Endo Appointment

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I just got back from my latest endo appointment and am amazed -- I'm already getting the results of the blood work, thanks to the group's new online health management tool. I'm liking this -- sort of!

The good news: I've lost 3 lbs since the last appointment. Definitely not complaining, since at my last appointment, my weight was 10 lbs higher than before! If I could lose another 6-8 lbs over the next 6 months, I'll be happy. Also, my bp was great, at 98/68. :D Certainly makes me happy!

Now on to the lab results. They were mixed, some good, some bad. What was good?

HDL: 54 -- lower than my best result (around 75), but still in the "good" range that docs like to see

Triglycerides: 97 -- Best result yet! YEAH!!

TSH: Normal -- it was on the low end of normal, but still within the normal range

Now on to the not-so-good:

A1C: 6.4 :( Don't like that number, though I do know it's within the AACE's recommendations and far better than my mom's was. Plus, when I had A1cs in the 5s, I was also having far more hypos, which that's got exactly good, either

Fasting BG: 116. This I don't get, because my bgs when I got up were 91. Must have been from the toothpaste, right? ;)

Total cholesterol: 219. Yeah, it's high, but all the cholesterol ratios (e.g. total:HDL, HDL:LDL, Triglycerides:HDL) are all really good, so while this is higher than the docs would like, when looked at in context with other forms of cholesterol, it's not as bad as it seems.

LDL: 146. Again, it's higher than docs want, especially for diabetics, but in context, it's not as bad as it seems. The ratios are good, and I still have really good HDL levels, which aren't often seen in diabetics.

I've also been having some foot issues. My right foot sometimes gets a little tingling/coolness feeling that my endo in Indiana said was most likely neuropathy and that feeling has come back. It isn't as bad as it was when I was in Indiana, but it is definitely there :( The good news on that was the endo didn't think there were any circulation issues. Good news on that, considering I have a family history of peripheral artery disease.

Well, there's obviously some work to do, but at least a few things are going in the right direction! I'm happy these test results are coming back to me so quickly. I'm used to having to wait a month before I get results back, so this is just amazing!

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Just a couple of comments. You didn't say when your appointment was, but if it was early in the day, that fasting number could easily be accounted for by Dawn Phenomenon. DP strikes different people in different ways. For some, it occurs in the wee hours. For others, it kicks in after arising. That's how mine works. So that's one possible explanation (but only one).

Your lipids, on the other hand . . . if I am reading it correctly, your HDL was 54 and LDL was 146. If that's accurate, it's really upside-down from what's preferred. HDL is the "good" cholesterol and LDL is the "bad" one. Normally they like to see HDL as the higher number and LDL as the lower.

Your other numbers look pretty good. That A1c reading really isn't awful, but I can certainly understand your wish to get it down some more. The trick is to do it without running into serious hypos, as you obviously know. Good luck and keep up the good work!

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David, sorry I didn't get back to you a bit earlier. Been a bit busy here and finally have had the time to write back. Hope this finds you well.

The appointment was at 8:40 AM. When I tested my bgs earlier that morning, they were 91. I suspect it's not the dawn phenomenon, but the somogyi effect. I've noticed that I've had much lower bgs in the wee hours of the morning (60s and 70s), a characteristic of the somogyi effect but not of the dawn phenomenon. Regardless of what it is, it's still frustrating when your bgs have risen and you haven't eaten anything!

You're not quite reading the cholesterol numbers correctly. Everyone has a higher level of LDL than HDL. What doctors want from us is to have an LDL level at 100 mg/dl or lower and to have an HDL of at least 40 mg/dl. Yes, doctors are always on us to raise our HDL levels and lower our LDL levels. The reason is that doctors believe that HDL can help clear our arteries, whereas LDL clogs them. I've personally had my HDL levels in the 70s which is actually quite rare and as far as I know, doctors are unsure whether or not HDL levels that high are actually helpful or harmful.

I'm pretty happy with my numbers overall. Kidney function numbers look fine, and the vitamin D numbers came back in the normal range, too. Given I've had diabetes for nearly 21 years, I think I'm doing pretty well! :D