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Tight Control

I am a 40 year old, mother of two, who has had type 1 diabetes for 19 years. My HbA1c levels are consistently below 6.5%, but the range of blood sugars is large. I would like to know what would be an acceptable standard deviation in my situation.

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I wish to know if there is a possibility to reduce the hemoglobin A1c by exercises or diet. Mine is 6.9%, and although I am doing 30 minutes walk and diet, nothing changes.

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I need to figure out how much Humalog lowers his blood sugar, and if there is a formula for determining the amount of Ultralente to give. Are there any sorts of formulas or ways of calculating these items?

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I would certainly like my son to have a little more spontaneity in his life and not live as rigidly as we have done for over a year with the two shot method. I am under the impression that you can be very flexible with the multiple shots. Since blood sugars are a little challenging to control during adolescence, what is the best approach, in your expert opinion, for keeping tighter control over blood sugars?

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My 2 year old’s endocrine doc recently told me that studies have shown that high blood sugars that occur (300’s for instance) on a regular basis (say every morning) in an otherwise fairly well-controlled (mid 100’s) diabetic child will not have the same harming effects for later in life as they would if the child were over the age of 10.

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How low would he have to go to have a rebound? Is it better to rebound? Is there any more sensitivity to giving insulin after a rebound? If he hadn’t rebounded, what would have been the likely scenario?

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I’m currently completing a residency in ophthalmology, and I have met a lot of people who have diabetes during my years of training. I think that, if you can maintain a mean blood sugar level near normal over your entire life with diabetes since the time the diagnosis was made, you will not experience any complications and you will live a normal long life.

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Since being diagnosed a month ago with Type 1 diabetes, our 13-year-old son has really been terrific watching his food intake, monitoring himself and accepting his twice a day shoots. How do we stress the importance of tight control without dashing his hopes for a cure?

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My daughter was diagnosed at 3. Her father and I have been trying to keep her in tight control to prevent future complications, but we have just been told that frequent bouts of low blood sugars could cause brain damage. What is considered frequent low blood sugars?

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My 72 year old father, diagnosed with type 2 diabetes, is currently taking several different oral medications, but his A1c is 9.5%. Yesterday they went to their doctor who suggested my father should be satisfied with keeping his blood sugar around 200 mg/dl [11.1 mmol/L], and told him he was in great shape. Is it unrealistic for my father to aim for an A1c under 7.0%?

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