The Diabetic Report Card

June 13, 2012By 0 Comments

What’s in a number?  Numbers mean different things to different people.  Many people are focused on such things as the number on a scale, or the number in their bank account.  There are people who are so focused on their age, that they obsess about the number and waste years away thinking they are old when before you know it they’ve missed out on life entirely.  Often times we are so hard on ourselves based on whatever number we are so laser focused on that we forget why we are shooting for the goal associated with that number.  These all may sound like motivational sentences that you may have read in the latest Malcolm Gladwell inspiration but there is indeed a reason behind whatever number you are obsessed with.

I know for me, the numbers that I focus on every day have a greater meaning and taking the time to actually figure out why and how I react to the result has helped me deal with the weight of it all.  My hemoglobin A1c (HbA1c) is my diabetes report card.  It gives me my three month average of how my blood sugars are trending and indirectly tells me what kind of damage I have either done or saved myself from.   I beat myself up mentally and emotionally more times than I can count if this number comes back well below my standards.  Having worked in the diabetes industry for eight years, I have seen many A1c’s from many different types of patients.  Unfortunately, many patients have not fully understood what that one little percentage on their lab results really means and how it correlates with the risk of diabetes complications.  The overall goal for an A1c is 7% which equals an average blood sugar of about 170.  What the doctors don’t always explain to their patients is that this is in fact an average… which means the blood sugar could be an average of 250 and 70 all day long.  This variability is what does the real damage over the years.

My A1c has been between 6.4-7% over the last six years or so (my early twenties are a time I would like to forget for many reasons, and my A1c is one of them).  Most diabetics would be ecstatic over an A1c like this, but not me.  It isn’t a matter of being hard on myself, or beating myself up about it mentally and emotionally (which I do anyways) but it’s a matter of understanding the number and why it means so much to me.  When I have had A1c’s in the 6.5% range over the last couple of years, it’s as if I’ve just painted a fresh coat of paint over an old house… again and again.  Never taking the time to replace the weathered layers.  I knew, and didn’t want to admit, that my average blood sugars looked great on paper, but in reality, they were a complete mess.  When I would get my report card from my Endo, I would pat myself on the back, and go about my business of over treating my lows and over correcting my high’s.  But I couldn’t do that anymore.  When I went to my Endo this past January and my A1c had crept up to 7.3%, the highest is had been in years, knowing I was planning on trying for a baby within the next year, I took it as a challenge.  Anyone who knows me is aware that I don’t back down lightly from a challenge, and in fact I am defiant and stubborn, and wanted to show my diabetes that not only would I get my A1c down, I would do it right this time.

My most recent A1c was 5.9%!  I immediately broke down in the doctor’s office, and somehow mumbled under my runny nose that they were ‘happy tears’, to my Endo who handed me a tissue.  How can I put into words the amount of energy and work it has taken, and that it takes, every single second of every day to get those kind of results?  All I can say is I am not promising myself that it will last forever, as I am human and I have diabetes, and it isn’t going away.  I am willing to put in the work now, to make my body and my life as healthy as it can be, so that when I am ready to start a family in the future I will be confident that I have given myself the best chance possible and that I have done whatever it took to control all the moving parts and take charge of my health.  I was able to get my A1c to this number without severe lows, and without rocket high blood sugars crashing down and leaving a gaping hole somewhere in my kidneys.  I did it right this time.  While I can’t say I always will do it right, I am damn proud of my most recent report card.

I was lucky enough to be asked to be part of a teen panel at a JDRF event over this past weekend.  I spent the entire day talking to families of newly diagnosed kids or with other type 1 adults.  When I was sitting in on a lecture on diabetes technology, the audience was asking the speaker about the benefits of continuous glucose monitoring.  I raised my hand and explained to the audience that without a CGM device I would not have been able to safely get my A1c down to 5.9%.  As soon as I said ‘5.9’ everyone  started clapping.  I wasn’t looking for attention and only wanted to share my success with CGM, but at that moment I felt more validated, proud of myself and more part of my diabetes community than ever before.  We all get each other and we all get that same goal that we are striving for, that one number, whatever it means to you as a diabetic, you can get there too.  We can’t be perfect diabetics all the time, but I’ll be damned if I don’t at least try every single day.   You have two choices as a diabetic: let it swallow you whole or pull a Katniss on its’ ass and beat it at its own game.

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