It’s a tricky balance and each patient is different. What really bothers me with my doctors over the years is that they didn’t expect much from me. And when I started to have problems and my A1c rose to 8.5%, they didn’t offer me any practical advice to turn things around.
All of my gains have been from sites like this and other T1D’s that have learned things from trial and error and passed them on. I really wish that I had a professional team including and endocrinologist, Certified Diabetes Educator, dietitian, and nurse that would coalesce around my needs and really help me. But that’s a pipe dream that our modern medical system in the US can not deliver.
I’m thrilled that I live at this point in time and I have access to this great communication tool. My health would definitely be worse off without the Internet and sites like TuD.
I think too that with the constant urging for "caution", doctors remove any possibility of "excellence" from our equation. There's bunches of people who do as well at this as I have done but the majority of us are struggling, if TuAnalyze is any indicator. I refuse to think that's because "we" are not talented but, if you are aiming at 140ish BG levels and hit an A1C of 6.9/7.0, that's pretty darn good and, perhaps moving the target a bit might get you a different result? I could get a team if I wanted to but, mostly use my doc for rx support. I had a few key points (schwerpunkten...) over the years and the docs I've had very very useful in them but it was me and my meter and thinking about what to do with the gizmos that got me where I am. I don't get why doctors don't give it a whirl.
well, that's a shame. a 8.5% is too high so that's disappointing to hear they weren't offering any support. my endo would have said, "that's TOO high" by anyone's standards, that's why we're supposed to have A1C checks every 3 months. i agree, TuD is a fantastic tool, it's interaction with other type 1's...absolutely, it's the best tool we could have, honestly.
I’m sure it’d be hard for me if I was an endo and faced non-compliant patients all day. What bothers me is when someone like me comes to the office, someone over-compliant (test 15 times per day for years), if anything, that the doctor would appreciate that and maybe explore some tighter management techniques. I feel like I’m just another diabetic unit the s/he processes through the mill in the 15 minute allotment, writes a few Rx’s and sets up another appointment for three months later.
Yeah, I’ve been getting A1c’s every three months for 29 years. I didn’t start to feel anxious until my A1c crossed 7.5%. I was alarmed and filled with questions at every appointment, trying to understand what was going on. This was not a sudden event; it took place over about three years. I thought I might have cancer or a serious gall bladder infection or an infected appendix. I had spent almost my entire diabetic career with A1c’s in the 6% range.
Looking back, I can see what happened. I had gained 20 pounds over 10 years and became insulin resistant. Once I went on a lowered carb diet, I regained much better control with half as much insulin. I also started walking every day and that helped a lot. I lost 20 pounds last year. But none of the actions I took was suggested by a doctor. And I saw three different endos during this time, one at a prestigious university diabetes center.
Congrats on meeting your goal Terry! And get your dog a treat you probably scared him.
I agree that A1C is a flawed number, but I also feel that it defines us. The first quetion any medical team asks you is what is your A1C? Then they draw conclusions based on whatever number you say. Everything else is just excuses. You could have dropped your A1C 2% and be working very hard or faced a a bad case of poison ivy and a strong steroid treatment raised it dramatically.
Capin - Thank-you. The A1c number is but one facet of a multi-faceted truth. I sometimes wonder if medical team analysis stops once it knows it. There’s so much more to glycemic control. As you point out, we are real living human beings trying to live our lives as best we can. Unfortunately, I think there are too few medical practitioners that combine understanding, empathy, and insight to help us. Managing BG’s is complicated, difficult, and often leaves PWD feeling isolated, cut off from substantive ideas and tactics that recognize each of our unique circumstances. And most endos try to address this data heavy complicated reality with 15 minute appointments 4 times per year!
Yeeeeehaaaw, Terry! It's so incredibly rewarding to attain a goal ... eleventy billion congrats!
I am learning so much about my T1 on this site and in just this thread: hypos are really quite bad. I just worried about going high for the last several years and treated my lows as a sweaty, confused inconvenience. Thanks to you and others who are opening my eyes to the hidden consequences of lows.
And eleventy thanks to you, Ren! Lows are definitely the bad guys. In addition to the threat to our safety, lows accompanied by all the extra carbs (useless for overall nutrition) we ingest to treat them give us the added effect of gaining weight.
I'm aiming for the same goal too....my last A1C was 6.1, so not far away...my endo is supportive of my goal to aim for 5.9, but she wants it done by clipping the peaks rather than too many lows. We also discussed, as mentioned above, that in the region of 5.9-6.1 you are in the relatively flat portion of the A1c vs complication rate curve so small deltas here make less of a difference.
I am currrently eating around 140 g of carb a day, I may try to go lower as you have to help reduce the standard deviation.
Amen, Terry. 1% of what I know about managing diabetes, I got from the medical profession. The other 99% came from self study and the people in THIS community.
I wonder if doctors are even aware of this sentiment. If they were, would they care? I think they could really up their game if they took to heart some of the sentiments expressed by this community. I also think we could benefit from some of their perspectives if they ever took the time to really talk with us. DNS, thanks for the comment.
Thank you. In a conversation with Gary Scheiner, he also expressed the idea that small changes in A1c around 6% do not carry with them significant complication reduction. I’ve never seen the source of this info. Have you?
I always remain skeptical about those type of claims because I’ve seen too often that with the passage of time, understanding changes. All I really know is that closer to normal is better provided I can keep the hypo monkey off my back.
