Recent Posts - DAFNE Online

Aug 11, 2014

Dyonisus 9 posts

Topic: General Discussion / Disposing needles

Tell that to the newvy GP fresh out of UNi, who goes by the book. Is not about saving money or pestering my GP for a freebie on prescription, is about creating unnecessary waste.
Is cheaper to burn a paper bag than a plastic container.
Anyway, for the price given at the surgery, I can get a bin with 3 times the capacity for a fraction in Amazon( free delivery).
Another question springs to mind: how many litres of waste a surgery or Council cope with?
I can carry 5 to 10 litres to my local surgery, will they accept it?
If they can not be bothered to collect, neither can I.
Out of sight, out of mind!

Kind Regards

D.

Aug 11, 2014

Marje 3 posts

Topic: General Discussion / Calculating QA with Carb/Sugar Content

Hi there. Many thanks. That's what I thought but something was niggling in the back of my mind that you have to take sugar content into account on certain foods. Smile

Aug 11, 2014

Laramango 1 post

Topic: General Discussion / no food but blood sugar still increase

my sugars were 8.8 when i woke this morning and as usual I did my levemir, but didn't feel like eating so no novorapid...then a few hours later my sugars were 12.0, why does this happen?sometimes its way worse, for example can jump into 20s! does this mean i should increase my levemir?

Aug 11, 2014

geordiesgirl 16 posts

Topic: General Discussion / Calculating QA with Carb/Sugar Content

You go by the carbohydrate on the label. However, baked beans you go by the sugar content and recently i was advised not to count sweetcorn because of the GI. have a chat with your diabetes dietition.

Aug 11, 2014

geordiesgirl 16 posts

Topic: General Discussion / Disposing needles

You can get plastic sharp containers on prescription. Once full return it to the surgery and they will dispose of it. Some areas if you phone the council they will collect your full containers from your home and replace it with an empty one.

Aug 11, 2014

Dyonisus 9 posts

Topic: General Discussion / Disposing needles

Once upon a time, a man finished a Dafne course. He was told he could get a box at his local surgery to incinerate the sharps on prescription. Unfortunately, his GP was away on holiday. She was replaced by a fellow colleague.
The letter from the Dafne educators, requesting it just arrived in time, at the surgery, when this man was speaking to the GP.
He was told he box was not available under prescription and would have to pay for it.
The man decided not to pay Â£ 7.00 and search the internet for cheaper alternatives.
He found different sizes and prices to match, but could not make he's mind up.
On a trip to his local hospital, he asked if He could dispose the content of sharps in the paper bag.
He was told by a nurse that she could not handle in the bag because she could get injured.
The man replied how could this be, as He was grabbing the bag.
To what the nurse replied: yes, but is just you.
The man walked away and decided to chuck the paper bag and it's content in the nearest rubbish bin.
As He done so, He thought is conscience was clear. He could not believe that inside the hospital no one would accept that bag unless it was in Â£ 7.00 box.
The moral of the story here is, in order to dispose rubbish you have to create more rubbish.

Good night and good luck!

Dyonisus

Aug 11, 2014

Marje 3 posts

Topic: General Discussion / Calculating QA with Carb/Sugar Content

Would be interested to know on how you calculate the number of QA units of insulin when a label states both the Carbohydrate and sugar content.

Aug 11, 2014

Muna A H 34 posts

Topic: General Discussion / Lantus - Splitting

Hi,

I switched from Lantus to Levemir few years ago, but as far as I remember my Lantus was one dose a day before bed as it worked for 24 hours. I have am/ pm doses of Levemir now.

Cheers

Aug 10, 2014

Warwick 423 posts

Topic: General Discussion / Lantus - Splitting

Oh, and when you split, what you do is drop a unit at night, and add a unit in the morning each day until you get your 50/50 split. Don't just drop half your evening basal at night and add it in the morning or you will have wicked highs. If you are on 18 units, then it will take 9 days to get to the split, and a couple of more days after than before things stabilise so don't panic too much if you find your BGs are a little out of control over that period.

You may also find after you have split that 18 per day is not enough (because I assume that you are running out of basal now), so you will need to up your basal a little, probably to 10 units in the morning and 10 units in the evening.

All the best with it.

Warwick.

Aug 10, 2014

Warwick 423 posts

Topic: General Discussion / Lantus - Splitting

I split my Lantus early last year after consistently getting higher BGs between dinner and bed time. I tried to up my QA at dinner, but that just gave me hypos. Splitting gave me stable BGs all day. I split 50/50 and it worked well.

Aug 10, 2014

Storm 6 posts

Topic: General Discussion / Lantus - Splitting

Hi,

I was taking 18u of Humulin i like you once a day at bedtime, then did the Dafne course and my dose is spilt now and it was the best thing for me. I take 12u at 8am and then I take 10u at 10pm and my control is great now.

Maybe you could do a straight 50/50 and see how things go.

Aug 10, 2014

mum2westiesGill 502 posts

Topic: General Discussion / Lantus - Splitting

I've seen a lot lately about it being the best thing people have done to split their lantus - I know we are all different. I've also read an article somewhere that lantus can be a split injection.

I'm currently taking 18u of Lantus once a day at bedtime & seriously considering doing a split.

I'm unsure whether to start with a straight 50/50 split 12 hours apart or do I take slightly more when I do the am dose with it being during the day & being more active then slightly less when I do the evening dose & being less active.

Any help would be appreciated x

Aug 10, 2014

mum2westiesGill 502 posts

Topic: General Discussion / My last 7 days BGs - comments wanted please

Have you thought of splitting your BI into two half doses one morning and one night? It might not be lasting 24 hours - fasting test mid-afternoon to bed would show this.

Hi Gemsa,
Thank you for taking a look at my data & for your comments.
I am serioulys thinking about splitting my BI, I'm on Lantus, but I'm unsure whether to a 50/50 split or take slighlty more am & less pm.

HI.Are you on multiple injections or insulin pump ? What insulin are you on ? Have you spoke to your diabetes team ?

Hi geordiesgirl,
I'm on multiple injections. The insulins I'm on are humalog (QA) & lantus (BI).
My diabetes care is done at my GP surgery & it's the practice nuses who takes care of my diabetes. I also go to my local diabetes drop in clinic as & when I want/need to & it's a DSN who runs that. Between the practice nurse & the DSN they always seem very happy to let me make any changes on my own then visit them if I have any problems.
I don't have a meter for blood ketones but I do have some urine ketone testing strips & the last one about a week ago was normal.

Aug 10, 2014

mum2westiesGill 502 posts

Topic: General Discussion / My last 7 days BGs - comments wanted please

Hello,

I'm analysing your data and here are a few questions for you....

1) What is the correction factor that you use during the day?
2) Why did you not do a correction on BED on three occasions? Probably due to risk of overnight hypo?
3) You have some massive BG drops overnight ... Sun 19.1 -> 5.0, Tue 18.0 -> 5.9, Wed 18.5 -> 8.8. When did you last do a fasting test at night to check basal level?
4) Are you certain your BI was 18u every day?

Thanks ... JontyW

Hi Jonty,
Thank you for your reply & for taking a good look at my data.

1) My correction factor is 1u for 3mmol
2) The three occasions when I may not have corrected at bedtime is I'm afraid laziness :-( ie I've done 1 injection which is BI so too lazy to start having to do another injection
3) Yes I too have been noticing the massive overnight drops. I last did overnight basal testing on 01/07 @ 5:40am BG was 4.1
6:44am BG was 3.3
6:59am BG went to 5.5 after hypo treatment
then on 03/07 @ 4:24am BG was 9.3
6:49am BG was 6.9 then on waking at 9:43am BG was 3.2?
4) Yes I am certain that my BI was 18u every day

Aug 10, 2014

geordiesgirl 16 posts

Topic: General Discussion / Just finished my course today. ..

Morning. On the DAFNE pump course you go through probably similar topics like nutrition, what is diabetes, insulin and carb countin e.t.c..
Also do :
- Insulin adjustment....corrections, step-wise approach, escalation and reduction of insulin
- Insulin injection technique and pump hints and tips
- Basal testing

Aug 10, 2014

geordiesgirl 16 posts

Topic: General Discussion / My last 7 days BGs - comments wanted please

What are your blood ketones ?

Aug 10, 2014

geordiesgirl 16 posts

Topic: General Discussion / My last 7 days BGs - comments wanted please

HI.Are you on multiple injections or insulin pump ? What insulin are you on ? Have you spoke to your diabetes team ?

Aug 10, 2014

geordiesgirl 16 posts

Topic: General Discussion / Insulin Pumps

I did the DAFNE (when on multiple injections) about 7 yrs ago and have recently done the pump DAFNE. I found it very usefull.It was lovely to meet others on the pump as i know no one on a pump.Also some carb sizes have changed and for example, previously counted sweetcorn but no longer need to. It was also very informative and gave me the confidence to mak insuline changes.

Hi Neville, i can honestly say that going on a pump was the best decision i ever made. I was reluctant for about 2 yrs...little things like, how do i have a bath ? where do i attach it if wearing a dress or at night ? Since going on the pump 6 yrs ago i have had no admissions to hospital with DKA. I have had one site infection at the start which i felt got worse only as the gp ( not my usual) would not give me antibiotics. Initially the cannula i tried didn't suit so changed to a different type. You do have to put in a bit more effort but it is worth it. People i find if they see it think it is a pager. cuts down on multiple injections. It's finding the right pump to suit your needs. nothing is perfect and at times we will have issues with the pump but with support from your diabetes team and the pump careline you can get through these. If your team are suggesting the pump then i guess they think it will benefit you. Good luck whatever you decide x

Aug 9, 2014

Neville COL 23 posts

Topic: General Discussion / Insulin Pumps

Part of recent post DAFNE discussions with my consultant was about the possibility of an insulin pump, as I m a shift worker, with, pre DAFNE, considerable control difficulties. As the only person I had met with a pump had recently had issues, I politely declined: its good to read that there's people out there without issues: I m still not convinced though: 42 years of injections at last seem to be working!

Aug 9, 2014

misspinky2510 1 post

Topic: General Discussion / Just finished my course today. ..

Hi I did the course about two weeks ago and am getting on much better xx Very Happy

Aug 9, 2014

Vickyp 137 posts

Topic: General Discussion / Insulin Pumps

I did normal DAFNE too Gemsa, still follow those 'rules' and am around 80% average in target. Not sure how pump DAFNE would be different? Interesting question

Aug 9, 2014

Vickyp 137 posts

Topic: General Discussion / Pregnancy - what was HbA1c when you got the go-ahead

I've been on 5mg folic acid for over 2 years now, we have since discovered we can't conceive naturally and as we are awaiting ivf I must continue with this high dose, as well as vitamin D tablets, so nothing wrong with taking the higher dose folic acid for extended periods of time.
I am also certain I was on this strength before my diabetes diagnosis as I naturally have low folic acid, so no adverse effects of this dose.
Good luck kdg100 and congratulations Gemsa Very Happy

Aug 9, 2014

Gemsa 20 posts

Topic: General Discussion / Insulin Pumps

I'm a pumper too - Accu-chek Combo for 15 months. I honestly couldn't think of life without it now, injections seem so historical and inflexible.

How different is the pump DAFNE to normal DAFNE? I did normal DAFNE and found the 'rules' weren't really working so went on the pump and now I can crack the basal with such fine tuning they do work very well.

Aug 9, 2014

Gemsa 20 posts

Topic: General Discussion / My last 7 days BGs - comments wanted please

Have you thought of splitting your BI into two half doses one morning and one night? It might not be lasting 24 hours - fasting test mid-afternoon to bed would show this.

Aug 9, 2014

Gemsa 20 posts

Topic: General Discussion / Pregnancy - what was HbA1c when you got the go-ahead

Hi kdg100. My HBA was 7.4%/57mmol when I asked if I had done enough yet to could consider safely concieving and I was told I was in the right ballpark but the lower I could get my HBA the better and the gold standard is 48mmol.

Don't forget that in an ideal world you need 3 months of folic acid 5mg doses (only available on prescription) prior to conceiving and then for the first 12 weeks. My diabetes team asked the GP to prescribe this way before my HBA was even remotely acceptable as they understand accidents do happen. There is no harm in taking this level of folic acid unecessarily i.e. if it takes you a year to get pregnant.

Since getting pregnant (I'm now 24 weeks) my care has been outstanding from the team (THANK YOU!) and my HBA has even been at "normal person level" (6%/42mmol) for two months running... although I know my next one will be higher due to some blips. In my opinion there is only so much a pre-conception HBA can reassure against... pregnancy hormones/changes in diet etc throw up a whole different set of challenges and lots of head scratching so a good HBA at the time is no guarantee - its confidence in making the smaller and bigger tweaks to ride the changes that is more important as the changes will change your HBA throughout. It is a lot easier for friends to accept my anal eating habits now as its because of the safety of my baby rather than because of the fussyness of the diabetic - people understand fear of miscarriage far more than they understand fear of bad HBAs even if one causes the other!

Aug 11, 2014 Dyonisus 9 posts	Topic: General Discussion / Disposing needles Tell that to the newvy GP fresh out of UNi, who goes by the book. Is not about saving money or pestering my GP for a freebie on prescription, is about creating unnecessary waste. Is cheaper to burn a paper bag than a plastic container. Anyway, for the price given at the surgery, I can get a bin with 3 times the capacity for a fraction in Amazon( free delivery). Another question springs to mind: how many litres of waste a surgery or Council cope with? I can carry 5 to 10 litres to my local surgery, will they accept it? If they can not be bothered to collect, neither can I. Out of sight, out of mind! Kind Regards D.

Aug 11, 2014 Marje 3 posts	Topic: General Discussion / Calculating QA with Carb/Sugar Content Hi there. Many thanks. That's what I thought but something was niggling in the back of my mind that you have to take sugar content into account on certain foods.

Aug 11, 2014 Laramango 1 post	Topic: General Discussion / no food but blood sugar still increase my sugars were 8.8 when i woke this morning and as usual I did my levemir, but didn't feel like eating so no novorapid...then a few hours later my sugars were 12.0, why does this happen?sometimes its way worse, for example can jump into 20s! does this mean i should increase my levemir?

Aug 11, 2014 geordiesgirl 16 posts	Topic: General Discussion / Calculating QA with Carb/Sugar Content You go by the carbohydrate on the label. However, baked beans you go by the sugar content and recently i was advised not to count sweetcorn because of the GI. have a chat with your diabetes dietition.

Aug 11, 2014 geordiesgirl 16 posts	Topic: General Discussion / Disposing needles You can get plastic sharp containers on prescription. Once full return it to the surgery and they will dispose of it. Some areas if you phone the council they will collect your full containers from your home and replace it with an empty one.

Aug 11, 2014 Dyonisus 9 posts	Topic: General Discussion / Disposing needles Once upon a time, a man finished a Dafne course. He was told he could get a box at his local surgery to incinerate the sharps on prescription. Unfortunately, his GP was away on holiday. She was replaced by a fellow colleague. The letter from the Dafne educators, requesting it just arrived in time, at the surgery, when this man was speaking to the GP. He was told he box was not available under prescription and would have to pay for it. The man decided not to pay Â£ 7.00 and search the internet for cheaper alternatives. He found different sizes and prices to match, but could not make he's mind up. On a trip to his local hospital, he asked if He could dispose the content of sharps in the paper bag. He was told by a nurse that she could not handle in the bag because she could get injured. The man replied how could this be, as He was grabbing the bag. To what the nurse replied: yes, but is just you. The man walked away and decided to chuck the paper bag and it's content in the nearest rubbish bin. As He done so, He thought is conscience was clear. He could not believe that inside the hospital no one would accept that bag unless it was in Â£ 7.00 box. The moral of the story here is, in order to dispose rubbish you have to create more rubbish. Good night and good luck! Dyonisus

Aug 11, 2014 Marje 3 posts	Topic: General Discussion / Calculating QA with Carb/Sugar Content Would be interested to know on how you calculate the number of QA units of insulin when a label states both the Carbohydrate and sugar content.

Aug 11, 2014 Muna A H 34 posts	Topic: General Discussion / Lantus - Splitting Hi, I switched from Lantus to Levemir few years ago, but as far as I remember my Lantus was one dose a day before bed as it worked for 24 hours. I have am/ pm doses of Levemir now. Cheers

Aug 10, 2014 Warwick 423 posts	Topic: General Discussion / Lantus - Splitting Oh, and when you split, what you do is drop a unit at night, and add a unit in the morning each day until you get your 50/50 split. Don't just drop half your evening basal at night and add it in the morning or you will have wicked highs. If you are on 18 units, then it will take 9 days to get to the split, and a couple of more days after than before things stabilise so don't panic too much if you find your BGs are a little out of control over that period. You may also find after you have split that 18 per day is not enough (because I assume that you are running out of basal now), so you will need to up your basal a little, probably to 10 units in the morning and 10 units in the evening. All the best with it. Warwick.

Aug 10, 2014 Warwick 423 posts	Topic: General Discussion / Lantus - Splitting I split my Lantus early last year after consistently getting higher BGs between dinner and bed time. I tried to up my QA at dinner, but that just gave me hypos. Splitting gave me stable BGs all day. I split 50/50 and it worked well.

Aug 10, 2014 Storm 6 posts	Topic: General Discussion / Lantus - Splitting Hi, I was taking 18u of Humulin i like you once a day at bedtime, then did the Dafne course and my dose is spilt now and it was the best thing for me. I take 12u at 8am and then I take 10u at 10pm and my control is great now. Maybe you could do a straight 50/50 and see how things go.

Aug 10, 2014 mum2westiesGill 502 posts	Topic: General Discussion / Lantus - Splitting I've seen a lot lately about it being the best thing people have done to split their lantus - I know we are all different. I've also read an article somewhere that lantus can be a split injection. I'm currently taking 18u of Lantus once a day at bedtime & seriously considering doing a split. I'm unsure whether to start with a straight 50/50 split 12 hours apart or do I take slightly more when I do the am dose with it being during the day & being more active then slightly less when I do the evening dose & being less active. Any help would be appreciated x

Aug 10, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My last 7 days BGs - comments wanted please Have you thought of splitting your BI into two half doses one morning and one night? It might not be lasting 24 hours - fasting test mid-afternoon to bed would show this. Hi Gemsa, Thank you for taking a look at my data & for your comments. I am serioulys thinking about splitting my BI, I'm on Lantus, but I'm unsure whether to a 50/50 split or take slighlty more am & less pm. HI.Are you on multiple injections or insulin pump ? What insulin are you on ? Have you spoke to your diabetes team ? Hi geordiesgirl, I'm on multiple injections. The insulins I'm on are humalog (QA) & lantus (BI). My diabetes care is done at my GP surgery & it's the practice nuses who takes care of my diabetes. I also go to my local diabetes drop in clinic as & when I want/need to & it's a DSN who runs that. Between the practice nurse & the DSN they always seem very happy to let me make any changes on my own then visit them if I have any problems. I don't have a meter for blood ketones but I do have some urine ketone testing strips & the last one about a week ago was normal.

Aug 10, 2014 mum2westiesGill 502 posts	Topic: General Discussion / My last 7 days BGs - comments wanted please Hello, I'm analysing your data and here are a few questions for you.... 1) What is the correction factor that you use during the day? 2) Why did you not do a correction on BED on three occasions? Probably due to risk of overnight hypo? 3) You have some massive BG drops overnight ... Sun 19.1 -> 5.0, Tue 18.0 -> 5.9, Wed 18.5 -> 8.8. When did you last do a fasting test at night to check basal level? 4) Are you certain your BI was 18u every day? Thanks ... JontyW Hi Jonty, Thank you for your reply & for taking a good look at my data. 1) My correction factor is 1u for 3mmol 2) The three occasions when I may not have corrected at bedtime is I'm afraid laziness :-( ie I've done 1 injection which is BI so too lazy to start having to do another injection 3) Yes I too have been noticing the massive overnight drops. I last did overnight basal testing on 01/07 @ 5:40am BG was 4.1 6:44am BG was 3.3 6:59am BG went to 5.5 after hypo treatment then on 03/07 @ 4:24am BG was 9.3 6:49am BG was 6.9 then on waking at 9:43am BG was 3.2? 4) Yes I am certain that my BI was 18u every day

Aug 10, 2014 geordiesgirl 16 posts	Topic: General Discussion / Just finished my course today. .. Morning. On the DAFNE pump course you go through probably similar topics like nutrition, what is diabetes, insulin and carb countin e.t.c.. Also do : - Insulin adjustment....corrections, step-wise approach, escalation and reduction of insulin - Insulin injection technique and pump hints and tips - Basal testing

Aug 10, 2014 geordiesgirl 16 posts	Topic: General Discussion / My last 7 days BGs - comments wanted please What are your blood ketones ?

Aug 10, 2014 geordiesgirl 16 posts	Topic: General Discussion / My last 7 days BGs - comments wanted please HI.Are you on multiple injections or insulin pump ? What insulin are you on ? Have you spoke to your diabetes team ?

Aug 10, 2014 geordiesgirl 16 posts	Topic: General Discussion / Insulin Pumps I did the DAFNE (when on multiple injections) about 7 yrs ago and have recently done the pump DAFNE. I found it very usefull.It was lovely to meet others on the pump as i know no one on a pump.Also some carb sizes have changed and for example, previously counted sweetcorn but no longer need to. It was also very informative and gave me the confidence to mak insuline changes. Hi Neville, i can honestly say that going on a pump was the best decision i ever made. I was reluctant for about 2 yrs...little things like, how do i have a bath ? where do i attach it if wearing a dress or at night ? Since going on the pump 6 yrs ago i have had no admissions to hospital with DKA. I have had one site infection at the start which i felt got worse only as the gp ( not my usual) would not give me antibiotics. Initially the cannula i tried didn't suit so changed to a different type. You do have to put in a bit more effort but it is worth it. People i find if they see it think it is a pager. cuts down on multiple injections. It's finding the right pump to suit your needs. nothing is perfect and at times we will have issues with the pump but with support from your diabetes team and the pump careline you can get through these. If your team are suggesting the pump then i guess they think it will benefit you. Good luck whatever you decide x

Aug 9, 2014 Neville COL 23 posts	Topic: General Discussion / Insulin Pumps Part of recent post DAFNE discussions with my consultant was about the possibility of an insulin pump, as I m a shift worker, with, pre DAFNE, considerable control difficulties. As the only person I had met with a pump had recently had issues, I politely declined: its good to read that there's people out there without issues: I m still not convinced though: 42 years of injections at last seem to be working!

Aug 9, 2014 misspinky2510 1 post	Topic: General Discussion / Just finished my course today. .. Hi I did the course about two weeks ago and am getting on much better xx

Aug 9, 2014 Vickyp 137 posts	Topic: General Discussion / Insulin Pumps I did normal DAFNE too Gemsa, still follow those 'rules' and am around 80% average in target. Not sure how pump DAFNE would be different? Interesting question

Aug 9, 2014 Vickyp 137 posts	Topic: General Discussion / Pregnancy - what was HbA1c when you got the go-ahead I've been on 5mg folic acid for over 2 years now, we have since discovered we can't conceive naturally and as we are awaiting ivf I must continue with this high dose, as well as vitamin D tablets, so nothing wrong with taking the higher dose folic acid for extended periods of time. I am also certain I was on this strength before my diabetes diagnosis as I naturally have low folic acid, so no adverse effects of this dose. Good luck kdg100 and congratulations Gemsa

Aug 9, 2014 Gemsa 20 posts	Topic: General Discussion / Insulin Pumps I'm a pumper too - Accu-chek Combo for 15 months. I honestly couldn't think of life without it now, injections seem so historical and inflexible. How different is the pump DAFNE to normal DAFNE? I did normal DAFNE and found the 'rules' weren't really working so went on the pump and now I can crack the basal with such fine tuning they do work very well.

Aug 9, 2014 Gemsa 20 posts	Topic: General Discussion / My last 7 days BGs - comments wanted please Have you thought of splitting your BI into two half doses one morning and one night? It might not be lasting 24 hours - fasting test mid-afternoon to bed would show this.

Aug 9, 2014 Gemsa 20 posts	Topic: General Discussion / Pregnancy - what was HbA1c when you got the go-ahead Hi kdg100. My HBA was 7.4%/57mmol when I asked if I had done enough yet to could consider safely concieving and I was told I was in the right ballpark but the lower I could get my HBA the better and the gold standard is 48mmol. Don't forget that in an ideal world you need 3 months of folic acid 5mg doses (only available on prescription) prior to conceiving and then for the first 12 weeks. My diabetes team asked the GP to prescribe this way before my HBA was even remotely acceptable as they understand accidents do happen. There is no harm in taking this level of folic acid unecessarily i.e. if it takes you a year to get pregnant. Since getting pregnant (I'm now 24 weeks) my care has been outstanding from the team (THANK YOU!) and my HBA has even been at "normal person level" (6%/42mmol) for two months running... although I know my next one will be higher due to some blips. In my opinion there is only so much a pre-conception HBA can reassure against... pregnancy hormones/changes in diet etc throw up a whole different set of challenges and lots of head scratching so a good HBA at the time is no guarantee - its confidence in making the smaller and bigger tweaks to ride the changes that is more important as the changes will change your HBA throughout. It is a lot easier for friends to accept my anal eating habits now as its because of the safety of my baby rather than because of the fussyness of the diabetic - people understand fear of miscarriage far more than they understand fear of bad HBAs even if one causes the other!