Keep on swimming, swimming, swimming…

Here we go again! At least I can say that my A1C is improving. Not quite where I’d hoped it would be this time, but getting there.

  • Hemoglobin A1C: 8.2% (was 8.8%) [4.8-5.6%]
  • Serum Glucose Fasting: 119 mg/dL (was 83 mg/dL) [65-99 mg/dL]
  • BUN: 14 mg/dL (was 14 mg/dL) [6-24 mg/dL]
  • Serum Creatinine: 0.79 mg/dL (was 0.66 mg/dL) [0.57-1.00 mg/dL]
  • TSH: 1.330 uIU/mL (was 1.330 uIU/mL) [0.450-4.500 uIU/mL]
  • Total Cholesterol: 226 mg/dL (was 213 mg/dL) [100-199 mg/dL]
  • Triglycerides: 129 mg/dL (was 137 mg/dL) [0-149 mg/dL]
  • LDL Cholesterol: 138 mg/dL (was 124 mg/dL) [0-99 mg/dL]

I really thought that my A1C might sneak in under 8.  I was so hoping for a number in the 7s (I knew it couldn’t possibly be less than 7, which is the ultimate goal for this T1D), but I would’ve been thrilled with a 7.9999 (smile).

[For those who may not know or have forgotten, the Hemoglobin A1C test is a diabetic’s touchstone into how they well they are managing their diabetes.  It measures glycated hemoglobin, or, simply put, your average blood glucose for the past 2 to 3 months].

So, my A1C was 8.2%, which means my average blood glucose for the last 2-3 months has been around 190. (Last go ’round, it was 8.8%, which is an average blood glucose of 200+.  And the time before that, it was 9.0%, which is an average blood glucose of 212).

Note that  a normal A1C is between 4.5 and 6. Most diabetics have a goal of <7%, which would indicate an average blood glucose of about 154.  That sounds like nirvana to me!

Anyway, my doctor and I looked at graphs of the last 3 weeks from my pump and CGM.  There were two clear trends:

  • My morning blood glucose is running too high (which means it has been running too high through the middle of the night too often) and it doesn’t seem to lower quickly enough (whether I eat or not).
  • My late afternoon blood glucose is dipping too low too often.

We made some adjustments to my basal rate and carbohydrate ratio at different points in the day. And she was happy that I am exercising more (so am I, although a bit frustrated that the scale moves down as slowly as my A1C).

I did mention that I am not sensing my lows like I used to (I’ve had several in the 40s recently where I barely knew I was low – this can be a bit scary).  She said that is a normal progression (neuropathy) for someone like me who has been diabetic for 30+ years.  We also discussed using a temporary basal when I exercise to (hopefully) prevent the lows that I seem to be having now that I am exercising more.

You might have noticed that my cholesterol inched up, even though I have been exercising more and eating better.  I realized a couple of weeks ago that I had not been taking my Crestor as regularly as I should (it is on a different refill schedule than my other meds, and I have another pill that looks very similar. Doh! So hopefully, with more rigor in taking my medication, that will improve, too).

Overall, a good appointment, and I am trying to focus on the good news. My initial reaction was to be disappointed and discouraged, but I told myself (and keep telling myself) that I am doing the right things, and it just takes time.  So I shall, like Dory, keep on swimming, swimming, swimming…and work towards that ever elusive <7% in June.

Thanks for listening!

 

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