Hi all- I wanted to post a follow up to this discussion. I had done a home A1C in August which was 6.3. Then I did the second test in the box in November on WDD and got 7.6! I had been having a spate of recent highs due to trying to stabilize my basal dose. So I was asking how heavily weighted the A1C was to recent days to account for such a jump and got some great replies.
So now 1 1/2 months later I had an A1C done at the lab for my pump paperwork and it was 6.4. So I am back about to where I have been holding pretty steadily for quite awhile. So, baring a problem with the home kit (which I've heard are pretty reliable) it seems like the highs of a few days can really skew the results! Lesson learned: Don't do an A1C when you have had unusually high (or low) numbers recently!
(Since I've hovered between 6.3 and 6.5 since I've been stable on insulin, (a bit short of two years), I'm looking forward to seeing a lower A1C with my brand new still in the box Animas Ping!
While the blip in November might have been related to a few days of bad numbers, it is just as likely to have been a bad lab test. I've run a couple tenths +/- 6 for most of the last 3 1/2 years except for one test that came in at 6.9. My logs weren't consistent with those numbers and the A1c was back to normal on my next test.
I can say with five years experience of taking care of a Type 1 child, no, a few over 200 numbers could not possibly account for an A1c of 7.6. She has numbers over 200 at least a couple of hours each 24 hour period since diagnosis (not always postprandial; these can be growth hormone driven) as well as at least one low a day. And her A1c has only been 7.1 once in all that time. When having particular problems with control, she skews toward the high sixes instead of the low sixes. I can only guess the high A1c is due to high overnight numbers which have not been corrected. We will correct highs or lows at 12midnight and 1:30am to 3am or just 2:30am. The main thing is to correct and bring down the highs as quickly as possible. Otherwise, I would suspect a mistake at the lab and I would buy a home A1c test and retest.
This post was from November, Jan. I was just updating people. The 7.6 was from a home test. Last week I got a lab test which was 6.4 so I agree the 7.6 was an anomaly of some sort, either caused by a faulty test or by having the A1C taken during a period of several unusual highs. I don’t generally have highs like that and am starting on the pump next week which I hope will further reduce my A1C. I don’t generally have highs overnight, but if I did I wouldn’t bolus corrections during the night as I live alone and would fear lows. I’ve posted before that I would advise if your niece is spending “at least a couple hours of each 24 hour period above 200” she needs to readjust her numbers, rather than correct “after the horse has left the barn”. Continous time spent over 200 is a setup for complications.
