Is this advice counter productive?


#1

My DM is 76 and started insulin approximately 2 years ago as her blood sugars were quite high on Metformin and her kidneys were being quite badly compromised. Just under a year ago she started Slimming World to lose some weight and within a very short time had to cut her doses of insulin significantly as her blood sugars got much better. This morning she had a consultation with the Diabetic nurse who told her that her HbA1c levels were too low at 6. My Mum says that her fasting blood sugars are never lower than 5 each morning and go up to 7 after breakfast. She tests often and has never been hypoglycaemic so she was surprised when the Diabetic Nurse told her off stating she should be keeping her blood sugars at around 10.
My Mum is so upset by this as she has worked hard at getting the weight off, reducing her blood sugars and staving off dialysis which was looking inevitable a year ago. My knee jerk reaction is to dismiss the Diabetic Nurse’s advice without a second thought but it does occur to me that there might be a good reason for the advice. Please can anyone help?


#2

Sorry that I can’t give you any sound advice as I am not an insulin user but my insticts are the same as yours. An improvement (or lessening deterioration) of kidney function, good bg levels, weight loss and using a little less insulin - it all sounds good to me whereas numbers to aim for being a ten does indeed sound counter intuitive. Having said this, it is best to get the views of those T2s who use insulin.
I’m sorry to hear that the DNs advice has upset the lady, this is unprofessional and shouldn’t happen. Try to accompany her to future appointments. Best wishes.