Learning to Love a Slightly Higher HbA1c (Part 1 of 2)

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I’m between my quarterly HbA1c readings. OK, wait. I just realized that my first sentence this week is kind of a “Duh!” introduction. I mean, that sentence will be true for the rest of my days. I am always between my HbA1c — except, possibly, for that brief moment every three or four months when I’m having my blood drawn for an HbA1c test.

Oh, I see I’m about to go off the rails here, because I want to spend my blog-entry word allotment on wondering just what separates one HbA1c reading from the last: When I enter the doctor’s office? When I have my blood drawn? When the sample’s in the machine? When the HbA1c numbers output to the nurse? When my doctor tells me? When?

But you know what? That doesn’t matter one bit. It’s me being me. But let’s leave those questions for someone much more intelligent.

What matters is this: My average blood glucose readings from my daily checks, according to my meter, have been higher this summer. See, since my May HbA1c reading, I’ve slowly and consciously allowed my average blood glucose to run a bit higher than in the three months before my last visit to my endocrinologist. Why? Allow me to speculate.

My January 2010 HbA1c was 7.0%. My May HbA1c: 6.6%. Great trend, right? During a difficult four-month period, a time when I was going through recovery from a thyroidectomy, and about a month of miserable hypothyroidism, I brought my numbers down. That’s all well and good. It’s what I want. Right?

In the three years since I started life as a Type 1 diabetic, with an HbA1c of over 14% at the time, the way I thought about those numbers before the percent sign was to get them as low as I could as quickly as I could. And diabetes media only reinforced my thinking. Aim for a lower HbA1c! It almost felt like a competition. Some athletic contest. Wear your numbers with pride. Push to see how low you can go.

See, I wasn’t alone.

“I’m at 5.5%,” a blogger would post. “I got mine to 5.7%,” another would write on a Twitter feed. “I’m going to shoot for low 5s!” from somewhere else.

There the chants of support from the galleries, comment after comment on popular diabetes blogs extolling the hard work for those persons with diabetes who get their HbA1c numbers that low. Heroes!

Then you also have those writers of blogs slightly higher HbA1cs who worry about their numbers in every third post, who consistently write about an elevated HbA1c as if it’s an albatross ’round the neck. These people receive oodles of support from fans who encourage the higher HbA1c-ers to keep trying, to get that A1C back down around 6%.

My endocrinologist, to his credit, during the many times we’ve discussed HbA1c, always explains why numbers somewhere between 6% and 7% are just fine, and why aiming for something lower than 6% doesn’t really make sense. At least, not from his perspective (the dangers of hypoglycemic episodes when one keeps the blood glucose low enough to achieve those numbers versus the added benefits isn’t really worth it).

Before I break off with this week’s entry and leave you salivating for the “Why are you speculating you went higher this summer? Get to the meat of this entry!” let me say that I’m not advocating one way or the other. I’m not a doctor. I’m not up to speed on everything written by experts. I’m one little ol’ blogger writing about himself with diabetes. I’m probably writing this entry because in the spring, one of the things that started to chip away at my “lowest is best” HbA1c mindset — for better or worse — were the reports that came out about higher HbA1cs being healthier.

I mean, come on! Can’t you cut a person with diabetes a break and let me know what shoot for?

Next week I promise I’ll delve into my summer blood glucose mindset and share with you why higher’s been, if nothing else, happier-making.

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