Aim for an A1c of…What?!

All my life, I’ve been told that I should do what I can to keep my A1c levels between 6 and 6.5. This is the “ideal” range, the sort of long-term goal I should bear in mind on a daily basis.

So when my primary care doctor suggested that an A1c of 7 to 8 might be a more realistic, sustainable, and healthy zone, my jaw dropped to the floor.

He explained his reasoning for saying such a thing: Since people with diabetes obviously have different needs when compared to people without diabetes, it’s not entirely logical to expect a person with diabetes to maintain an A1c that they might have with a functioning pancreas. He said that as time goes on, it could affect cognitive abilities.

And then he said that this was the range that would be recommended to a person with type 2 diabetes – there’s no new research that indicates any difference in desirable A1c levels for a person with type 1 diabetes, so, as my doctor said, I should continue to aim for 6 to 6.5.

This was such a WTF moment for me, for a couple of reasons.

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Does anyone else feel super awkward taking selfies in exam rooms? Does anyone else even take selfies in exam rooms?!

One being that I had NO IDEA why he was saying this to me. He built up this whole explanation as to what the “new recommended A1c” is, only to inform me at the very end that it was only safely applicable to people with T2D at this time. Was he confused? Did he forget that I have type one for a minute there?

The other reason I was flabbergasted by this little discussion was that we hardly ever go into detail when it comes into my diabetes. In fact, he didn’t even ask me when my last A1c test was, or any questions regarding my insulin pump/CGM. He just asked the standard “how is your diabetes” question, to which I replied with a super-lengthy, not-at-all vague response: “good”. He did put orders in for the standard array of tests that I take for each annual physical, which would inform him of my blood sugar at that moment in time, as well as my current A1c. But it was nothing that I’d be talking to him about during that appointment because the results wouldn’t be available until late in the day. So yeah, I found the whole thing to be pretty bizarre and mildly misleading.

Coincidentally, I’ll be seeing my endocrinologist in a few weeks, and let’s be real here: She’s the one doctor who can best advise me when it comes to diabetes treatments and protocols. So I’ll be sticking with her recommended A1c range for me, which I have a feeling won’t be any different from what I’ve been told all these years with diabetes.

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An Abundance of Appointments

Ugh, I don’t know why I did this to myself, but about a year ago, I decided to schedule a bunch of my key doctors’ appointments back-to-back. That means every week for the next three weeks, I’ll be seeing one of my main doctors. Fun!!!

Truthfully, I don’t HATE going to see the doctor. It’s just the waiting and the feeling of being in a hospital-like environment that I detest. And I’ve gotta say, I’m not overly fond of my personal bubble being invaded for the sake of evaluating my wellness, but it is what it is.

First up on the calendar was a visit to the dentist. This is the only doctor I see who never asks about my diabetes, which is very refreshing. But that doesn’t mean diabetes is far from my mind when I go to get my teeth cleaned. My big fear is that my blood sugar will go low in the middle of the appointment, which would make things difficult seeing as I’d have to ask the dentist to stop what she’s doing and let me correct for the low. This would be super frustrating for both parties, as she’d probably have to start her work all over again and I’d have to wait for my blood sugar to go back up to normal.

Fortunately, this fear has yet to come to fruition and my blood sugar is usually fine, if not a little high, at the time of these appointments. And this trip to the dentist was likely one of the easier appointments I’ve got scheduled this month, because I was told my teeth look great. I was also told that my hair is awesome, which made me flash my pearly whites even bigger at the dentist. Yup, definitely the easiest (and CERTAINLY the most flattering?!) appointment I’ll have all month…possibly all year.

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The patient’s perspective.

Next up is my primary care doctor. It’s time for my annual physical. This appointment was basically a complete wash because it occurred within the hour of me fracturing my ulna (see a couple posts down). In between my tears, my doctor asked me standard questions and requested to me to fulfill the usual battery of annual lab tests. My blood pressure was a little high during the appointment, but if I had to make an educated guess, it’s probably because I was stressed due to the excruciating pain I was experiencing in my right arm. Just a hunch.

Thank goodness that everything else came back normally, though. Fewer things to worry about when it comes to my health will always be a welcome concept.

I don’t want to count appointment number three on this list, but I guess it’s worth mentioning my trip to the orthopedic’s office – you know, because of the broken bone. I get to have at least two more with him in the next six weeks as follow-ups. Joy!!!

Finally, the last truly pre-scheduled appointment I’ve got is with my endocrinologist. I’m nervous because I don’t know what my A1c will be like. I have an excellent and empathetic endocrinologist, so I know whether it’s good or bad, this reading won’t affect the overall tone of the appointment. It’s just pressure that I put on myself.

We’ll find out what happens before long. All I know for sure is that I’ll be relieved when I’m finally through with all these appointments.