There are many endos that do not take the time to establish what each patient is capable of, and just lump them all into the same category of “dumb helpless diabetic, unable to safely maintain normal BG’s”.
Not everyone can safely have a target of 100, but for those that can manage it safely, they should not be discouraged from pursuing it.
Well, to be fair, I think part of this comes from the diabetes community itself. The thing is, when my son was first diagnosed, I heard a lot of comments about how diabetes is just so chaotic and indecipherable that you can never predict and preempt most trends, and a lot of defeatist statements about how it was impossible to a) avoid spikes b) avoid A1Cs below a certain number c) manage diabetes in a toddler. For instance, whenever I would try to figure out why a certain spike happened, the answer was always “because your son has diabetes!” – as if there was no point or benefit in trying to figure out the cause. I also heard a lot of “well, I tracked and analyzed everything at the beginning but in the end realized it was impossible to predict what was going to happen.”
I think those comments are meant to be encouraging for those who are taking on a ton at first and maybe blaming themselves for not being able to rein in their kids’ numbers. And maybe it’s because people learned a lesson early on about avoiding self-blame and burnout and have come to a specific detente with their own diabetes care that works for them. But I found those comments really discouraging and depressing.
And so I can imagine that if you had an Endo who started out thinking it might be possible to lower A1C to say, non-diabetic ranges, and then they get a parade of people saying “I’m trying as hard as I possibly can and nothing works and there is no way I can get my A1C lower than 7.5 without having a lot of lows,” then it’s actually a sign of a good doctor that they listen to their patients and sort of internalize their experience. They don’t want to make all those struggling patients feel worse by telling them to aim lower than they routinely see is possible in their clinic!
I also can say that when I spoke with my Endo at first diagnosis, I asked her if it was possible to get our son down to below 6.0. She basically said she had very few patients with such low A1Cs and none of those patients had healthy CGM traces – they were having hours and hours of lows! So maybe you need to see 500 child patients before you find one that is both in non-diabetic range and not having excess lows. It’s possible, and I now know it’s possible from speaking to others via the Internet – but the internet is the perfect place to find all those “long-tail” people – they might be 0.1% of the population, meaning some endos never even see that percentage.