AC …I think it helps me , if another pair of trained eyes as my pump Nurse ,suggests changes .I need all the help I can get 
Hey now, I just entered my newest a few days ago in TuAnalyze and it went UP, and almost by an entire percent, so some of us are being honest
I am with Danny who replied below, the % of readings in range (as shown via Dexcom, not fingersticks), as well as my standard deviation are the two factors I look too most to assess my control. My doctor likes to see that my A1C is in line with our “goal” but even when it’s not, it’s not viewed as a failure as much as a problem to solve.
I remember the first time I got my average SD down below 25 over a 24 hour period (and I wish it stayed there all the time, but I’ll be honest and admit that it does not - my SD is usually in the 30’s, and I am okay with that - bad days control-wise are in the 50’s and 60’s, with a few that have gone higher than that even) I was completely elated - to me that moment signified my largest success in self-management, and that only came to me with the help of CGM. It was a breakthrough moment for me.
I see the A1C as just one more tool we have at our disposal… because it is a tool, just as SMBG is - you can you DO something based on the results. Choosing to not do anything is still a choice…
I find it really fascinating the conversations (threads) we get into, on this site about the separation of emotion and logic. Does this grade (which is really a culmination of your daily BG numbers) effect you emotionally? Sure! To say it doesnt is to ignore the big picture of the state of your D. Is it always accurate? No, I would imagine not. Although I am not a lab tech. which makes me unqualified to answer that question.
There are some who dont look at D with that particular summary and instead use other means with the same outcome, e.g,. pie charts and online software to show multi-month average BGs. Guess what? Same results occur with an A1c as do 3 month trend summaries (so why is it always different!? lol ).
I guess the question boils down to how you emotionally handle the medical establishments labeling of the care of your disease. If your seeking their and your peers approval then the A1C holds a good amount of weight (and emotional responce). If your dont mind the lack of approval then forget the number. There are plenty of other ways to see how your control is doing. Bare in mind its hard to not want approval.
Logically though, I need all the information possible in order to better understand my current control state, be that a summary number or a multi-month pie chart. Also,
Well mine isn’t below 6, but I think it stays in the 6’s more easily with a CGMS… and I feel like I achieve those in the 6 range with much less variability than I had been before I used a CGMS. I was VERY reluctant to adopt the technology too… I thought it had too many shortcomings to be worthwhile, and that opinion was based on what I knew of the glucowatch and the original MM CGMS which I wore (with the cord connecting the sensor to the receiver). There was no way you could have paid me to wear those sensors (which are the same used now) full time.
For me the A1c is a confirmation of how my diabetes care has been for the past few months. For me it’s a big motivator because I like to see the number be as low as possible.
I’ve had diabetes for 35 years and have a record of my A1c’s going back to the early 80’s. The test was not the same in those early years so I don’t think that all the results are completely comparable. However, it’s an interesting road map for my diabetes care and for the available tools and insulins that we now have available. The advent of Humalog and Lantus resulted in the biggest improvement in my A1c of any tools or insulins in all those years. I’m an avid pumper and feel that the pump has made my life more “normal” and definitely has resulted in fewer severe hypoglycemic episodes. But my A1c did not change because of the pump. I’m an on-and-off Minimed CGMS user. I feel that I am safer when using the CGMS, but the pain and inaccuracy of the Minimed system drives me crazy. Unfortunately my insurance will not allow me to switch to Dexcom. Argh!
The one thing I like about the A1c is that you can’t cheat on it. I remember in the early days of my diabetes, when I was pregnant and had to do urine tests at the obstetrician’s office, that I would stop eating and would drink tons and tons of water so that the urine test wouldn’t turn the dreaded brown color. I don’t look fondly back at the days of blindly taking insulin. On the other hand, we didn’t have as much guilt in those days.
I don’t think that the goal of posting A1C in the TuAnalyze gizmo should be to post it, it should be to enable dialogue. I think that the medical industry FAILS in that they are unable to bridge the gap between looking at a list of #s and going “ooh, here’s a good one, here’s a bad one” and communicating implementable solutions to us, the patients effectively? Patients can see a log as a list of success or a list of failure when really, it’s probably a whole lot of both but a short appointment or even an involved dialogue with a team*, it still falls on the patient, not the doctor, to implement whatever changes or non-changes need to be made. Their guesses are educated but without, or even with, perfect logs, they are still guesses in a lot of cases. Of course, a lot of what I do is guessing too.
*= which I haven’t had much of, I had a very short “team refresher” when I was getting my pump but seemed to be a bit outside of their experience as my control got worse, even as I was getting a lot healthier. I was also extremely confident that the pump would solve the problem and, amazingly enough, it did, although I didn’t badger them about it and did it myself. I just badger them for the technology and the prescriptions which totally peeves me. I should be able to write my own freaking prescriptions. It also peeves me to read about the people w/ other types of diabetes who are interested in exploring pumps, CGMs, etc. and can’t get them because of barriers put up by administrative entities.
I really never cared much about the A1c, except when it was WAY out of range. But in general, I don’t trust it very much. What has motivated me is the Flatliners Club – just seeing what other people can do has gotten me working harder. If I can keep my BGs relatively flat most of the time, (which is a 50-50 bet), the A1c will take care of itself.
I’ve been in this forum for 2 years. While I’ve found some very inspriational and some very insightful information here- and some great people- there are always going to be different attitudes and different types of people who will ask more from us- possibly more than we are able to give. When I used to post a lot last year, I would offer the advice that I had learned over the course of 13 years as a type 1. Some would go to my profile and see my (at the time) high A1c and then completely disrespect everything I had posted because I “obviously didn’t know anything about type 1 control, seeing as my A1c was so elevated.”
Some of it is just luck. Others is how our bodies are built and taught to function. I’ve tried everything I can possibly think of- from diet & exercise, to eating the same foods at the same times daily, to taking gastroparesis testing, to trying the pump, the CGMS, to taking Metformin on top of my injections, to switching insulin brands like it was my full-time job. I can’t seem to get my A1c lower than 6.5%. But, I’m still proud of that number. Not because it’s low, but because it’s controlled. I’ve had less swings in the past few months than I’ve ever had in my entire diabetes life.
I only care what my A1c is because I’m tired of the doctor lecture. Especially when I understand that a low A1c is not beneficial when it’s based on swinging BG numbers. It’s the swings that cause complications, not necessarily the “highs”. Note that anyone in the constant 200s is going to feel sick, but having a constant 150-180 BG isn’t anything to shake your fist at.
Don’t let it get you down. I would love to some day say that I’m “nearing 40 years” with this disease. Or not! I’d love to say that “40 years ago I HAD type 1”.
although, my “team” was all in the same hospital, UCLA, they really dont communicate nor approve of one another. Id go to see one doc who would get pissed at the other doc. Cracked me up. I think the main issue is ego with those med type folks. In only one case did i ever have a ring leader to the gang and she was just a progressive CDE. Too bad though, it would be nice to have a whole group thinking about how to help you to live complication free.
What I see in this community are people celebrating each other’s success & being supportive when someone needs a shoulder, understanding or encouragement. I haven’t noticed bragging or members being told their A1c’s aren’t good enough. A1c’s listed run the gamut & no one is required to list their A1c.
I still think though that everyone here works hard regardless of what their A1C is? I think the focus is missing from the healthcare system and communications.
I must say, I brag a lot about TuD, and my support group here. Ranging from bsc and his source sighting posts to Gerri and her all knowing low carb recipe book, to Danny, FHS, and the flatliners gang.
Really I think we all should brag about the amazing community here on TuD. I know my diabetes has made a 180 turn around since I started to lend an ear. Ive seen this happen to others too.
Jennifer …I suppose I belong in the other 10 percent of the above crowd !!.
And 28 years plus as a PWD
THANK you so much EVERYONE. I am very proud…not to be 60 but to have survived D for 57 years. I do feel “guilty” for a lot of the things I ate (when I shouldn’t have) and a lot of things I did with “couldn’t be bothered to take a shot”. Eventually, it kicked in, somewhere in the brain. Stress, emotions, everything play a huge part in your control of this horrible disease and you should never feel guilty about “numbers, what endos. say” …just SMILE and say OK…
Sheila
Thanks. I was actually diagnosed in Colonial East Africa, where I was living with my parents. Nairobi. When I look back I definitely say “WOW”…it was extremely uneducated, un-informed, and basically very primitave. I also lived in the UK and now am thankful to live in the USA where Diabetes has progressed so much and so much knowledge is available to us. Take advantage and try and be the “best informed person with D”…
Sheila
I definitely wrote my A1c on here too- even when it was stuck in the 9% and 8% for 2 years. I listed my A1c as far back as I can remember. Honesly, I’ve worked SO HARD my entire diabetes life to get my A1c down to where it is now, that I really feel like I deserve to pat myself on the back once in a while.
Other than that… I didn’t change A THING to get my A1c through the 2-3 year plateau of 8.5% to the now low 6s. I took Metformin for 3 months, hoping to re-boot my body, and then viola! 6% A1cs for the past 12 months. I’m SURE my A1c will rise again, but I’m trying my damnedest to touch the 5% mark for at least a month before it becomes uncontrollable again. Not by going into comas, but by controlling my BG numbers into an average of 100-110. There is such a balance. I use the A1c as motivation because I like to see it come down after all the hard work I had to go through to get it there.
I don’t listen to a word the doctors say about the A1c because there were definitely times when I was expressing my urgency in caring for multiple comas during those 3 months, but the doc looked at my 8% A1c and told me not to worry- then increased my insulin dosage.
I don’t listen to the docs anymore at all. They just write my scrips. I forced my endo to give me a scrip for Metformin. I ignored his request to take Lipitor to lower my cholesterol (and lowered it by myself). I ignored his request to NOT split my Levemir dosage and split it anyway. I completely self-manage my disease. With the help of the internet and wonderful, knowledgeable communities like TuD. I love you guys.
I’m getting there. This past week, I’ve tested over 60 times in 7 days and my average BG according to my meter is 114. That’s including a surprise 250 yesterday that I luckily could take back down to 100 within one hour. I’m hoping for a somewhere-in-the-5s A1c this year. I’ve NEVER been there and have NEVER been this controlled. No CGMS. I’ve got some scabbed fingers, though!
Not only do you deserve to pat yourself on the back, but you get one from me, too. I know how hard you’ve worked, even when your A1c has been higher than you wanted. A1cs are tricky little items, and not the be-all and end-all for evaluating your control.
And I think you are wise to be pro-active in your control – it’s a sign of an intelligent person!
MsKitka, I would agree. It tells a test of your blood in that one place at that one time. It doesn’t give us an accurate measure of what is really going on within our bodies. I would think that the day to day readings are much better over time. My vampire, for lack of being able to spell phlibotanist, told me that the needle goes into one spot in my arm, it draws back a sample of the blood going through that vein at that time…and that’s what it measures, it’s a space in time. We all get all excited about our A1C’s and the numbers, only because we are told to. But do we get excited about the average of our numbers over a week, a day, a month a quarter? Nope, because the docs can’t have that control over them…so they want to do it themselves. Thankfully, my PA, a diabetic herself, takes my meter and averages those numbers, and then looks at the A!C and that’s where we get a better picture. Sounds like a more sound answer to me.
Jen,
All the time that I had the Navigator, my A1c has been between 6.2% and 7.3%. Last one, in February, was 6.7%. The cgm actually does miss many hypos, and many highs. I don’t think that any technology, will ever be able to catch all of them, same as we cannot catch all of them, with stand alone meters. Then there are other considerations too, like any medications, illness, etc., that may be harboring the gremlins. Prednisone, and some antibiotics, are very good at playing havoc with all of it.
As far as being stressed about A1c’s, that is one number that doesn’t concern me. It is just another tool, and one for past Bg history. I look at the % of time I’m in my target area, and the Standard Deviation. To me, those numbers are much more important. One could say it would also be more current, if one uploads their meter or cgm, each day or once a week. Doing this gives a better outlook on being able to make changes sooner, as needed.
My navi died awhile back, and I have a new Mini-Med Guardian CGM on the way to me!
Trisha
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DX July 1984 IDDM (=250.01=Type 1) ~ member since 2/15/2011 on TuDiabetes
NEVER DOUBT the power of Diabetes OR the power of diabetics >>>my ADA blog
~ Born with IgA Nephropathy (= a diabetic autoimmune kidney disease)
~ Retired Trauma Radiographer (Level II trauma centers)
~ First light brings a new day, new hope, new wisdom, and a chance to start fresh again - PAL (me)
~ He is most powerful who has power over himself -Seneca
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