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11.4, 10.1, 8.3, 8.4, 7.1...7.1 (WHAT?)

Time to get a bit sentimental.  Today, I went to my Diabetes Educator for another session of just checking up with things.  What this really means is that I went to the doctor to make sure my knowledge of my technology (Insulin Pump, Glucose Meter, Continuous Glucose Monitor) was up to date and that things were working well.  From my last post, The Ups and Downs of Living with Diabetes, you hopefully learned a little bit about what it's like to have diabetes and some of the things that I can find rewarding about the monotonous day-to-day of dealing with diabetes.  While there are good times and bad, this post is about the amazing times.


Hemoglobin A1c

Hemoglobin A1c also known as glycated hemoglobin, is the measure of your glucose control over a period of time.  What's known about this value is that it's a rolling average of your blood glucose for the past 2 to 4 months, these numbers vary so much because of what the HbA1c (Hemoglobin A1c) test actually performs and how each person's body processes iron in the blood stream.  What is also known is that this test is much more weighted towards the more recent time because of the degradation and replacement of the red blood cells.  The video to the right does an amazing job of explaining the HbA1c test and how it works, as well as some of the risk factors associated with poor control.

The conversion from HbA1c to the blood glucose is A1c*28.7-46.7, so an A1c of 10 would translate to an average glucose of 240.3 mg/dL.  The goal for people with diabetes is around 6.5% or an average glucose of about 140 mg/dL. 

The Why


Once again, why do I tell you all of this stuff?  Because after going to the doctor, I found out about my HbA1c test.  The numbers in the title of this blog are some of the HbA1c values that I've had in the last 18 months...you can see that at 11.4, my control was absolutely terrible, this meant that I was very much prone to many of the complications that come along with diabetes.  There is a HUGE list of Diabetes Complications many of which you hear about in the news with some of the older members of our community and society.  Diabetic Neuropatthy can usually lead to something that you hear a lot about with respect to amputation of limbs (usually feet).  Another issue that commonly comes up is Diabetic Retinopathy which can lead to blindness.  After having a family member suffer many of these complications, I realized that I needed to turn my life around and stop being so damn stubborn.  Once I got my new job, I knew that I had to really turn my health around.  I've been set up with all of the tools that I need to succeed, and I'm doing that.  in the last 9 months, I've gone from a Hemoglobin A1c of 10.1 to a Hemoglobin A1c of 7.1.  It's in the lower values where change is harder.  I'm hoping to drop below 7 in the next 3 months and get to around a stable value of 6.5%.  Like I showed above, 6.5% is a rough average of 140 mg/dL, that means when I'm below that 140, I'm helping to drop the value, but when I'm above it, it tends to hurt the HbA1c more. 

Getting below the value of 6.5% can be dangerous for many reasons.  Having a low blood sugar (especially when living alone) is significantly more dangerous then a slightly elevated blood sugar.  Especially dangerous when living alone because if I pass out due to a low blood sugar, I have no one who is able to give me a shot of glucagon to bring me back to normal.  At work, I'm fortunate to work with people who are understanding of my health issues and are awesome about providing help. 

In the end, the takeaway is that with hard work and dedication (and a little bit of technology) you can really hone in on the solution to getting better care for yourself.  Currently, I'm using my Dexcom (CGM), Minimed Paradigm 723 (Insulin Pump), and my One Touch Ultra Link Glucose Meter to accomplish this goal.  It's working well, but I'm really hoping to better shape the issues where I have high spikes and low spikes.  Spiking either way is always dangerous and can cause a lot of problems.  I'll keep you all updated though!

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