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Tuesday, November 8, 2011

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. 


  1. i agree! i have 3 healthy children, ages 28,26, & 22. my pregnancies were fairly uneventful, and all three children were born healthy with no complications. and this was with about as much conscious effort as a non-PWD. i dont even know what my A1c was at any point during any of my pregnancies! i am not saying this was a good way to go through pregnancy, and i would likely be much more diligent about my health were i going through it now. but i am saying your A1c is just a number. not a value of yourself.

  2. OMG, the cookie-monster lows! I know this sounds crazy, but go buy a bottle with a wide mouth on it to help you with lows. It's already marked with the ounces, and it helps when you're so low you can't really think. Then, just drink the 4oz of juice from there (without the top screwed on, of course! LOL!) I didn't think of this until AFTER BabyK was born and it was an "ah-ha" moment.
    I know it's hard to do, but keep up the tight control til after the first trimester. My endo said it's ok to relax just a bit after that because then all the parts are there, they're just getting bigger after then. After that, a high every now and then won't hurt because even "normal" preggo's go high sometimes and never know it.
    Hang in there girl. YOU CAN DO IT!

  3. My favorite line...
    "doesn't look like the cutting side of a bread knife"


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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.