Doctors and A1c's

My A1c’s have been in the 5.4-6.4 range for almost 20 years. My internal med doc wanted me in the 5.5-6.0 range, and he wanted me to avoid lows. That is impossible, but I never convinced him. Then I started seeing endos in 2007. They wanted me in the 6.0-6.5 range, without lows. That is certainly more feasible, but I still have some lows. My previous doc does not like the A1c’s now being greater than 6.0. My endo likes my current A1c’s, but she thinks I can avoid lows. I cannot satisfy either doctor. I just sit there and smile. They smile back at me, and write my prescriptions. Then we wish each other well, and that is how all my office visits go. I have been my own doctor for many years.


check out the site/thread on “Bad Endos.” youre guaranteed a good laugh! :wink:

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In my opinion, you should not be trying to satisfy your DR! I have never met a DR that is treating diabetes that is a diabetic, so they have all these great ideas but have never had to implement them personally.

If you are keeping your A1c’s in that range without dangerous lows, then your DR should be really happy to have a compliant successful patient.

The first diabetologist that I had told me something that I think all diabetics should take to heart. I asked him what to expect from the treatment he was suggesting and his answer was; ‘I don’t know, diabetes is different in everyone. In the end this is your diabetes, not mine and only you will know what is best for you (with my help)’ Basically he was telling me that I needed to own this to control this.

From what your numbers are, you are owning and controlling your diabetes. Can you do better, sure maybe but dont worry about your DR. Do it for you! Keep up the good work!


I completely agree with @Richard157 and. @dughuze. I take everything the Dr says with a grain of salt and if it works into my perceived treatment plan, great. Otherwise…

Alternatively, when my CDE who is also T1 makes a suggestion, I am all ears.


If you,like many of us, have successfully treated OUR diabetes loner than our endos have been.alive.,then I think you’re question is moot.


Welcome “home”, @docslotnick!


Good to see you, doc!

i had an endo for 30+ yrs who was a horse’s ass. but he, himself, was T1D on an insulin pump. after all his completely unhelpful guidance and arrogant attitude, i finally went and found myself someone else.

my new endo is a think outside-of-the-box kind of guy. he is up for anything that works for me. and, as always, YDMV, and he knows this and he never doubts me when i tell him something about my D that doesnt necessarily fit into the “mold” of things.

and, in fact, i am seeing him tomorrow, and i will be showing him all of my successes with my D management and my swimming. i am T1D, a pumper, (no CGM), and my last A1c was 4.9%. i’ve worked my butt off for this!! (my former endo complained that A1cs this low were unhealthy and that i should be closer to 7%. )


I had a friend that worked at Yale studying the long term effects of low blood sugar on diabetics including but not limited to ‘dangerous lows’ (great guy, moved back to Scotland). He studied this for years and told me that they could find NO long term ramifications from low blood sugar events.

That being said, we all know the long term effects of high blood sugar events. We, as consumers of health care, need to realize that we can kick a provider to the curb who is not meeting our needs. This is not to say that we have to like our provider. (I dont need to like a surgeon, I need to know that the surgeon will do the best job)

The days of DR as demi-god, all knowing and not to be questioned need to be over. Keep advocating for yourself and doing what you are doing!

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this is extremely helpful information to know. thank you very very much.

i think that this is the reason that i started using the IM shots to bring down BG highs ASAP. (my usual IM shot takes about 1/2 hour to bring my BG down, and is basically out of my system in just 2 hours…as opposed to the 4 hours it takes for a pump bolus to get out of my system)

( this way i do not remain high for very long at all )

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Daisymae, If I find that I underestimated my need for insulin, I just take more. When I know that I have a food that will hit me late with a ‘carb bomb’ I split my dose. When I take my insulin can change based on fast acting or slow acting carbs…

Don’t let some DR tell you that there is a rigid formula for having to do this or that, it is different in everyone and you working with trial and error will be much better at management than a DR from afar telling you what ‘should happen’.

Keep up the good work.

when i have chosen to eat long lasting/absorbing carbs, protein, fat, etc, i use my pumps dual bolus feature and extend my insulin duration.

just out of curiosity, what does this have to do with the topic? i am confused.

To protect the personal information of one of our members, I took the liberty of deleting some posts which discussed how the information came into the public area.

Thanks. Still new to forum, did not know how it worked.


No problem at all. We are happy you found us!

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