Down A Tenth

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It’s been a little over four years now since I was diagnosed with Type 1 diabetes. I’ve noted my diagnosis HbA1c in previous blog entries, but I’ll do so again. It was 14.5%. Yep, that’s right. Fourteen point five! Oh, and my blood glucose on the morning they ran the tests to determine what was wrong with me: 450 mg/dl.

Diabetes had never affected my life before February and March of 2007, so these numbers they threw at me didn’t matter. At first. Tell me my weight, or my blood pressure, or my body temperature, and I have context in which to evaluate it. But A1C? Repeat that, please. Is that two letters and a number? A1C? What was that? A? Onesie? Oh, c? Well, what’s the 1 stand for?

They gave me the brief doctor’s-office explanation of the significance of the numbers. You probably know the type of explanation I’m talking about. “We’re concerned.” “These are too high.” “No, these aren’t normal. Normal is x. Your numbers are y.”

Of course at this point all I heard was mumble-mumble — sort of like the teacher in Charlie Brown — because they’ve said diabetes; they’ve said, We’re not sure, and they’ve definitely just told me — or I definitely heard — “There’s something really wrong with me,” way worse than the common cold or flu or drug interaction that I went in thinking I’d been afflicted with.

Still, although the doctors explained their concern, and although I’m sure they told me some specifics about why it’s dangerous to have A1C and blood glucose numbers so high — more mumble-mumble — the data were simply information I wasn’t equipped to process. I showed up at the doctor’s office because I felt rotten. I wanted to know what to do to be able to feel better. Get a shot, or get some drugs, send me on my way, and in a week I’d forget about it.

The other problem was that these first doctors I went to weren’t ready to put all their eggs in the Type 1 basket. They didn’t know if it was Type 1 or Type 2 or something in between. It would be another week or two before I’d know which diabetes team I played for.

In the months that followed the diagnosis, though, in that time during which I read and tried to comprehend as much as I could about A1C and blood glucose, I became one of those people who went from one end of the spectrum to the other. A1C ignorance morphed into a pretty good layperson’s comprehension of what HbA1c was. Clinical trials, medical reports, ADA Web sites. You name it. I overdid it. Actually, and I became slightly obsessed — as I’d guess many newly diagnosed persons with diabetes are — in my attempts to keep my blood glucose as low as was safely possible, thereby also lowering my HbA1c. I wanted the 5% to 6% range. Failing that, I’d try for as low in the 6s as possible. Over the next year or two, I’d get a report of 6.4% and think, “OK, next time I shoot for 6.2% and one of these checkups I’ll see the 5s.”

All of this is to say that at my quarterly endocrinologist’s appointment a couple of weeks ago, my HbA1c went down a tenth of a point. From 7.1% to 7.0%. And I was fine with that. I felt no stress, no worries. I haven’t given up on the 5s, but I don’t care. If it happens (and I doubt it does), it won’t be because I obsess over blood glucose numbers.

I’ve come to see my ideal range as somewhere in the 6s, not the 5s, and if I peek over 6.99% and spend a bit of my time in the land of the low 7s every once in awhile, so be it.

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