Jan, that's a beautiful trend. My concern is that it was brought down so fast! If you bring your A1c down fast (at a pace of more than 1% per month) then your vascular system doesn't have a chance to get used to the change and will start to break down. I've talked to other type 1s who brought their A1cs down a few percentages in just three months and ended up getting retinopathy because it was a shock to the system. Just keep an eye on your body and notify your doctor if you notice anything changing in your sense of touch or eyesight.
5.9% is fantastic, though. Great job! I was only in the 5s for a month, and that was during my last pregnancy. I'd like to be in the 5s again, and am hoping for it with next A1c test which is next month
The A1cs are a good tool to average all of your glucose levels over the course of three months, including those times when you're not testing. The only way I could see less of a need for an A1c is if you have a CGM and the CGM is always accurate. Then, you can take the data from the CGM over the course of 3 months, and average the glucose levels out and make your own A1c.
My experience with CGMs, though, is they are only about 75-80% accurate, which leaves a 20% variable in the end average.
If you're not using a CGM, then the A1c will tally the glucose levels, but also including the times when you're asleep, or extremely active, when you can't test. A1cs are a good tool for you to see the bigger picture. It's fantastic to focus on the here and now, but in the end we are mostly trying to avoid diabetic complications and extending our lives. So, A1cs give us the bigger picture of how tight our control has been, including all the times when we're not testing.
I think that you need both A1Cs and the data from BG readings and the CGM to really keep an eye on things. I'm not usually suprised by my A1C because if I perceive my numbers being off (including diet as I sometimes will notice that I'm eating more jellybeans, which generally seems to be a "meter" suggesting that my basal is running high?), I will check the CareLink reports and see if my perception matches the data and make some small changes? I like the A1C as a "report card" for the "semester" (quarter?) to make sure that things are in line. Most of the time for me, they are.
A1C can also be a useful "shorthand" for other doctors to perceive how much your diabetes may impact other procedures, cardiac health or other issues that we encounter. My dentist even asked what my A1C was the first time I went to her but I think she sort of just looks at my gums and can perceive that if they are ok, I'm probably doing ok w/ my A1C so she hasn't asked that for a while?
I just got checked for retinopathy, and for kidney disease, and was cleared on both counts.
I don't keep a strict diet though. I even eat sugar - I know, that is like, crazy talk around the DOC. I just brought it down by taking insulin and exercising, and as I already exercised before diagnosis... I don't see how I could have done it slower. I mean, I eat fruit, bread, and other carbs daily, and dessert a few times a week. My diet is pretty indulgent. I'm not one of those people that says "I'm living on just meat and salad to have a low A1c". I also don't test as much as I should cause I pay for strips out of pocket, so I'll often get by on only 3 tests a day, or 5 tests a day. So basically, I did everything "wrong", and still got a fast low result.
My last one was 7.1 and I was pretty darn proud of that! I would like to be in the 6s, but I can't seem to get my A1C that low without struggling really hard and battling lows daily.
I have found that, since going back on the pump, not only has my a1c come down, but my standard deviation is smaller and I'm having fewer large swings between highs and lows like I was experiencing on MDI.
I'm still having the higher than average standard deviation 39%, but that's on MDI. I'm working on getting basal rock solid then I'll worry about I:C ratios more. I think the glucose excursions are what will lead to complications, even more than higher than average blood sugars or A1C's. Time to head to work.
I'm not even sure there is an "average" StDev. It comes up every now and then but it seems to me like when my A1C is lower, it goes down but that might be because they are different ways of expressing the same thing?
You're probably right about that, what I meant was in Think Like a Pancreas, he says try to keep the SD down to less than 33%. SD is just how often you "deviate" from your targets, whether up or down. I find the lower I get my bg average the higher my SD because there are more downs and ups so I deviate more. Still working on it but there is progress and I finally got the CDE to realize that I wanted to be closer to euglycemic so we are adjusting just about every week to see how it goes. Still too many lows for me at the moment and being hypo unaware it can be a big problem. OMG I just realized how many acronyms I put in this post, I have got to get off this site now, back to work.
Just did my A1c today and it was 6.6, which pretty much made me stoked on life, haven't had it that low for a long while. What concerned me is my meter I got 3 months ago said I was 8.3 vs what the lab said, 7.5, would you replace your meter if it was off that much? 10% margin of error? Definitely had clean hands :)
No no, I mean they wanted to test the accuracy of my glucometer compaired to what they read as my bg from the sample they pulled. So I had 8.3mmol/l (153mg/dl) on my glucometer, compaired to what they said I had from the lab 7.5mmol/l (135mg/dl). Sorry my Canadian numbers look like some sub-par A1Cs.
The lab tests the plasma, the glucometer tests the blood. My endo says up to 1mmol variation is normal cause they are not testing the same thing. More than that, to contact the meter manufacturer.
Just got my A1c...5.5. And not that many lows. I had a few a couple of weeks ago, but I had a slight infection that was jacking my blood glucose levels up, and when that started clearing, I had a few lows as I readjusted my basal rates.
Thanks for the clarification. I obviously was not thinking Canadian. I always bring my glucometers with me to my clinic appointment they are usually within about 15mg/dl with the one they use at the clinic. If they were significantly different I would contact the meter company. They usually are pretty receptive and the meters are for all intents and purposes free, it's the strips that cost.
