We have the same name, have a t1d endocrinologist, and my first a1c was 7.2% we have entered the twilight zone lol.
But anyway I have a 6% without hypos, I'm really content with that,I'm stickin' to my usual stuff and sticking to that treatment as long as I can. I consider myself to be with good control, tight enough for me and I feel best now than before and I don't think I'd wanna really risk going much lower because it'd probably mean giving myself hypos. I think my endo thinks the same thing. I'm pretty sure in your case it's just a billing code, don't beat yourself up over your a1c. In general: don't beat yourself up over your a1c. It's not a punishment thing if you're too high or have a really low one and lots of hypos it means you need to work on your treatment but it's probably nothing you did.
that's OK, you're more than welcome to take offense. you said you have NO hypo awareness, need a medical notification from your endo to ensure you get pump, CGM, supplies because of this, etc...it's just common sense. just because you haven't doesn't mean you won't. no diabetic, IMO and probably a ton of others, should try for a 4% A1C with hypo unawareness. maybe if you didn't try to get your blood sugars SO low, unsafe for Type 1's, you'd have your hypo awareness back, that's the recommended solution.
That's what I thought too, 'meee'. I have never been checked uncontrolled except when first diagnosed, of course. I've never gone lower then 6.3 for A1C but never higher then 6.5 either. I have both highs and lows, of course.
The doctor relationship is a complicated one. As diabetics, we have lots of needs. We want encouragement and praise, if warranted. We want good advice that works and we sure as heck would like the doc to fix our diabetes!
The doctor can't fix us and besides, s/he has their own checklist of things that they need to punch to satisfy their sense of duty.
We often see the person in the white lab coat as a kindly gentle presence that can soothe our medical discomfort. While doctors can do a lot and we expect much of them, they can't fulfill our fantasy expectations.
I feel like Dorothy in the Wizard of Oz when Toto pulls back the curtain to expose the Oz sham. Doctors are just human beings with a few letters after their names. They can't fix us! Only we can do that, or at least slow down the inevitable toll that time takes on all of us.
We and fate are the two most potent forces with regard to our medical health. We must take full responsibility for our health, learn and act on facts, and accept the reality of our situation. Doctors are useful counselors but should not be elevated to a position of more importance than is justified. I do not need my doctor's praise, respect, or even understanding. Those would all be nice but not every doctor is capable of delivering all that.
As long as the doctor is ready with requested Rx's and can refer me to other specialists from time to time, that's good enough.
well, isn't it the role of a doctor to indeed 'fix us'. maybe not type 1 diabetics per say (we're 'unfixable..ha!), but a cancer patient goes to an oncologist to try and fix him/her - hopefully to get rid of the nasty cancer. you go to a doc w/a bad heart, broken leg, an infection, whatever to be fixed. that said doctor with those added letters after his/her name are indeed supposed to provide medical assistance. many of us who were DKA when diagnosed were absolutely fixed from DKA and saved by said endo and emergency team who helped us back to life. I don't expect anything more from my DTeam then what they're supposed to do, their job(s), recommended insulin levels, guidance, pump start - guidance. support..it's a partnership. Like most of us, I had NO idea about type 1 when Dx. Hadn't a clue about shots, insulins, meters, blah, blah, blah, it was my endo who drove the bus, not I, I was hopeless and helpless to them all.
makes sense to me Sarah.. and I think when people talk about low a1c and hypo dangers they need to remember that a high a1c isn't a guarantee of no hypos. Some people fluctuate no matter what their a1c is and are very insulin sensitive/exercise sensitive at times. I've had hypos when I had no fast acting for hours too, and even though I have backed off corrections quite a bit I still get quite a few hypos. I had lows and highs at all my a1c.
Kristi, I agree you should run higher if you're becoming less hypo aware and you think you're having worse hypos… I have a snack before I sleep most of the time now and if i don't eat a meal I do eat a some snacks and candy with no bolus at times too when I'm more active.
I concede your point about doctors "fixing" us during a crisis like DKA. The context of my upthread comment is about the ongoing relationship most of us experience with our doctors in the setting of treating a chronic disease like diabetes.
My point was that we, as long-term diabetics, may have unreasonable expectations of our doctors. I'll grant you that a doctor or nurse or CDE may provide much-needed support and advice for newly diagnosed diabetics. I see that value. There's a time and place for close supervision and guidance. It's a different relationship once a few decades roll by.
Jennifer, I've been told that too. That my expectations of type 1 are not realistic and I too am a perfectionist (hey, T1 just took a hold of all of us, who says we have the 'right' personality for this stupid disease, whatever that is?) Sometimes I think I'm influenced by some of these T1 websites where type 1's seem to never go high or low and stay steady and can get crazy A1C's in the 4's or even very low 5's with no lows, huh? So, I come away thinking that's the norm for type 1's, my endo said it is not, it is the nature of type 1. However, an A1C of 8% is certainly not close to good but I wouldn't if I were you prebolus 45 minutes per meal, you're not only waiting too long, but might miss the peak of your insulin bolus? IMO?
