% and you want to know what that means in the new world, take away 2.15 and then multiply the result by 10.929 to become enlightened.

Or you could use Diabetes UK’s handy HbA1c converter.

Avatar of Alison

by Alison

The psychology of CGM

25 July, 2011 in Kit & equipment, Living with diabetes

As much as I love, cherish and adore my continuous glucose monitor, I have to say there has never been a piece of diabetes kit so expertly designed to mess with your head. My pen, pump and meter combined have never provoked such a wide range of emotions as my CGM. In one day I can go from ecstasy to blind rage, all provoked by one tiny little machine. Here are just a few of the emotional responses it provokes:

Celebration. You wake up in the morning and the graph looks like you’re dead. You’ve been a 5 all night, one single flat line right across the screen. You celebrate sheer basal brilliance.
 
Comfort. You’re a 3. You’ve finally admitted that it might be a good idea to acknowledge the low and actually eat something. There’s something very comforting about seeing the numbers start to climb again on the screen. It happens very slowly, 3.0, 3.2, 3.3, 3.6 but they give you hope that things are moving in the right direction and that a second bottle of juice would be overkill.

Convenience. You’re just getting on with your day. A quick glance at the CGM shows that all is well with the world.

Reassurance. You’re going to sleep, on your own. You can see you’re a 6, you have no insulin on board and you’re holding flat. You know the CGM will alarm if you drop below a 4. You’re reassured and sleep well.

Irritation. There is little more irritating than having a smug little machine remind you that you’re high, when you know you’re high, you’ve been high for several hours and no amount of insulin is bringing it down. There’s no need to go on about it. That’s why I like the “alert silence” setting so much, it’s the CGM equivalent of “yes, I know, now shut up”.

Fury. The machine alarms to tell you you’re 17, when you really weren’t expecting that at all. You’re torn as to where to direct your fury. First you shout at the CGM because there’s no way in this world you can be a 17 and it is obviously making stuff up. Useless piece of junk. Then you check on your meter and that says you’re actually 16.5, so to be fair to the useless piece of junk it was pretty spot on. So now you have to admit you were wrong and split your raging fury equally between your useless pancreas, your brain which seems to have lost its ability to play at being a pancreas, and the rest of your body because no doubt there’s something going on in there that caused the 17 in the first place. Aaargh!

Never has one machine provoked so many emotional responses in so little time. It’s only because it’s delivering great results that the thing hasn’t been pitched out of the window before now.

Changes in HbA1c measurement delayed

12 May, 2011 in news

Planned changes to the way in which HbA1c measurements are reported have been postponed from June 2011 until October 2011 basically because no one understands the changes and people are understandably a tad underwhelmed and befuddled by them.

This dog was hoping one of the ShootUp authors would have gotten their heads around this by now and actually written about the planned changes to move from reporting HbA1c’s as a percentage eg 6.5% to a figure in mmols/mol eg 48 mmol/mol. Sadly, both Tim and Alison have remained resolutely silent on the issue, probably because they’re struggling to care and suppressing irritation that we’re wasting time and effort changing a system they’re comfortable with. But that’s just this dog’s opinion.

Diabetes UK have the full story: http://www.diabetes.org.uk/About_us/News_Landing_Page/Change-in-measurement-of-HbA1c-delayed/

For more info and a calculator to help convert old to new try here: http://www.diabetes.org.uk/hba1c