HbA1c

It took me forever to remember these four letters and one number in the right combination. It didn’t take me quite as long to figure out what it meant and that I should pay attention when the doctor told me what it was.

It did take me a little while to figure out I should keep track of the number. When I was diagnosed with diabetes, I suddenly had a lot of doctor’s appointments. And then, to complicate matters, during a routine check-up about six months later, I was diagnosed with Graves Disease—my thyroid was about to go wacky-wacky, but wasn’t quite there yet. Add doctor’s appointments every four weeks to track it until it could be destroyed, then track it until I could be put on Synthroid, then track it until I was stabilized. A lot of appointments to remember, so I bought a PDA and filled it. The PDA has a memo section and at some point, I started recording my HbA1c numbers so I could have my own personal history to gaze at. (Yes, I know, I digressed and it took me longer than I anticipated to get to that last sentence. Best way to tell my cold is going away: I’m back to verbose entries.)

Anyhow, here’s my history. It doesn’t go all the way back to diagnosis, and there’s a few sketchy dates in there when my PDA went haywire (it’s been replaced with a snazzier version combined with a phone), but you get the general idea:

7/30/04: 5.5
1/13/05: 6.0
11/15/05: 5.6
3/22/06: 5.6
late ‘06: 5.8 (when PDA #1 died; may he rest in peace)
5/14/07: 5.7
11/5/07: 6.1
5/12/08: 6.0

I know I should have more in there, that I should be tested more often, but every doctor I’ve had has told me, “I wish my other patients had this control,” and they let me blip by on their radar. I try to go to the doctor about every six months, and the endocrinologist at least once a year. They always tell me if what I’m doing is working, just to keep doing it; no need to change anything. Sometimes I’m grateful for this, because the last thing I need is another doctor’s appointment to squeeze in on my lunch hour, and sometimes I’m disappointed in their seemingly lack of interest in my health—shouldn’t they be yelling at me to see them more often?

So, my latest number: 6.0. I know this is a good number, truly I do. But to be honest, I was a little upset by the fact that it wasn’t below 6. I’ve had a lot of tests in the fives, and I thought that’s where I should be. I was really good about diet and exercise and checking my levels and working my insulin from January through mid-April. Then I went off the tracks a bit—celebrated a couple of occasions with multiple elaborate dinners, went out of town and had a fabulous weekend, exercised a little less than I should have. And, of course, because it had been a full six months since my last HbA1c, only the last three months were really counted—and that didn’t include my only behaved-really-good months, it included the treated-myself-a-little-too-much month, one really-good month and one so-so month. So it was 6.0.

It had me annoyed. It had me ready to start sketching strict guidelines for food and grueling exercise routines and excessive blood sugar testing. And then I read a blog about numbers, and did a little research. And I found out that sometimes, the low numbers are just as bad as the high numbers. If your HbA1c is too low, it could indicate that you have too many low sugar readings. Guilty as charged. In the past, during the 5-range days, I regularly hit 65 and considered 65-70 my usual “low” number. These days, I aim for 75-80, a much safer low.

So now I think I’m okay with my 6.0, or slowly coming to terms with it. And while I’m still going to watch what I eat and exercise, I’m not going to go overboard. As long as it doesn’t go too much higher than 6.0. A girl’s gotta have her standards…

As always, more to come…