Endos are so focused on A1C that they miss the forest for the trees. Now that it is relatively easy to maintain A1C in the 5-6% range, patients live longer; however, invariably, they die early to cardiac events. Endos take a cursory high-level look at Cholesterol, but it is all about the apoB. When diabetics start controlling their apoB, they will stabilize their CAC scores and add many years of life before succumbing to a cardiac event.
Well done. Ignore your Endo.
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I totally agree with @Frantastic’s direct brevity.
I also agree with the many comments that observe endo judgement of overall glucose management based on A1c alone is short-sighted, lazy, and ignorant. It indicates a lack of respect for the hundreds of thousands of hours of lived experience of diabetics.
Since you use a CGM, I highly encourage that in addition to TIR and time spent low, you should focus on your glucose variability. The less your BG swings, the safer you will be as you minimize the metabolic mayhem.
I think choosing your customized, within reason, limits for TIR should be your and not some standardized range endorsed by officious doctor organizations. If you improve your management and reduce glucose variability, there’s nothing wrong with squeezing the overly easy (for some!) limits of 70-180. I use 65-120 effectively as it helps me to identify inevitable ongoing adjustments I need to make.
There are no perfect settings, just better.
You don’t need any doctor’s stamp of approval on your management practices. A good doctor is willing to assume the role of important assistant who respects your role of primary manager of your metabolism. S/he should seek to educate, not dominate! Only you have an essential stake in the consequences.
It took me years of effort to bring my current endo into philosophical alignment with my glucose management. I show up every 90 days with all the evidence, CGM data, that supports my management style. Over several years’ time, my endo was smart enough to see that my practices were rational and safe. And they do not permit dangerous-to-health hyperglycemia that may relieve a doctor’s tension but at the expense of your long term health.
In short, well done; ignore your endo!
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Continued lows not only cause cardiac problems. As in my case it also can cause kidney problems
Thank you for clarifying that expression, it always puzzled me how old expressions stick around even in the age of advance tech when we don’t deal with horses anymore unless you are rich and love horses!
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Even if that were the case, what are the chances someone is going to actually Give me a horse.
I think we can just eliminate this idiomatic expression from our collective vernacular.
But while we are at it. Why is it that we park on the driveway, and we drive on the parkway?
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Wow I did not know it was possible to get that low.
I’ve been 11.5 for 3 years and I was down 8.5 now that I have lost weight it is creeping back up. I’ve totally changed my eating habits to get the weight off so that I can get off shots and pills and it has gone up to 9.1 after all the hard work I’ve done I’m now being put on the pump. I think 5.9 is beautiful.
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For the same reason, we recite in a play but play in a recital.
@zander , there is a Facebook group where some of the members have hacked the algorithm of Tandem CIQ and have A1Cs closer to 5.0 (5.1-5.4) I am a 25 year pumper. 5 on CIQ. If you want, there are groups that can share the inner workings of the Tandem algorithm.
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