This Saturday I am going to the lab to take my next A1C.
I am so afraid.
I know that I'm been doing my best about being diligent about my BG's (I can COUNT the number of highs I've had in three months on one hand. Give a take a finger from the second). I never miss any shots (I am the strange person who likes getting shots. I don't know why either). And I count out the carbs, or at least guess.
Yet I am still afraid that my number will comeback bad.
My A1C before the last was a 6.0. The previous one was a 6.8 (I know why it happened but it was a major bummer).
Sometimes I scream at myself when I see ANYTHING over 140. I try not to be too judgmental of myself but it is really hard.
I don't want any complications but sometimes I will bolus just so I can have a snickerdoodle cookie. And I keep wondering, "Oh my god did this just mess up my A1C?"
I just needed to say that.
Hey, Toddy, I'm sure it will be great! When I read the first sentence, "I know that I'm doing my best about being diligent about my BG's" I already felt you were being too hard on yourself because that right there is the best we can do! Then I read "I can count the number of highs I've had in three months on one hand..give or take a finger" Very few of us can even come close to that! Do you know how great that is? Me thinks you are waaaaay too hard on yourself. Regardless of the number you get, you are doing great and should pat yourself on your back immediately!
Toddy, no matter what your test results are, know that we've all been in the same boat and we're pulling for you. XOX
Sometimes, we just need to remind ourselves that it is just a number. A number. Not a grade, not a measure of your worth and certainly not a measure of your accomplishment. Just a number. No matter what you do, sometimes it will go up and sometimes it will go down. And after a great A1c of 6%, it probably will go up a tad. So give yourself some credit, you are doing great. And if it really bothers you then go give blood the day before and drink a lot of water before the test, then you will get an A1c of like 3.5%. See, just a number.
ah, i'm sure you'll do great. just curious where you got that 140 number? what do you consider a 'high'? did your endo, CDE or pump nurse tell you to correct over 140?
Sometimes I scream at myself when I see ANYTHING over 140
Many of us use 140 as the number we want to be under after meals, due to studies that show that significant time spent over 140 is when damage begins to happen. Others of us use 120 as a two hour pp goal.
For myself I do correct anything over 140, and if it is before eating I will add in a correction for anything over say about 125. However, as as a type 1 whose numbers are anything but perfect I don't "scream at anything over 140". I don't scream at myself for any number. I just correct it, learn from it and go on. However I have been known to scream at the D gremlins when I eat something innocuous I've eaten many times before and end up 200, or when I obviously had a site go bad during the night at wake up at 300!
I am donating blood tomorrow for the first time. I always though having D automatically excluded me from donating. But when I read a post here about another T1 who routinely donates blood I decided to go on the website and look at the eligibility requirements. I meet all the requirements and thankfully have never taken beef insulin from the UK. So I signed up for a blood drive tomorrow. I'm excited about doing it not because it could improve my A1C, but because I can possibly make a difference.
I don't think there's anything wrong with setting realistic goals for ourselves and feeling dissapointed when we do not achieve those goals. If you've worked heard enough to be able to realistically expect an A1C below 6, but your A1c does not come in below 6, you're going to feel how you're going to feel.
We've all been there and I know it would be disengenous for me to tell you to feel something different than what I feel everytime I do not achieve a goal. .
I think, however, that the real trick is to be as realistic in the level of dissapointment we feel as we are in the goals that we set and to avail ourselves of every opportunity for a "do over".
You didn't keep it below 140 this time. If you didn't feel disapointment, how much motivation are you going to have to re-evaluate either your goal or why you didn't achieve that goal? Reset, repeat, make adjustments, do over. The flip side to feeling dissapointment for not achieveing a goal is the satistaction you feel when you do achieve a goal. As diabetics, we have as many oppoortunities to feel a certain level of satisfaction as we do dissapointment.
Just keep it all realistic, both the highs and lows, whether they be BG readings or emotions.
And, beat yourself up over a snickerdoodle if it's undermining your goals. If it's not, enjoy!!
Yeah, I always get afraid of a postprandial BG of over 140 (which has happened a few times)simply because I'm always hearing horror stories about, "Oh, if you are over 140 then you are doing irreparable damage to your body!" And since I was diagnosed two and a half years ago I'm always worried about what Diabetes might be doing to my body.
Also, I think about the time I was DKA (When I was officially diagnosed and admitted to the ER at 444). Anytime I see a super high number (like two hundred) I get paranoid. My mind automatically transports me back to that HORRIBLE painful time. And I never want to go back to that again, EVER.
Yet, I know that even people who've lived with "D" much longer than I have are not always perfect.
Yeah, it is just a number. All I can do is my best and that is that.
Thanks guys. :0)
that's why i am asking, toddy. who told you, other then on Tudibates, that anything above 140 is bad and/or damage starts at above 140, as suggested ALWAYS on this site?
Sarah, I read that on another site called Blood Sugar 101. I actually read it right after I got out of the hospital two years ago. It literally put the fear of god into me and I am not religious.
Oh I've already read that one as well. :0)
The only proviso in all of the PP numbers and fasting numbers is the absence of hypoglycemic unawareness. Once you are labeled HU they completely change the rules for you. Instead of 6 strips a day you are allowed 12 or more, you want the G4 ? no problem and no co-pay. You want to be first in line for any new "cures", therapies, devices ? you are. But in the greater scheme of things, I can have the most amazing PP numbers and still get hit by a bus. So I live my life to the fullest every single day and attempt to thrive as best I can. Am I worrying or sweating out my next A1C ? not a chance it's only a number and unless Toddy is planning on getting pregnant ? or something I wouldn't drive myself to distraction with worry, life is just too short.
TRUE!
And I'm pretty certain I'm never going to pregnant. (lol)
I also strive for being under 140 mg/dl 2 hours after meals, but I am also human. I just looked, I was under 140 only 75% of the time after lunch, but I averaged 110-120 mg/dl. I have trouble with lunch but do better with dinner. And I am very strict, I only eat 50g carb or so per day and I bolus for every meal. And I have T2 and still have insulin production, so it should be easier. But it isn't. I just do the best I can. It is more important to me that I am diligent, that I do the right things to address blood sugar problems. The end result is what it is and various factors are just not under my control and I'm not going to beat myself up over them.
Yeah, interestingly, even though ADA doesn't have a recommendation for postprandial numbers according to this link, the 140 number comes directly from the ADA itself.
I've read through the studies on the Blood Sugar 101 site and none of the studies are actually designed to find out where damage begins. They all start with the premise that damage starts at 140 and then use that number as a general "over and under".
The 140 itself was taken as a guideline for all the studies listed because of the Oral Glucose Tolerance Test. For the OGTT, according to ADA guidelines, if you are at 140 2 hours post-ingestion, you are considered to have an impaired glucose tolerance.
I've looked up and down for the research that the OGTT guideline of 140 comes from and I just have not been able to find it.
So, bottom line? Yeah, shooting for 140 2 hours post-prandial can't hurt, and we certainly need something to shoot for. Be aware, though, that the studies haven't actually determined where that line is and, certainly, can't speak to where that line is for us as individuals since it is just an average of all the data gathered.
For individuals, it could be higher or lower and, like all research when it comes to humans, YMMV.
true the OGTT suggests diabetes if over 140 2 hrs ppl, these are the facts. so when people continually say damage begins at 140, there's no proof of this and I'd like to caution those who continually repeat this. It's recommended and we try to strive for 140 2 hrs. ppl (I certainly do) but there's no proof DAMAGE is occurring at that number. Aside from T1's on this website, and I have tight management, as much as I can over my D, the majority of the poplulation go above this number ever day and have no complications. Be weery of what's posted on the internet sometimes, ya know.
i actually believe it's the the highs and lows, drastic highs and lows - fluctuations (extremes and swings) which cause damange too, makes us feel awful, etc.., it's terrible on the microvascular system. bottom line, aim to keep numbers in check as best we can. we have type 1 diabetes, it's the nature of this beast.
also, remember T1 very young children, toddlers, even adolescents have fasting numbers at around 150 - 180 because it's too dangerous for them to run any lower...
Yeah, I did Shawnmarie, with particular attention paid to the section titled Postprandial Glucose Target because that's where they reiterate that the desired target should be 140 mg/dl.
Therefore, the consensus panel recommends a treatment-targeted 2-hour postprandial blood glucose level of <140 mg/dL.
The previous sentence lists two studies to support the idea that in people who do not have diabetes, BG levels fall to below 140 mg/dl by 2 hours postmeal.
In subjects without diabetes, blood glucose levels typically peak approximately 1 hour after the start of a meal and return to preprandial levels within 2 to 3 hours; 2-hour postprandial blood glucose
levels rarely exceed 140 mg/dL (39,40).
Here are the 2 studies referenced:
39: American Diabetes Association. Postprandial blood glucose. Diabetes Care. 2001;24:775-778.
Here's a link to that paper:
http://care.diabetesjournals.org/content/24/4/775.full
I've read that paper page for page and I, again, find mention of 140 mg/dl post prandial, but no studies in support. Maybe I just missed it in the references of that paper?
And
40: Polonsky KS, Given BD, Hirsch LJ, et al. Abnormal
patterns of insulin secretion in non-insulin-dependent
diabetes mellitus. N Engl J Med. 1988;318:1231-1239.
Here's the link:
http://www.nejm.org/doi/full/10.1056/NEJM198805123181903
This was a study conducted on 16 individuals and 14 controls. Again, I can't find reference to the 140 mg/dl marker or the studies that show anything regarding 140 mg/dl.
Maybe I'm just plain missing what I'm supposed to be looking for but I just can't find any studies that demonstrate how they determined that 140 mg/dl is what normal people will be at 2 hours postprandial or that damage actually begins at that point. It's been a few years since I've had to do some serious research through the primary literature.
Just for sake of completeness sake, though, I looked up some of the other studies in that section. I looked for others that might have reference to 140 mg/dl.
For the most part, they, again, reference individuals who undergo the OGTT test and fall in the category of Impaired Glucose Tolerance (Post-prandial numbers above 140 mg/dl).
Yes, indeed, people with IGT (with post-prandial numbers above 140 mg/dl)have a whole laundry list of problems and complications associated with diabetes.
In short, I think there is ample evidence in the literature supporting the idea that post-prandial BG is important and that we are, probably, better in the long run if we shoot for levels below 140 mg/dl 2 hours after a meal.
Splitting hairs though, the research does not show that "damage begins at 140 mg/dl." Like I said, given what we already know about variability in humans, that number is also going to vary from individual to individual.
Very true.
My goal, in all honesty, is to be somewhere between a 6 and 7. But sometimes, admittedly, I do get down on myself when I see various people constantly talk about having nearly perfect control. Then I start comparing myself and yada, yada, yada...Winding up being nervous about A1C's.
Anyway, I can't expect to have a normal pancreas (if I did I would not be on this forum). So all I can do is come as close to one as possible. With that said, so far, my best has been enough.