I strongly believe all people with diabetes deserve normal BG levels. It angers me that the standards are lowered for us. For many years I was in the low 6 and was praised by my doctors, yet I kept developing more and more complications and after decades of T1 also needed more and more insulin so I became more insulin resistant over time.
Luckily after a few years of keeping a much tighter control and A1c under 5, I was able to reverse some complications, and stop the progression of others.
Your average BG corresponds well with the center of the A1c scale. Your attention and discipline are impressive. Do you compare your meter with the lab from time to time?
You’ve illustrated Bernstein’s philosophy well. His methods work. But I’m also impressed with many here like @Sam19, @truenorth, @borijess and others who show what is possible with this blasted disease!
I’ve been eating very low carb for the past year and a bit and have yet to get an A1c below the low 6% range. My A1c does correspond well to the chart you posted (according to my Dexcom). At times I get very burned out eating this way, since it’s harder for me having to avoid many low carb foods due to allergies, not being able to eat many processed foods (which there are more and more of for low carb folks), and not being able to eat out often. Yet I continue because I do feel for weight loss it’s the best way to eat, and also because although it doesn’t stop the spikes and drops it does make them more manageable. It would be nice to find whatever secret formula others use to keep such spectacular control, though (time in range, standard deviation, average/A1c). I will keep plugging away. I haven’t found it after nearly 27 years, but hopefully sometime in the next 27 years I will, or if not then the 27 years after that, by which point I’ll have lived to 90 and accomplished my goal regardless.
When I read your comment last night, I knew I would respond but needed time to think about it. It forces me to accept something that I often resist. Life is not fair, it never has been nor will be.
It was never fair that any of us must live with diabetes. It was not our choice and we can choose to be angry, ignore its needs, or just try to do the best we can. You observe that your diabetes is harder than many of us. I think you are right and makes me feel helpless when I want to help. I just don’t know how.
I’ve been blessed with a metabolism that responds to low carb eating and I don’t have any food allergies. My efforts produce measurable improvements. It bolsters my deepest wish that the world will reward hard work with accomplishment and success. Yet I know that’s not always true – life is just not fair.
I believe in meritocracy but cases like yours force me to face the fact that the truth of my diabetes life is a truth, not the truth.
I watched your struggle over the years and wish to support your efforts. It disturbs me how little concrete help I can give. Your struggle and your successes have inspired me. Your persistence and tenacity impress me.
The common measures we use, like A1c and time in range, do have a dark side. They can act as markers for success but can also mock and discourage. Please understand that they are not cited with intention to harm! Thank you for reminding me of a truth larger than my experience.
Mila, I would like to point out a very large discrepancy between self-reported A1C’s in your tudiabetes poll, and the distribution of A1C’s among the broad T1 population as reported on t1dexchange.org.
I know that not all tudiabetes contributors are T1’s. But hear me out anyway because the discrepancy between the tudiabetes population and the broad collection of T1’s is very large and this discrepancy is important to how we phrase our discussions and get folks to participate online.
Below are the bins and Tudiabetes results in July 2018, vs t1dexchange.org 2016-2017 latest A1C distributions:
My conclusion is that tudiabetes members who chose to participate in your poll, are an extremely self-selected group of the best-controlled diabetics, and not actually reflective of the broad population of diabetics in the real world. I have participated in tudiabetes for many years now, and participated in online discussion boards like misc.health.diabetes 25+ years ago as well. This self-selection bias, where only the best controlled are feeling welcome to participate in the online discussions, has always been there. But it’s possible that your poll shows this self-selection, is getting worse over time. The incredibly large discrepancies in the 4.0-5.0, and 10+, bins, shows that we are mostly just hyping our own successes and not really including the experiences of those who struggle the most.
I have struggled with my HbA1c in the past, and if it was over 10 right now, I probably wouldn’t have answered this poll. Quite frankly, seeing these results makes me feel bad for the decade I couldn’t get in control. If I was still out of control, I would probably leave this site because I would be afraid no one would or could understand why I was having such trouble. But I also needed a lot more help (particularly mental and emotional support) when I was in that situation so it’s a two edged sword where you know you need help, but you’re terrified of being judged, even by other, healthier diabetics. I don’t like talking about my decade of being over 10 because I’m embarrassed, but if you’re in that situation, know that you’re not the first and there are people who can help without judging.
Yes. I’ve done so in the past, using both blood from my fingertips and venous blood. I did it with 2 meters. I currently use mainly Contour Next One and Accu-Chek Aviva meters. In the past I used OneTouch Ultra Mini and found that it read a bit higher than the lab and the average A1c would correspond to which is a bit scary to think of.
I think my approach to managing is like an ongoing science experiment and I know there are many here with a similar approach to me, I think the way I eat just makes it a bit easier on me as it eliminates variabilities and is keeping me safer with smaller doses.
Of course if others here manage differently and get results that they are happy with and a good quality of life then that is all that matters I think. Also, this isn’t a competition.
I read recently that only 8.7% of diabetics have an HbA1c of 6.5 or less so it shows what a remarkable group we are here.
Since getting CGM I have dropped from 6.5 to 6.0 so in the poll I put myself in the 5.0-6.0 group.
I am so perplexed about why so many T 1’s and in particular clinicians are ignorant about CGM. It has totally changed my attitude to my diabetes putting me in charge for the first time in 40 years.
Because of this I have created a website to tell people about it and how to get both the regulated and unregulated versions with costs that apply to here in the UK. Costs that starts with a one off payment of £165 available to just a few to the eversence at over £5000.
Had blood work drawn Thursday and got call from endo’s office this morning (not unexpected). "Your latest A1C was only 4.7 and the doctor is concerned you’re at high risk for hypos or worse"
Why is it that with today’s improved tech, everything from better meters, better analog insulins, to pumps & CGM’s, and after a lifetime of trying to lower our sugars to avoid serious complications, when we T1D’s actually achieve non-diabetic A1C’s, the doctors tell us to back off?
I know, it makes no sense! Whenever my doctor starts to go down that path, I point to the mountain of data that my CGM provides and show them that my time with “serious, clinically significant” hypos (< 54 mg/dL or 3.0 mmol/L) is often in the 0.2% range.
The other statistic to use in your favor is blood glucose variability as measured by standard deviation. I suspect yours is less than 25 mg/dL (1.4 mmol/L). Your A1c reflects an average of about 88 mg/dL or 4.9 mmol/L. The lower your variability, the more capable you are of maintaining a low average glucose without the threat of inordinate hypos.
Doctors are hyper-phobic about hypo-glycemia. It’s a value written somewhere in their DNA. They are usually right about this caution for most patients but their warnings become reflexive and they don’t appreciate that a low A1c can be accomplished without too much hypoglycemia risk.