A1c disappointment

I try not to get disappointed with anything related to diabetes, but I got my A1c done today and was actually disappointed at the result. I have been working so hard on trying to break through that 5% barrier and really felt like I might have done it. I’ve had the longest string of “mostly good” days that I’ve had in a while.

My last A1c in December was 6.3%. My A1c today was 6.2%.

Can’t say I’m not a bit bummed at the lack of downward movement. In my head, I’d predicted that maybe I would be 5.8%. I’ve been stuck in the low 6% range for three years now despite always trying to strive for tighter control. And, I mean, that’s better than where I spent the previous 23 years…but geez, if I’m putting in this much work and can’t get into that range, I honestly have no idea how anyone gets there.

I know that an A1c doesn’t mean much, and many people would be grateful to have an A1c like mine. But I put a massive amount of daily effort into my diabetes compared to many people. And in a site where it seems a majority of people hit 5% and Facebook groups that are the same…it’s hard to feel like 6.2% isn’t sort of mediocre.

If I can keep these efforts up, maybe I can hit the magical 5% range in another four months or at least sometime in 2018. I would really like to hit that number at least once in my lifetime!

I should have said majority of adults. I doubt most (or any) of the kids hit that range. But maybe I’m wrong there as well.

But I know in the end I just shouldn’t care. But that’s easier said than done!

It sounds like you care about yourself and how you are doing, and are taking good care of yourself which is very important.

If it is any consolation, we are in the 6’s and a little higher than you, and while it would be nice to be in the 5’s, I am comfortable as anything to have my son in the 6’s for the rest of his life.

According to the DCCT once you get below the hockey stick between 7 and 8 you are close to the risk of non-diabetics in acquiring complications:

image

Additionally, because of the vagaries of the A1c test, you might have better control than someone who sheds red blood cells quickly, and it won’t show up because their RBC’s aren’t around when the test is run.

Congratulate yourself, you are amongst the top 14% of 18 - 25 year olds and 30% of over 30 y/o adults who have an A1c at or below 7.

1 Like

Also this caused me to retrieve the A1c survey we ran a while ago.

image

Not everyone is in the 5’s, not even close.

2 Likes

Liam’s last A1C was 6.7%. We are happy if he can stay under 7% right now.

1 Like

It was 47 members. The survey doesn’t let you know who, so there is no way to understand if we have a decent sample. It could easily be selecting for those willing to answer. OTOH I find encouragement that not everyone is in the 5’s, which it might be easy to assume.

When I ran the survey, we were still pretty small as well, so the results shouldn’t be representative of our current population.

Well, I technically said “the majority” which is technically true according to that survey… :wink: Though yes, it’s possible and maybe even likely that people with higher A1c results didn’t participate.

I guess I’m just always interested in how people who have broken into the 5% range do it. Clearly it isn’t impossible, but for some it sure is extremely difficult.

I would be fairly happy spending the rest of my life at my current A1c level, but sometimes I feel like with all the effort I put towards food in particular (eating low carb, rarely eating processed foods, never eating mystery restaurant food) I should be getting better results than I am.

I guess it’s consolation knowing that if I didn’t eat the way I do, I’d be among the 70% of people aged 30+ without an A1c below 7%. That I know for sure.

1 Like

I can’t speak to every member, but clearly some of our members who have reported 5’s are comfortable living at a bg that I would be very nervous for my son to live in, i.e. not treating high 60’s and low 70’s because they are comfortable in their bodies ability to not go lower. Also, there is a fair amount of literature talking about the test variables, and the differences could easily be in those bodily differences, i.e. red blood cell lifetimes etc.

1 Like

To put it in perspective, Jen…

I had a doctors apt yesterday and my blood pressure was slightly elevated at 130/80… my doc said treating that was a higher priority for my long term health than keeping my a1c in the 5s…

You have a great A1C, and deserve to be proud of it. No use beating yourself up over some arbitrary number.

Re the Facebook groups… it’s a self selecting group. If I join a Facebook weightlifting group I’m probably going to encounter a lot of people who are either a) very strong, or b) pretend to be very strong and very very few average people

3 Likes

Yeah, blood pressure is more dangerous from what I hear. My blood pressure was 178/92 or something ridiculous at my last endo appointment so I was put on medication. It’s still around 140/80ish, which I think is still a bit high (though I’m not sure), so we’ll see what he says.

My endo will certainly be happy about my control, no doubt about that.

There is also no doubt I’m a perfectionist, which doesn’t mix well with diabetes sometimes.

I would congratulate myself with an a1c in the low 6’s. My wife would be happier, my doc would be happier, and I.would likely be healthier.

Like @Chris said,the DCCC says 6 is as good as 5.

1 Like

Well, I just got the rest of my test results and they are all perfect! Cholesterol is the best it’s been in years, TSH is good (it was looking like it was going too high last time I had it tested), kidney function is good. So overall that cancels out my disappointment with my A1c. Great bloodwork. If I can nudge my LDL cholesterol down a couple more points it’ll even be in the super-strict range my doctor wants it in.

7 Likes

I agree with @Chris about what good care you are taking of yourself!

Not us either and it’s the late 30’s in our house these days (no youth on our side for higher number reasons).

I’m sorry you feel let down. It is frustrating to feel like it’s 24/7 diabetes and no big improvement at the end. We would love a string of days that didn’t include 200. Or a string of days that we didn’t think about diabetes all day and night.

I’m proud of your hard work and your number in the sixes. I’ll root for lower if it’ll make you happy but will credit your hard work to get where you are today. :slight_smile:

3 Likes

Seems to me you recently had a pretty rough roller-coaster period, and had a fairly unsuccessful trial of Tresiba, and periodically posted pictures of soaring spikes and plunging lows, so I think, all things considered, those numbers are pretty effing impressive and you should be very pleased.

At least I’d be darned pleased, if I could ever get that low.

5 Likes

The Tresiba experiment was three to four months ago, so I think that should be out of my system by now. But yes, it was horrendous control.

And fortunately a lot of the highs and lows have calmed down. Most of those were caused by being on a split practicum (two different locations) and having a wildly varying schedule and stress and activity levels. I hit 13 mmol/L last night and did a double take because I haven’t seen a number that high in weeks, it seems.

I will just keep plugging along. I should note that if I wasn’t eating low-carb I would be ecstatic about this A1c and would have thought it’s fantastic. It’s in the context of only eating 30 grams of carbohydrates a day that I found it a bit disappointing.

2 Likes

Makes sense. That’s a solid commitment to low carb eating, which is really challenging if you’re not regularly at home during the day. I was wondering if your schedule with school and work was also adding stress and therefore an increase in the number. Might be so. But life comes first, then diabetes, hopefully. :smiley:

Best $25 I ever spent was a home monitor… white-coat sydnrome is real

1 Like

I have a home monitor (although mine broke several months ago, so I need to get a new one). Unfortunately, I’d gone to my endo saying, “I measured my blood pressure last month and it was really high, like 170/90.” He took my BP twice and said, “Well, you’re right, it’s really high.”

My blood pressure has been up and down over the years, so I’ve been on and off medication since my 20s. At this point I’m thinking that I’ll just stay on medication unless my blood pressure drops too low. Even with medication, my blood pressure is about 140/80 when I check it at the drug store or have it checked by doctors, so clearly at the moment I need it.

1 Like

I have seen a number of threads on TuD from low-carbers who see a lot more insulin resistance. They talk about huge spikes from small amounts of carbs after they have been on low carb diets for a while.

Don’t know if you have seen those threads. I think @Katers87 has referenced them a few times over there.

Have you considered doing a trial of a moderate increase to your carb intake? I know you did several weeks of a Tresiba trial. Don’t know if moderate carb would work better, but maybe worth a try.