Needless Excuses for my A1c

I was suppose to go see my endocrinologist a couple of months ago.  No fault of my doctor, but the place he used to practice shut down.  With no notice!  Diabetes America, no more!

Because there was some lapse in time between Diabetes America unexpectedly closing down and Dr. Mora opening up in a new spot, I haven’t been in to get my A1c checked since December.

I figured it would be pretty good because I have a Dexcom, so I have that information available.  But the last month has been pretty challenging because we were out of town during the entire month of June. We were eating out more than usual, and at places that I didn’t know how long the wait time was, so my insulin doses were often “off”, and my blood sugars suffered because of it.  I saw way more spikes than I like to, or than I normally do.

As I drove to my appointment yesterday, I said a little prayer hoping that this new place Dr. Mora is practicing out of will have the “finger stick method” rather than the from the “vein method” for my lab work. It’s ridiculous that I’m so squeamish with veins, but I am.  I could never be an intravenous drug user- I would never be tempted to shoot drugs up for sure! So, that’s a bonus.  Anyway… Praise Hallelujah!!!  It was just a finger prick.

But even more Praise Hallelujah than that- My A1c came back lower than ever.  5.5%. So even though the last month has been a challenge, I worked hard enough that it didn’t screw things up.

I hadn’t checked the Dexcom Clarity app lately, but I did check after I got my lab results back from my doctor yesterday.  Although Clarity no longer gives a predicted A1c, it does tell your blood sugar average over a 90 day period (which is essentially what the A1c result refers to), and mine was 115.  According to the chart below, my A1c should be 5.4% based on that… That’s pretty close! And I’m very happy.  And proud!  My OCD behaviors are paying off.

As I drove to my appointment, besides saying my prayers about the blood draw via finger prick, I also mulled over my excuses I would give to Dr. Mora in case my A1C was higher than it had been at my last appointment. It’s funny that I feel I owe him excuses.  As if I’m being graded and my lab tests are something I either did or didn’t study for. As if it’s him I’m trying to impress. But I think it’s a common patient behavior. I know I’m not alone in this.

I’m not quite sure if the last month’s blood sugar average has more impact than the previous two months on the A1C, so I was a bit worried.  I was going to tell my doctor, “Traveling gave me an added challenge.” Paired up with, “Also, I’m a woman of a certain age, and I’m sort of going through “puberty” and it’s messing with my blood sugars.”  I will always have an excuse, because life always throws us little challenges, and sometimes big challenges.  But, we keep plugging away, and we keep trying our best.  And sometimes, you end up rewarded for all that trying. And this time, I was definitely rewarded!

And that’s the greatest motivation for me to keep trying my best. Not for my doctor.  But for me.

Yay, ME!

Dexcom Tells Me More Than My A1C

Last week, as I was driving to my appointment with my endocrinologist, fighting horrible traffic to get there I started to question, really, why was this appointment even necessary. My last appointment was only 3 months ago.

My main reasons for these appointments have always been:

  1. to find out my A1C and
  2. to get prescription refills.

That’s pretty much it. But now, I have a Dexcom, and I look at the Clarity app often enough that I know what my “predicted” A1C is.  Besides that, I think my trend graph is way more important than that A1c number anyway.  An A1C could spit out an impressive number, even if someone didn’t have very tight control on their blood sugars.  As long as the average works out to be something within a good range, the A1C might deceivingly seem “good”even if your control isn’t.

One thing I love about my endocrinologists office is that you get an immediate result of your A1c test.  Last week, mine came back as .5% higher than what the Dexcom Clarity app predicted.  When I told my doctor, he said “we pay more attention to Dexcom results than the lab work.”  I didn’t ask why or for any further explanation, but it’s how I’ve felt about it all along and I’m happy with how things have been going so, I’m just sticking with what my Dexcom is telling me.

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The Dexcom Clarity App on my iPhone.

It seems like an A1C result isn’t as important as it used to be now that we have more advanced technology.  I can see graphs of what my blood sugar is doing every 5 minutes of the day with my Dexcom CGM.  I can get a predicted A1c for a 7 day, 14 day, 30 day, or 90 day period with the Dexcom Clarity app.  Even better, if I access Clarity from my computer, I can see all sorts of trend graphs to see where where and when my “problem” blood sugars are. I pay a lot more attention to whether or not my blood sugars are staying within my target range than anything else.  The actual A1C or average of those readings is far less important to me than simply staying in my ideal range as often as possible.

I’ve tightened that range little by little.  I think when I first had a Dexcom, I had an alarm set for a high of 180- maybe even 200.  Now I keep my low alarm set for 65 (that hasn’t changed), and my high at 150.  These days, it’s a rarity for me to have a blood sugar that ever gets (or at least stays for long) above 170.  Of course, it still happens from time to time, but thanks to having the alarm set for 150, I can be proactive and avoid those highs I use to battle. Treating a slightly elevated blood sugar is a lot more manageable than treating one that gets way up there.

My endo told me to make my next appointment in 4 to 6 months.  Of course, I chose 6 months.  Unless something new comes up, there’s no reason for me to go any sooner than that. I get more meaningful information about my blood sugars from my Dexcom than an A1c result is ever going to tell me.