A New Low

My A1c this spring was 4.7%.  That’s a normal, non-diabetic result that’s lower than a lot of adults my age. It's also lower than someone who's been labeled as pre-diabetic for Type 2.  I was surprised and thrilled to see that number in March, but I’ve been hesitant to make it public here.  When you have Type 1 you’re often judged by that number alone, and people have a tendency to compare their number to other people.  I've heard "you're a better diabetic than me" and "oh, you're worse than me."  Doctors also praise or demean based on that single result:  you’re either a “good” or a “bad” diabetic.  I don’t want to play into those labels because I don't agree with them.

The reason I ultimately decided to share here is that I want people to know it’s possible to set your own goals with this disease.  The only thing my endo told me is that the goal is for diabetics to be under 7%.  He didn’t tell me what a non-diabetic result is.  When I was in the 5.5-6.0% range and he was happy with my results, I asked him what a “good” T1 result is and he said that his best patients are generally somewhere above 7%.  The fact that the goal is to be below 7 but that well managed patients are typically above 7 should tell you something about how incredibly hard it can be to live with Type 1. 

The more I read about T1D the more I questioned why my goal shouldn’t be to try and have “normal” blood sugar.  If the long term danger with any kind of diabetes is spending a lot of time with elevated blood glucose, why wouldn’t my goal be to have levels that aren't elevated?  4.7% means my BG averaged about 90 for the 3 months leading into my appointment.  When I was diagnosed in 2014 my A1c was 8.4%, translating to an average blood sugar of 222 – the official goal of 7% comes out to around 170.  For my lifestyle and where I am today, that's high.  For a lot of other people, that’s a destination.  That’s OK.  With a disease where all of the day to day management falls to the patient (or their parents), it seems reasonable that we each set our own goals.

Initially I wanted to reach and stay under 6%, and for my first 2 years I achieved that.  When I added my CGM in 2016 I had more information available because I could see my number every 5 minutes.  More data means I can react more quickly to changes up or down.  Since I decided to get a Dexcom my A1c has been under 5.4% or less.  I was honestly ecstatic when my doc handed me the sheet with the 4.7 - I knew I'd like where I was but wasn't expecting what I saw.  Now that I know I can do it, my goal is to keep that number under 5%.  If your goal is to beat 6% or 7% or 8%, go for it!  Maybe when you get there your goal will change again, maybe it won’t.  But I think T1s should know that it's possible to set any goal you want, and that’s why I’m going public.

Coming up with titles for blog posts is something I struggle with almost every time.  For this post I had the title before I wrote a word.  As nerdy as it is, as soon as I thought “A New Low,” I thought of “A New Hope,” A.K.A. Star Wars.  May the Force be with you.