My A1c today was 6.6. I’m actually really disappointed in that. I’ve been going low a lot lately and haven’t been having many highs (I go slightly over 11 (200) only a handful of times a week for the past few months). I was really pretty sure it would be under 6.5. A 6.6 corresponds to an average blood sugar of 7.9 (143) which is much higher than the daily averages I’ve been achieving. I’ve been putting in SO much effort these past few months—logging everything, exercising more and eating better (and testing/bolusing more often when I eat out), spending time each day looking for patterns, adjusting pump settings every few days … My control has obviously improved (my last A1c three months ago was 7.1), but just not to the goal I’m aiming for yet. I’m beginning to think I will never manage to reach it. I’ve only gotten a 6.4 twice in the past 18 years …
I honestly don’t know how people manage to get in the low 6s or high 5s. I can’t imagine having much tighter control than I do now without being low half the day. Heck, the CDA recommends under 6.0 for people who can manage that safely. I don’t think there’s any reason I can’t manage that safely if I could just manage it at all! I think I might not be this disappointed if I’d achieved this A1c without all the lows … but I keep thinking of how once I eliminate the lows that A1c will probably go up a few notches.
My diabetes educator says that overnight BGs are the key to a great A1c because if you’re high during the night, you can stay that way for hours before bolusing to correct.
Two weeks ago, she suggested that I add a little insulin to my 3 - 5 am basal rate and my morning BGs are better.
My last A1c was 7.4 and I’ve only been this low once before. My plan to get under 7 by tackling the overnight numbers.
Hang in there! You’ve got lots of determination and courage, too, to keep plugging away at this tough one.
Night time levels are key. Before I was on lantus my sugars were wonderful during the day but at night it was brutal. This caused a really stupid A1C and the doctors told me that i was lying about my readings. Great numbers in the night will help you acheive your goal.
Hi Billy. When I switched from Lantus to the pump and was able to d deal with dawn phenomenon issues my A1c dropped from 7.9 to 6.7 in three months, JUST from controlling my overnight levels better.
I’ve gone on a CGMS for a week that shows my basal rates are pretty dead on and keep me almost perfectly flat. So until recently when I’ve started goin glow, if I went to bed at a good level I could wake up at a good level.
Last night I adjusted my overnight basal rates as per my endocrinologist’s suggestions. I went to bed at 4.6 and woke up at 4.7, and it’s the first night in over a week that I have not either gone low or dropped a lot overnight. So I hope this has fixed my overnight lows problem, and I can work on my daytime levels more easily.
Jennifer, have you tried bolusing earlier for meals? When I got my A1c down to 6.4 that was how I did it. I was high after eating for 2-3 hours. When I started bolusing 15-25 minutes before the meal (even waiting 45 minutes if I am high), I was able to reduce post-meal highs. You must be careful with this because if you wait too long, you will have horrible lows. Perhaps try bolusing without eating immediately and testing every 5 minutes to see when you blood sugar starts to drop. For me Humalog only starts to drop about 25 minutes after bolusing. So when I can, I wait 25 minutes before eating!
You can’t see my smile - it’s just a matter of perspective, I guess, because I’m still working so hard to get Eric below 8.0 that 6.6 sounds like HEAVEN to me!
Hi Elizabeth: I think controlling a toddler’s blood sugar is ENTIRELY different than controlling BG as an adult, even though they are both type 1. The two are not even comparable! There are so many minute things that I take into consideration now (emotions, how I’m feeling health-wise, that ten minute walk I took just now, what I’m planning on doing later today) that were impossible to account/adjust for as a kid. I was diagnosed at age 9 and my blood sugars as a kid were MUCH more erratic than they are now … I imagine it’s ten times worse for a toddler. I admire all parents who manage blood sugars of really young kids.
Jennifer, for me the biggest contributor to a good A1C is diet. Lower amounts of carbs = lower amounts of insulin = smaller mistakes = better A1C. However, the best intentions can go awry without the feedback from bg measurements. When I was pricking my fingers 12 times a day the best A1C I could achieve was in the high 5s. Any improvement beyond that would have been torture. Now I am using a DexCom 7+. My A1C has dropped to 5.2 while reducing the occurrence of lows at the same time. For the first time in my 36 years of D I feel in control. I encourage you to continue on your quest.
