“What do you think your hba1c is?”
“Low 6s?” I mused, thinking about the average blood glucose levels I have been running of late.
It was better than my best guess. While it definitely ‘wowed’ me, it wasn’t inconceivable. I hadn’t even really been aiming for that particular number, and yet I had set myself a new personal best without even really trying.
When I think about all of the hba1c results I’ve received over the years, I’ve either been dying to know the result or completely dreading it. I’ve either walked out of clinic literally jumping for joy or feeling bitter disappointment. Every healthcare professional asks me what my last hba1c was the minute I mention that I have type 1 diabetes, and I’ve definitely let myself feel ‘judged’ by that number at some point or another.
But this one was different. I wanted to get my a1c done because it had been over six months since my last one, rather than because I actually wanted to know the number. I’d actually given far more thought to the context leading up to that number as I’d been mentally preparing for this appointment, rather than the number itself.
Things like my average blood glucose levels. Or the standard deviation of my numbers. My time in range, when I’m wearing a Libre. Or the Winter insulin resistance of late. How much I’ve been eating. How well I’ve been sleeping. Just how I’ve been feeling about diabetes in general.
I think my diabetes educator was more pleased for me than I was. We went through my numbers, and she was satisfied that there weren’t a lot of highs and lows. She pulled out my file that impressively documented my history from my diagnosis nine years ago, possibly trying to convince me how well I was doing, and we laughed over a note of me being ‘a lovely 17 year old uni student living with his parents and three siblings.’
“This has been three years of constantly learning about my blood sugars, and learning from experience.” I told her. “I really think that I only get out of these appointments what I’m willing to share with you. If you looked back at some of these appointment notes, you’d probably find that most of them would say that I was doing well. But I know that I wasn’t. I was just too scared to be honest.”
When it comes to living with diabetes, I only spend a fraction of my time in the company of a healthcare professional. For the other chunk of that time, I’m left to make hundreds and hundreds and hundreds of decisions on my own. The only person who I really hear talking back to me is my own subconscious. I’m always thinking about what I haven’t done well. Or what I could be doing better. I’m my own worst critic.
What my subconscious is not good at is giving myself credit for my efforts. I think that’s what my diabetes educator was picking up from me. So it was nice to hear someone else’s voice, rather than my own, telling me that I was doing pretty well.
If that didn’t convince me, white hot chocolate would have to.
Wow good on you. I think sometimes we have to be kind to ourselves.
Good on you Frank.
Of course the HBAIC is giving a sort of average only and one is relying on the accuracy of a cgm device to show the excursions in bSL.
But purely as illustration on the HBAIC front, after 52 years on insulin and currently on a Tandem pump – ,
HBAIC – Nov, 2018 46 (6.4) Feb 2019 39 (5.9), having started low carb/keto diet 6 weeks before the test, and June 2019, 36 (5.6).
WA Parliament sent a delegation to UK late last year to talk to Digital Diabetes Media and Dr David Unwin about the low carb diet progtram for T2Ds which the NHS has taken up. DDM and Dr Unwin are launching a low carb program for TIDs this year. Meanwhile i believe a group of doctors and medical students in WA are looking into the low carb diet for TIDs in WA.
I have been in the 5’s for about 6 years now. Sometimes low around 5, and sometimes 5.8. But mostly around 5.7. I think it is great to be in the 5’s and frankly that is good enough. I know those who want to be in the 4’s. but you know I am a fairly happy guy, I am glad you are as well. Bravo Frank.
Love this post Frank thanks for sharing!!!