"And your a1c.."
HbA1c. Oh boy. You would think after 8 consecutive years of 7.6 and lower a1c readings, the fear of my endocrinologist and this number would fade away, nope, not even close.
One of the original benchmarks I learned about in regards to diabetes long term care was an, "a1c." It was explained to me as a 3 month average of your blood sugars, and anything 7.0 and below was considered the goal for a long, healthy chance at life. I vividly remember my first 3 a1c readings, 6.3, 6.6, 6.8. Summer 2002-Spring 2003. My Dr's praised me, congratulated me, reconfirming I was on the right path. Then, for the next 5 years, the struggle was real.
Let's take a few steps back. HbA1c, the measurement of a binding molecule in our red blood cells, that when connected with glucose, creates a "glycoslated hemoglobin a1c." This process increases the overall level of a1c in our blood. The higher the % of a1c, the more glucose there is running through your body, inhibiting oxygen intake, and overall health. Hence the high risk for strokes, heart attacks, amputations, various metabolic issues, bad eyes, the fun doesn't stop.
Between 2003-2008, I regularly ran between 8.1-9.6. After a few too many journeys down the rabbit hole, either I was going to wake up and switch directions or stay blindfolded and lost on the current path. After a tough talk in summer 2008 with my endocrinologist, her frustrated tone had me shook as she expressed some real concern with my blood work and my health. It was year 6 and my control was only worsening. She almost demanded I get on the pump, and maybe additional medication over the next year or two if change didn't happen. Shaking my head, "Doc, no, please let's take some small steps.. I've been incorporating more cardio workouts into my routine.. basketball, riding my bike, and running, I am even having lows again. I can get my a1c in a healthier range, I can do this."
Luckily she agreed that I was young enough before any drastic changes needed to be implemented. In a few less words she gave me a time frame to see some progress or she was making demands for my own longevity's sake. I agreed to wear a continuous blood sugar monitor for my last two weeks of summer before the school year began. My inner author began taking notes, writing down my levels again, what kind of exercise I did, and 2-3 hr post meal readings.
August 12, 2008.. the first day of the rest of my life (yes, I still have that notebook.) I recorded my sugars down and committed to getting that a1c lower and feeling healthy again. I woke up that day to a 101 reading, lunch I was 114, dinner, 92. The next day, 92 at breakfast, 136 lunch, 74 dinner. The rest is history.
November 2008, my next check up, I was 8.1. In August I was 8.9. We met again in June 2009, my a1c was 7.9. I was doing backflips over the moon, but my Dr shot me down mid flip with concerns about my creatinine. Woops. I was taking an over the counter supplement at the time, increasing my body's own creatinine production, in turn, putting excess pressure on my kidneys. Not good. I have to admit to regular alcohol binging on the weekends, and an everyday diet pop in this era too. However, the combination created the perfect storm for a 2.5 x creatinine reading. She assumed I was taking a supplement as I never showed indication of kidney malfunctioning before. I swore off anything over the counter and to this day I don't take anything, unless you count coffee and peanut butter. I've never had any issues since. So attention to you supplement fiends, have your blood checked, really understand how your body is metabolizing your workout must haves. Oh, and the days of alcohol are long gone. A Guinness or Yuengling with a burger or steak, that's about it. Alcohol and diabetes doesn't add up (future topic.)
While in pursuit of the perfect ranged a1c, similar to athletes working towards their next goal, the road isn't always smooth. I am proud to say though, my a1c has been 7.6 and lower since December 2009. Each year that passes, I am that much more cognizant of my body. Before running became a main staple in my regular routine, I was on twice as much Lantus, a 24 hour baseline insulin I take every night between 10-11 pm. When the runs became more regular, the need for the amount of insulin naturally decreased over the years. Insulin sensitivity, the phrase all diabetics should get familiar with. One of the greatest wonders of exercise are it's naturally insulin sensitivity enhancing properties. Essentially, the body efficiently can use smaller doses to keep you within a healthy range of glucose in your blood. Life's much, much easier this way. A lot more balanced too. I was taking 24 units of Lantus in August 2008, I now take 12 units in April 2017.
Some key points to stay observant of in regards to the holy reading of a1c. If your a1c is higher or lower throughout the year, make note of what was different, at least every 3-6 months. My a1c in July 2013 was 6.6. Hindsight has proven that my reading at the time didn't paint the full picture. I had pretty routine low blood sugars giving me my "perfect reading." My a1c in 2014 was between 7.1-7.4, and one of those visits, I swore I was 6.5-7.0. I was furious, but my Dr. remained calm and explained to me, I wasn't having regular lows as much as I was in a more stable range, and while she hopes to keep me in the 5-6 range for life, a 7.3 reading within a stable range can be tweeked a few ways for the perfect reading. She was very pleased with my overall progression and direction since we met when I was 21.
Going on my 15th year next month, May 29 to be exact, I never fail to be amazed at what this disease has taught me. It's taken me down some uncomfortable, rather frightening roads yet also given me the courage to jump off the stratosphere, hike to Angels Landing or do hill sprints in the heat of summer, just to remind myself, I can do this. I am doing my best to retrain my white coat syndrome tendencies, and keep my a1c pursuit in check too. In the last two weeks I checked myself for a 6.8 reading. I sat there for a moment to let it sink in. While an a1c reading never paints the full picture, it surely does give a peace of mind, and some reassurance. Anybody out there fighting the good fight can attest to, a peace of mind and some reassurance is all we really need.
One of the original benchmarks I learned about in regards to diabetes long term care was an, "a1c." It was explained to me as a 3 month average of your blood sugars, and anything 7.0 and below was considered the goal for a long, healthy chance at life. I vividly remember my first 3 a1c readings, 6.3, 6.6, 6.8. Summer 2002-Spring 2003. My Dr's praised me, congratulated me, reconfirming I was on the right path. Then, for the next 5 years, the struggle was real.
Let's take a few steps back. HbA1c, the measurement of a binding molecule in our red blood cells, that when connected with glucose, creates a "glycoslated hemoglobin a1c." This process increases the overall level of a1c in our blood. The higher the % of a1c, the more glucose there is running through your body, inhibiting oxygen intake, and overall health. Hence the high risk for strokes, heart attacks, amputations, various metabolic issues, bad eyes, the fun doesn't stop.
Between 2003-2008, I regularly ran between 8.1-9.6. After a few too many journeys down the rabbit hole, either I was going to wake up and switch directions or stay blindfolded and lost on the current path. After a tough talk in summer 2008 with my endocrinologist, her frustrated tone had me shook as she expressed some real concern with my blood work and my health. It was year 6 and my control was only worsening. She almost demanded I get on the pump, and maybe additional medication over the next year or two if change didn't happen. Shaking my head, "Doc, no, please let's take some small steps.. I've been incorporating more cardio workouts into my routine.. basketball, riding my bike, and running, I am even having lows again. I can get my a1c in a healthier range, I can do this."
Luckily she agreed that I was young enough before any drastic changes needed to be implemented. In a few less words she gave me a time frame to see some progress or she was making demands for my own longevity's sake. I agreed to wear a continuous blood sugar monitor for my last two weeks of summer before the school year began. My inner author began taking notes, writing down my levels again, what kind of exercise I did, and 2-3 hr post meal readings.
August 12, 2008.. the first day of the rest of my life (yes, I still have that notebook.) I recorded my sugars down and committed to getting that a1c lower and feeling healthy again. I woke up that day to a 101 reading, lunch I was 114, dinner, 92. The next day, 92 at breakfast, 136 lunch, 74 dinner. The rest is history.
November 2008, my next check up, I was 8.1. In August I was 8.9. We met again in June 2009, my a1c was 7.9. I was doing backflips over the moon, but my Dr shot me down mid flip with concerns about my creatinine. Woops. I was taking an over the counter supplement at the time, increasing my body's own creatinine production, in turn, putting excess pressure on my kidneys. Not good. I have to admit to regular alcohol binging on the weekends, and an everyday diet pop in this era too. However, the combination created the perfect storm for a 2.5 x creatinine reading. She assumed I was taking a supplement as I never showed indication of kidney malfunctioning before. I swore off anything over the counter and to this day I don't take anything, unless you count coffee and peanut butter. I've never had any issues since. So attention to you supplement fiends, have your blood checked, really understand how your body is metabolizing your workout must haves. Oh, and the days of alcohol are long gone. A Guinness or Yuengling with a burger or steak, that's about it. Alcohol and diabetes doesn't add up (future topic.)
While in pursuit of the perfect ranged a1c, similar to athletes working towards their next goal, the road isn't always smooth. I am proud to say though, my a1c has been 7.6 and lower since December 2009. Each year that passes, I am that much more cognizant of my body. Before running became a main staple in my regular routine, I was on twice as much Lantus, a 24 hour baseline insulin I take every night between 10-11 pm. When the runs became more regular, the need for the amount of insulin naturally decreased over the years. Insulin sensitivity, the phrase all diabetics should get familiar with. One of the greatest wonders of exercise are it's naturally insulin sensitivity enhancing properties. Essentially, the body efficiently can use smaller doses to keep you within a healthy range of glucose in your blood. Life's much, much easier this way. A lot more balanced too. I was taking 24 units of Lantus in August 2008, I now take 12 units in April 2017.
Some key points to stay observant of in regards to the holy reading of a1c. If your a1c is higher or lower throughout the year, make note of what was different, at least every 3-6 months. My a1c in July 2013 was 6.6. Hindsight has proven that my reading at the time didn't paint the full picture. I had pretty routine low blood sugars giving me my "perfect reading." My a1c in 2014 was between 7.1-7.4, and one of those visits, I swore I was 6.5-7.0. I was furious, but my Dr. remained calm and explained to me, I wasn't having regular lows as much as I was in a more stable range, and while she hopes to keep me in the 5-6 range for life, a 7.3 reading within a stable range can be tweeked a few ways for the perfect reading. She was very pleased with my overall progression and direction since we met when I was 21.
Going on my 15th year next month, May 29 to be exact, I never fail to be amazed at what this disease has taught me. It's taken me down some uncomfortable, rather frightening roads yet also given me the courage to jump off the stratosphere, hike to Angels Landing or do hill sprints in the heat of summer, just to remind myself, I can do this. I am doing my best to retrain my white coat syndrome tendencies, and keep my a1c pursuit in check too. In the last two weeks I checked myself for a 6.8 reading. I sat there for a moment to let it sink in. While an a1c reading never paints the full picture, it surely does give a peace of mind, and some reassurance. Anybody out there fighting the good fight can attest to, a peace of mind and some reassurance is all we really need.
Comments
Post a Comment