Unexpected A1c---Good---Why?

Community Share Your Stories
1

Do not like selecting a narrow category for this. TuD folks from just about all those categories have helped me in one way or another since 2007 or so…But…

I am a T2 not on meds yet, controlling so far since 2007 with diet and exercise only. So that may sound inappropriate for your attention, but I’m here to tell you that when things are difficult or even in crisis, Nobody in the medical field knows what the hell to do with me or this “category” of diabetic…

When I was in the hospital for a total knee replacement having a horrible time following Their schedule for recovery due to inability to keep food down and cognitive difficulties due to Fibromyalgia (it mimics low blood sugar, but isn’t), everyone panicked when I had a 69…That is not low for me, though I know it is for so many of you. I was thrilled that it wasn’t 400 in such painful, disturbing circumstances. They had no idea what to do. I needed a big protein hit with minimal carbs. Nowhere to be found. So I gave in and had 1 tsp of regular peanut butter (yup–with sugar, of course) and my bs spiked to 200. Okay they said, relieved, let’s give her some insulin…

I just find this unacceptable behavior, especially in the hospital. And I have read all your horror stories of incompetent treatment in such situations. I just thought it might be interesting to hear a related story from someone who doesn’t have the med worries that you do…

We all suffer from ignorance in the medical community…

But what I am exploring and could use some input on, is my new today A1c of 5.4. I had a horrible summer with physical pain, nasty emotional upheavals and the resultant scary numbers–especially fasting ones—one of the curiosities—they would come down over the day with obsessive attention to exercise and carbs. The heat was oppressive, causing all kinds of edema (in spite of a small dose of daily diuretic) in hands and knees—ankles okay, amazingly.

In the last few weeks, as temperatures dropped, so did my fasting # and so on for the day. I seem to recall posts on the old platform about a critical last 30 days before getting an A1c–that those days have more impact. Does anyone have a memory of those?

I have been chatting back and forth with Tamra about the nature of heatstroke, because I also experienced these out-of-the-blue, day-long episodes of nausea, even though I drink a lot of cold herbal tea and water…

But this is getting much too long. Longer term, I would like to advance the education of dealing with T2s not on meds yet…That’s the overall drive behind this post…

Oh–sorry–my A1c dropped from 5.6 to 5.4 and I have no idea why. I have never wavered off my lo-carb eating and as much as I hurt these days, I always get in 50-90 minutes of purposeful movement, though often very gentle now—but that’s been true for roughly 7 years…Blessings. Sorry to be long-winded, but that’s how I do life…Blessings…

2

Your description of the hospital is unfortunately a common experience.

A 5.6 to 5.4 can in Hba1c could just be a lab variation. It is a decent number, considering your are working so hard to keep your numbers reasonable. The drop in your fasting levels with the cooler weather is probably a contributor. If fasting numbers can be kept down, it tends to skew things downwards (and the last 30 days are more heavily weighted than the previous 60).

I am adult onset type 1 of about 7 years duration, and I really do not envy your position. IF you go high you can pray, walk, drink lots of water, and wait. I just get to use bolus insulin to adjust if I need to. And basal to keep things pretty flat in between.

What you are doing is about all you can do; the flow carb and exercise. However, if this all becomes too hard, maybe you can ask your dr to let you try an insulin sensitisers such as metformin, or start with a fast acting insulin so that you have a means to address the highs when they come.

2 Likes
3

Is your answer as to what you did! Great work @Judith_in_Portland

Seems to be your answer! The last time I had a hypo that required assistance (2011…long story…user error LOL…), I went to the ER and had my CGM firing away and could see my BG was like 200 from the IV Dextrose from the EMTs/ OJ MrsAcidRock poured down my hatch (when I wasn’t spitting it all over the place…) so I was like "nah, I’m not gonna drink the seriously big gulp of OJ the doc “prescribed”. Yuck. They also provided a chicken salad sandwich and potato chips. Pass on chicken salad as I’ve never been a fan. I ate the chips as I’m unable to resist them but I discretely bolused which probably would have annoyed them too…

2 Likes
4

I place limited faith in the accuracy of the HbA1c. The national standardization program certifies labs to be accurate to +/- 6%. If your HbA1c was actually say 5.5% that means you could get a lab result of anything between 5.2-5.8% and it would still be considered perfectly accurate. I think we often read too much into our numbers.

And I really like your idea about having more discussion and education for those of us managing our diabetes without meds. Personally I think you are doing great. Our true measure of ourselves is how we overcome adversity and doing that with diabetes makes us heroes.

2 Likes
5

I wouldn’t worry too much about that small move in your A1c. I’ve come to learn that the A1c is a much coarser number than I at first thought. It makes an assumption about the longevity of red blood cells. If your red blood cell life varies from that assumption, the number will be off. Anemia will also throw off the A1c. My A1c should be 5.4%, as predicted by my cgm and meter. I clock in at 6.0%.

6

By the way, I’m moving to Portland next year. It’d be nice to meet!

2 Likes
7

will you still be living aboard?

1 Like
8

No, I’m selling the boat and buying an RV. I will be fulltime on my land-yacht with some interim time in Portland, Oregon.

2 Likes
9

Wait! There’s no place for your boat in Portland!!

10

Portland, OR is a seaport and I could liveaboard my boat but I’m changing lifestyle gears. I want to tour t
the beauty in North America.

1 Like
11

Cool! I have also changed my boating gears for touring the beauty of North America. Plans to come on an adventure starting in …

Portland, OR

1 Like
12

Portland will welcome you–asea, or, well, “ariver”, more accurately, though we are indeed a port with the ocean ships coming into Astoria and getting here via the Columbia and the Willamette. You’ll need a pronunciation tutorial…it’s Orygun, for instance, but you kind of swallow the “y”. And WillAmette, with a short “a”…Hehe…

If you haven’t seen a story about the River pilots that go onboard ocean vessels and navigate them through the that mighty Columbia to Portland, it’s a great story…

I was a TuD Ambassador for PDX back in the day and arranged several meet-ups in various parts of town. I’ve stayed in touch with Rick Joe Cook over the years—Portland’s (and TuD’s) very own Blind Chef. It’s hard for me to get out now, but let’s stay in touch! Mountain, Sea or fertile green valley, Oregon has more beautiful places to visit than you could in a lifetime and we’d love to recommend some when the time comes!..Blessings to you @Terry4…Judith

13

Thanks @acidrock23!..So many of us have awful hospital stories, don’t we. I just hadn’t put the pieces together that they would find an unthought-of variation just for me…LOL…

1 Like
14

See below (or wherever, hehe, I still mess up where I put my replies sometimes), @YogaO in my response to @Terry4----stay in touch and I’ll do a tutorial for you both on whimsical pronunciations and important colloquial identities like the “Keep Portland Weird” bumper stickers that do battle with those declaring “Keep Portland Beered.” I moved here in 1976 from Minnesota to dance with a National Dance Touring Company and was only going to stay 2 years! I still love it…Blessings…Judith

15

@Terry4 and @YogaO: Here is some imagery to inspire you about Oregon! And info on the amazing River Pilots:

https://www.google.com/search?q=Oregon+may+have+the+most+stunning+places+of+the+50+states&biw=1202&bih=615&tbm=isch&tbo=u&source=univ&sa=X&ved=0CCQQsARqFQoTCNO2yZjejsgCFRBLiAodqWECWQ&dpr=1