Ever since I stared on the CGM in 2009 I wanted to improve my BG control without risking more hypos. I read about PWD on this site that were able to push A1c’s below 6%. I wanted to do that too, but I did not want to achieve that number with long and frequent excursions into the 50’s and 40’s.
I know that A1c is just a number and as measurements go, a flawed one at that. It has taken on more importance than it deserves but it’s still viewed as the best shorthand way of communicating the quality of BG control.
Three years ago I asked my endo if he would support me in my quest to reach a sub-6% A1c safely. He wasn’t interested in the least. He looked at me as if I were crazy. I know what he was thinking. He didn’t believe that someone like me could do this safely. And he sure wasn’t going to compromise his legal exposure. I lost a lot of respect for him that day. He’s now my former endo.
I had blood dawn last Friday and received the results today. My A1c came in at 5.9%. I know it’s just a number but see it as evidence of all the work that I have put in during this last year to better control my BG’s. I’ll add that I was able to do this without any severe hypos and my mild hypos were not very frequent or long.
I hesitated to share this here because I didn’t want to discourage others. I hope that people can learn from my experience that trying to make things better is what matters most. And if I can’t celebrate here, what other community really understands? With my friends and family it will simply go in one ear and out the other.
Today is a good day. I think my dog was wondering what the heck was going on as I was hootin’ and hollerin’ when I read the news!
There is nothing wrong with a little bragging either. I think you have earned the right. Congrats on your accomplishment. Now lets all celebrate. I love a good party especially when it's for the right reasons.
Thank-you, Stemwinder. It feels good to get feedback from people who really understand. It makes me wish I could celebrate like my pre-diabetes days, with some decadent food and drink! That doesn’t tempt me too much, once I consider the metabolic hangover.
This is an outstanding accomplishment! Not everyone appreciates that you have had D for more then 25 years. We always hear this stuff, you can't achieve tight blood sugar control because it will place you at risk. I know your dog to help, but achieving this without severe hypos is a real inspiration. Thank you for sharing.
Congratulations! Please let us know what changes you made to achieve the improvement, and if it had to do with changing diet to a really low carb intake. Have you always been a type 1?
My biggest breakthrough came with adopting a low carb diet. I limit carbs to 50-70 grams per day. I did this because of a diabetes complication diagnosis one year ago. I was aware of people using low-carb but resisted making the change until I received that diagnosis.
I also learned from this site about insulin dosing for fats and proteins. That change in insulin dosing and adopting low carb allowed me to enjoy many hours of relatively flat BG’s each day.
I also started walking 40-60 minutes every day.
Things are not perfect and I still must stay vigilant about my BG’s but I’ve never had such good control before.
Brian - I’ve always found your contributions here interesting and informative.
I download my CGM several times per week and I’ve monitored the standard deviation number as an indicator of BG variability. Prior to my low carb diet, my SD was in the mid-50’s. Now it’s around 32. Thanks for the comment.
Nice job Terry! That's a great accomplishment to be proud of! Enjoy whatever you do to celebrate! Tattoos, tequila, tranquility, watching some basketball!!
AR - Thank you. I’ve always enjoyed your comments here. I know that while your methods for BG control are different that mine, you’ve done a great job with superior results, especially your use of an aggressive exercise routine. And you don’t let diabetes hold you back from enjoying a wide range of food!
good job, the thing is, i'm not sure it really matters to our bodies if it's 5.9 or 6.1, i just don't. but, if that was your goal then CONGRATS! especially with no bad hypos. we think even mild hypos don't affect us but they really can, remember hypos are caused by too much analog insulin which effects our brain cells and every part of our bodies, even continued mild hypos. my endo told me he has a type 1 who just also strives for lower blood sugars, mild hypos all the time. he longer feels hypos and when he gets low, not even dangerously low, it takes his brain cells so long to fire and come back, he often has to be hospitalized for 24 hours because he's so out of it. safety is what matters. i just don't think it matters that much in terms of our bodies reactions to a .__% in a lower A1C.
Sarah - You make a good point. I don’t know that there’s an appreciable difference between 6.1% and 5.9%. If I had to choose between the two without severe hypos with either, of course I’d choose the lower number. As I said at the top, the A1c is an imperfect measure. But it’s a milestone just the same, much like all the hoopla and celebration as we moved from 1999 to 2000.
My understanding of hypo-unawareness is that it’s caused by frequent hypos that exceed the mild ones. I’ve lived with this disease a long time and have gotten to know a few endocrinologists. To a person, they would much rather have a patient with BG’s north of 150 or 200 than one who experiences hypoglycemia.
In fact, I think that they give up on the idea of doing what I and others on this site have done: reduced average BG’s, reduced BG variability, and held to a minimum the depth and frequency of hypos. I believe that they have sold us short. With the right tools, training and persistence, we do not have to accept a mediocre standard.
I actually take more pride in lowering my standard deviation from the mid 50’s to the low 30’s during the last year than I do in moving past an even number A1c. That’s the real reason that I’ve had fewer and less deep hypos.
The docs don’t have to live with the consequences of continuously elevated BG’s; we do. We each have our own path to choose and I like the one I’m on. Who knows at what exact A1c level each of us may fall to diabetes complication. That’s a complicated thing that science has not revealed to us. All I know is that every inch closer to normal is better. If I can do that without undue hypo risk, I’m going there!
Thank you for raising this issue. I appreciate your comment.
my endo encourages a lower A1C and wants me correcting at 140...but he also doesn't want me having hypos all over the place either. they also see the effects of severe hypoglycemia and are typically the first to be called if their patient has a seizure, a severe accident, passes out and all the other stuff. no fun, i would imagine, on their end either. i don't believe my endo wants to see complications for me or his patients, just sensibility and to have the realization of how truly powerful analog insulin is. but we have type 1 diabetes, this isn't easy stuff, we just kind of have to figure this out as we go along and there are many patients out there who are very challenged by this, even the 'math' part..mistakes are made, we all make them, for someone who takes insulin and not fully capable (but has no choice) those mistakes can be very dangerous...so of course, they, those endos, side with caution. this is a 24 hour job we undertake everyday...not all are capable of taking this profession on, ya know.
Your brain is a big part of your body and, if your brain perceives a difference between 6.1 and 5.9, that's where it matters.
I don't like the notion of the "horror story" that Sarah's endo is tossing around. I can say that I have less interesting hypo symptoms than I used to have but I can still cultivate awareness of my BG. I can feel 70s and I can feel 150s and that's pretty useful for me. Doctors like to talk because they get paid tons of money to do it.
I also think that where it matters is to successfully tame a dangerous disease and do something that many people, including many doctors, say is too difficult, too dangerous, too disruptive, noncompliant, not safe, etc. at a level (and, from Terry's original post, he's doing it the right way, tracking SD, being conscious of lows, not passing out naked and spitting cranberry juice all over the place...) that he sounds very powerful at.........
it wasn't a horror story at all, he's totally supportive of a lower a1c, in fact he encourages it and has never tried to talk me out of it, but it was just a fact. i had a really bad low, felt pretty messed up for a while and talked to him about it, that's when he shared his experience. actually, i don't think endos like to talk all that much, my experience has been they're kind of nerdy scientific, data, kinda math driven people. my endo likes to 'draw' pictures..ha!
people who share stories on here seem dedicated to their management of type 1, it seems. this is not the majority of the diabetes population. i was at the eye doctor last week, the assistant was a type 2, she noticed I had diabetes. she was telling me her numbers run between 200 - 300, that's her range and she knows better. I'm thinkin'..OMG, i'd be so sick or dead throwing ketones everywhere. She doesn't even throw ketones. So, sometimes endos just try to do what they can do.
