Damage from disease

Hi forum, long time!
I am wondering… what causes the damage? The spike too high too fast and drop too low too fast OR spike high and remain high for too long?

Cathy @HopeFloats2020, this is a good question and has been debated and I’m not certain if a “correct” answer has been found.

From what I know, both sides of the question you pose have been known to cause lasting damage; put another way, both can cause harm. The more heavily accepted thought now appears to learn toward sharp and frequent variations between high & low. Then the question arrives, what is to high [>350 ???] and to low [<50 ???] - current thoughts about hyperglycemia and hypoglycemia.

Personally, my most critical damage was caused by what has been assumed to be living my youth in constant hyperglycemia causing retinopathy diagnosed in 1966 - in the days when blood tests were very infrequent.

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@Dennis
Thank you for this info! Always appreciate your feedback!

@Dennis
My Endo (former) told me once when I asked her what she would like my post-meal high to be that she was not too concerned with that as long as the number came down to my target number at the four-hour mark! I still crinkle my face in disbelief when I say that out loud!
I haven’t taken her advice quite yet.
I am looking for second, maybe third, opinions!

Cathy @HopeFloats2020, the guidance provided by that endo is also the guide I’ve been using since BGM arrived 40+ years ago when I began checking BG before meals - when we were developing and perfecting MDI.

How high you will go after eating depends on a few “little things” such as type of foods, quantity of food eaten, insulin bolus you administer; glycemic value of food will mostly govern the “spike”. Personally, I eat a well-balanced diet most days with total carb intake ranging in the “normal recommended” 230 grams for a moderately active adult - with or without diabetes. What I watch for when reviewing my periodical CGM charts is a standard deviation in the mid-20s. For several years, my lab HbA1c has remained in the mid-5s mostly between 5.3% and 5.7%; 90 day TIR >90%. I don’t let a post-meal reading of 200 mg/dl bother me as long as four hours later I am back to about 100 - and staying higher than the 70s. My primary “test” is that I’m feeling good, staying active, and can do everything a mid-80s guy would desire.

My desire for next Monday is to see lab-work show that I’ve safely brought my A1c back up to 6% while maintaining my TIR.

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@Dennis
Thanks again!!
Good luck Monday!

Cathy @HopeFloats2020, just to let you know, the report I received from the lab on Tuesday shows my HbA1c at my anticipated target - 6.0%. This was a 5 step campaign bringing it up from 5.3% and keeping my 90=day TIR at 91%.

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Great work @Dennis good news too.

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