I'm pretty focused on glucose control right now and I think I have to be. I have all the tools and discipline to get better results and am ready to put it out there. A little bit of public accountability, if you will.
I'm going to try to get my A1C into the 5s. I've never seen a number lower than 6.2 in the past.
I have found the Bayer A1C Now tests to be accurate "at home" measurements. I have done them the same day as my lab work was done and gotten the exact same number.
While I was typing this I was actually running one of the tests to get a baseline... but, 2 of them came up with a QC error. So I've wasted 2 tests today, with no numerical results. I wonder what I did wrong? I've never gotten an error before and today it's 2 for 2. I have one left, should I try it once more? Is there something chemically whacky in my blood that is throwing the whole thing off? I'll call them A1C Maybe Later kits.
Alright, I'll be flexible... I'll go with my average glucose number according to my CGMS, which is also prone to error... at times. My 30 day average is 150 mg/dl. And my meter average agrees. It's been a rough month with infection causing swings all over, mostly up. I think it will be easy to improve on this.
My goal, based on less error prone devices... will be to bring my average BG reading to below 126 mg/dl. According to my A1C test kit, that's equivalent to 5.9% Right now, according to my numbers I have something equivalent to a 6.9%. While I was in the hospital for my heart arrhythmia they tested it at 6.8%.That was roughly a month ago.
Okay, I'll record my progress here around the beginning of every month.
P.S. I have never been able to get my pump to tell me the average BG in the past. I just found out this weekend while looking at the manual (it took me 4 years to go back and read it) that it was just one more button press away. Now I can quickly see my average sensor glucose and meter glucose anytime. So, my monthly averages won't be a surprise at all, like A1Cs sometimes are...
I used to set goals around blood sugar control like getting an A1c below 6.5, or an A1c below 6 or a meter average below anything. I stopped because my blood sugar control is impacted by so many things I don't control. Setting a meter average goal was a problem for me at one point because then I really didn't want to test my blood sugar when I suspected it might be high.
ReplyDeleteMy blood sugar average for August was roughly 118. My blood sugar average for November was 138. Was I doing anything really different? Nope.
It seems to me that if I set a goal of having an average blood sugar below 120, or being in range 80% of the time, and I get sick and it's not realistic, well- it doesn't help to feel bad about it. And if I have a really lucky streak like I did this summer- that's great, and it's to my credit that I was on top of it enough to take advantage of my stability- but it's not really any more of an achievement. I am as proud of keeping my A1c down to 7.0% for my June A1c as I am of my 6.1% in October. Actually, I'm more proud of the 7.0 because I had to persevere with discouraging numbers.
It makes more sense to me to hold myself accountable for the related things I can control. Like periodically measuring carbs and proteins at each meal, and making adjustments to my insulin doses, or going to bed on time, or waiting to eat after injecting if appropriate, and making the correct call about whether or not it's appropriate, or injecting for highs promptly at whatever threshhold or treating lows promptly.
Knowing your A1c does not tell you your average blood sugar. The wikipedia article on HbA1c is actually worth a read. Frankly, I think for those of us who use CGMs, the A1c is only worthwhile as a motivational/communication tool.
Jonah,
ReplyDeleteYou are right, they are just numbers that don't take into account many things going on. But, you know, I just want to quantify my improvement plan in some way... I've never had an A1C under 6, so it's a goal that will show improvement, hopefully to a level I've never achieved before. I know that lots of things will get in the way (the 2 different sicknesses this Fall/Winter), but I can work on this for a while.
With my current obstacles, I'm not getting there this week, but I hope I can get all the discipline together to make a lower A1C a norm. Trying to make my "normal" better.