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Wednesday, June 23, 2010

The Endo, A1c, and CGM . . . OH MY!

This past Monday I had my quarterly endocrinology appointment.  I feel (as I'm sure many diabetics do) that the endo appointments are like the progress reports, not just for diabetes, but for your life.  You can either leave the office feeling accomplished or bummed and ready to start over.  The latter was me after my last appointment in February. 

My last A1c in February was 7.1.  *waiting for the throwed stones*  I know that's a great number for a lot of people, but it was the highest I had been since I had went on the pump and my highest A1c except for my steller 9.1 post-diagnosis.  My lowest A1c ever was 5.1, but that was after the summer I was a camp counselor chasing kids all day, still on MDIs including 20 units of Lantus every night.  I was pretty much living in 60s during that time.  The following fall is when I received Arnold. 

My appointment in February wasn't actually my scheduled appointment.  The morning of that day I had a *ahem* girlie appointment where they found sugar in my urine (it was a post-breakfast high following some Life cinnamon cereal).  My gyno made sure to lay a guilt trip on me, which was easy to do given the humiliating experience of that appointment, anyway.  Of course, I freaked out and called my endocrinologist's office after I left.  The poor nurse didn't know what to say except, "We have an appointment open at 2:15."  "OK *sniff* I'll be there." 

When I saw my endo that afternoon, I was still in tears.  I'm not sure how many emotional crying girls he gets during the day, but he handled it well.  He told me sugar in my urine is fairly common especially if your BG is over 200, an easy feat for a type 1 diabetic.  He said the main thing to worry about is protein in the urine (which I knew).  But to ease my worries, he said I could go have some lab work done.  I agreed and he wrote me up a lab request.  My lab work came back clean except for a slightly elevated cholesterol level, which I've made adjustments to change since then. 

So, after my self-fail A1c of 7.1, I started taking diabetes more seriously.  I started measuring out my food properly and tried to count carbs rather than SWAG bolusing.  I also started this blog, and what's not serious about that, right?  Then, when the weather got warmer I started walking with my RoscoeAll of those changes helped me drop to 6.5, down 0.6 points in 4 months!  *baby circle dance* 

And what's so exciting (to me) is that I feel like things will get even better once I get my Dexcom CGM.  My endo signed the letter for my insurance, who now hold my approval in their hands.  I already know they will cover 90% of the costs, so it's just a matter of time and paperwork before I'll be a real-time diabetic.  As funny as this sounds, I'm so excited to have another piece of hardware stuck to me 24/7!  I test at almost the same exact time everyday, resulting in chunks of time that I never know what my BG is.  Having a CGM will help me know what's happening during those blind times and my endo and I can adjust accordingly. 

How do you feel after a good/bad A1c?  Do you take it as just a number or does it affect your life for the next 4 months?  Is your endo helpful or do they make you feel berated? 


  1. Honestly, my A1Cs have not been ideal lately...I'm blaming it on the life transitions of graduating college, moving 2,000 miles away and starting a full time job. But I totally know that "depressed" feeling after the endo appointments. For some reason I commit myself to better control for about a week and then it seems to just go out the door. I try, I really do...but it is REALLY hard and I have so much respect for you and your awesome A1Cs!!!

  2. Thanks, April! I understand the whole life change thing. The first time I ever had high blood pressure was when I started working. Work is bad for my health, lol. Don't get down on yourself, though. I'm usually good for about 3 weeks, then a vacation or chocolate indulgence throws me off. *sigh* I need so much accountability it's not even funny.

  3. I feel as though I'm either walking on water, or being held underwater and struggling to get up - depending on the result. Historically, my A1Cs have been too high and I've had my share of Endos telling me they aren't good, and a couple berating. They didn't last long (the docs, or numbers at that level). I try not to put all my emotional stock in one number every few months, but it is tough - that is what we tend to shoot for.

  4. Congrats on the Awesome A1C!!! I'm hoping to get under 7 and trying really really hard!

    When my A1C is bad, I feel like a huge bucket of horse poop. My old endo used to yell at me. I would cry. Etc. Etc.

  5. It's funny, because if I have an awesome A1c, I'm all proud of myself, but if I have a crappy one, I try to talk myself out of feeling bad.

    Also, I could tell you many a story about girlie doctors (and other doctors who are not endocrinologists) passing judgment on sugary urine samples, high just-ate-breakfast blood sugars, and a bunch of other bullcrap. All you can do is try your darnedest, and it seems like that's exactly what you're doing.

    My CDE -- and my Endo -- and my PCP, now that I think of it, are all really supportive when it comes to the A1cs. Only took me 20 years to find them.


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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.