A1c Thoughts

When I found out I was pregnant and excitedly told my endo, the first thing he did was increase my basal rates 0.1u/hr.  This increase made my daily total jump from roughly 16 units to almost 20 units.  This puzzled me at first, because I had only heard of the plaguing first trimester lows associated with a diabetic pregnancy.  So I thought my basal rates should decrease or at least stay the same.  My endo warned me that I needed to arm myself constantly with fast-acting carbs for these oncoming lows. 

For the first few days after that appointment, I followed my low-treating guidelines by the book.  I religiously corrected using the 15/15 rule with scary precision.  But I kept correcting, and kept correcting, and kept correcting.  Eventually, I got tired of constantly correcting with oh-so-perfectly measured glasses of juice or exactly 4 glucose tabs.  Especially in the middle of the night, low correcting rules go out the window.  My low treating method became something like this:  drink enough juice that gets rid of the shakes, eat a tablespoon of peanut butter, chase with more juice or chocolate milk.  I'll admit that this resulted in some scary rebound highs that left me crying and vowing never to go outside the rules again. 

Things seem to finally be settling down and my 24-hour window on my CGM doesn't look like the cutting side of a bread knife.  Part of the resolution is learning my limits when correcting lows (like filling a glass of juice is always less than drinking it straight from the jug) and maintaining a constantly grazing schedule (like every 2 hours or less, seriously!). 

I know that being friendly with lows is good for Ferbie at this point in my pregnancy, and I'm quite proud that my A1c is in the 5s for the first time since I went on the pump.  But I must admit I could not do this everyday for normal diabetes management.  I know that everyone's comfort zone for A1c is different, but I feel the best when I land between 6.0-6.5% for my A1c.  Higher than that means I am hanging out on my higher end too much, but lower than that means I am spending a good majority of my days being low. 

I am coming to the conclusion, though, that the A1c holds a lot more value than it should.  My endo might give me a "Good job!" with an A1c of 5.5%, but looking back at the past month in my meter log shows that my body is roughly 50% apple juice.  I really put more value in my quarterly blood work for my kidneys and cholesterol, my yearly eye exam, and my overall "feeling" of health.  As long as those things get an A+ from all the medical personnel, I don't think it should matter what my A1c is when they happened.