A1c 6.2 vs. Glycomark 4.5

I opened the mailbox a few days ago and was both excited and apprehensive to see an envelope from my endocrinologist. That means my results are back from the recent blood work. This doctor is different than any I’ve ever seen. He wants to see the patient and not be distracted by the lab results. It’s great, I don’t spend the appointment defending or explaining the numbers on a page in my file that I’ve never seen. The envelope was addressed by hand, no computer generated labels. Someone actually took a minute and wrote my name and address on the envelope. My heart stopped for a second while I wondered if maybe this was not good news, maybe the contents was something horrible and the envelope was had written to give the bad news a personal touch . . . stop over reacting–it’s probably just faster.

I tore open the letter to find a single piece of paper, actually a copy of my lab results with circles arrows and stuff scribbled all over the copy. What the heck is all of this? I had to head inside to sit down and decipher this message. What did all of this mean?

Yeah, the first thing I could identify was the hemoglobin A1c. 6.2! Wow, that’s the lowest it’s been in YEARS this insulin therapy thing is actually working. I am a little confused because next to the number is a “H” and I now notice that it is in the “Out of Range” column. Typically that means “high.” High? That is a really great A1c number, how could they mark it high? How low do I have to be? Oh, read on “non-diabetic: <6.0” . . . ok, I get it now. The best part is the doc’s notation the number is circled and “excellent! Way to go!” written below it. I’m so proud that he thinks it’s excellent.

The other test ordered was the Glycomark. I’m still trying to wrap my brain around this one. My doc considers it sort of an experiment and it not sure if it is a useful tool yet. The results are also listed in the “out of range” column, “4.5 L.” He has written better next to the number and an arrow pointing up. This requires a little research on my part, how is it that I’m too low? We as diabetics are so used to high is bad and low (to a point) is good, so a test result that is too low is contrary to most things we do. The reference range listed is 7.5-28.4 Apparently I’ve missed the mark by 3 whole points!

Additional research was needed, and here’s the way I understand the test. The test measures a two week average of hyperglycemic spikes. The higher the number the better the control. In a perfect world above 10 is fantastic, 5-10 is good, 2-5 is poor control, and of course below 2 is really bad. Darn, just missed good control by .5. Same stuff we are already shooting for, fairly steady control, not too high, not too low.

I wish they had a test to see how often you go too low, probably wouldn’t score very well on that one either. Many of my highs that throw this Glycomark test off are a result of low Bgs. I absolutely hate it when I go low! I find it a very scary experience, my brain doesn’t function well, and I get really shaky. When I’m low I don’t eat something then wait to see what happens, I eat until it comes up. Then I go hypo. My doc just told me, I would rather you put something in your mouth if you think you’re going low than wait to see what happens. You’ll recover from the high, but your might not recover from the low. Doc, thanks for justifying that Glycomark test before you had the results.

I just had my first one done. My doc said the goal is to be above 7.0. I was not too far off at 6.2. Wondering what others are doing with this information…