Sunday, November 12, 2017

The Almighty A1c

I’ve been quite whiney lately. I’m sorry. Diabetes hasn’t been playing nicely for a while now and I just can’t seem to get my HCP to pay attention to my concerns because my “A1c is so good”. I saw him again and my A1c actually went back down a bit. WTF? Makes zero sense to me, but oh well. He said “no medication changes, see you in 3 months”. No comment about a 198 fasting or a 171 before dinner. I guess I’m just supposed to shut up, not worry and trust my doctor. Bullshit.

I posted my concerns/questions on Facebook about something the doctor said: “A1c is a better predictor of future complications than individual high numbers.” It made me think that maybe I’m just worrying too much, but some of the answers I received made me feel a lot better about my concerns. High individual numbers should be a concern and someone ought to be helping me figure out how to “fix” this. This gave me the desire to stop feeling sorry for myself and DO SOMETHING! (The old Kate may be back.)

About the only thing the doctor suggested to me was that I see a dietician. Meh. Although I’ve never met with one, I have spent the last 12+ years figuring out what I can and can’t eat. I have been in group meetings with dieticians and the things they suggest are so far from anything I can do (whole grain, cereals with more fiber, sweet potatoes instead of white, brown rice instead of white…) that I was never impressed. I am NOT dissing dieticians, I think they are a valuable resource, I’m just not convinced one could help me. We’re about to find out.

A very nice woman called me to discuss my referral to see her. We talked for a bit (I liked her) and decided to wait a couple of weeks before I see her. The reason? I want to go armed with data (she liked that). I have spent the last 2 weeks documenting everything I eat and when I eat it. I indicated amount of carbs (if it is processed at all) and my pre/post prandial numbers. I have been poking the crap outta my fingers! I haven’t been avoiding foods, I’m just eating like I normally do, occasional binges and too many carbs as well. I am going to call her back tomorrow to set up an appointment. I’m actually excited to meet with her! This exercise has been eye-opening. I’ve learned a lot about myself and how my body is reacting to food (spoiler: not too well). Wish me luck. I’ll keep you posted.

Oh, and I’ll be making an appointment soon with a new doctor, one who was recommended to me by a fellow PWD who just happens to be a nurse. Score!


  1. Doesn't that doctor understand that you can have a great A1c with lots of highs balanced by lots of lows? And that's not healthy.

  2. Kate, I thought dietitians are not all that helpful. Until I met one I liked and I decided she might be good to put in my diabetes tool box. I seldom talk to her, but she is good. I hope you find a good one as well.

  3. Keep your "attitude" up.

    A1Cs are a great tool for docs (aka clinicians), but not so great for actually living with a chronic condition 24/7/365. A better measurement for any TxD is Time in Range.


    Because increased time in range is something you can impact in near real time; it can be motivating and simultaneously frustrating; will result in better A1Cs.

    Because you live with a chronic condition ALL.THE.TIME! You are ultimately the best arbiter of what's best for you (and what's actually doable). Use any HCP as an adviser, but you are in control.

    Cheers ...

  4. So, how did the appt with the dietician go?

    1. Thanks for asking! I started a post in my head and then I got the flu, and then Christmas happened. I hope to have a post up very soon! Much to tell.


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