A Real A1C.
Last week, I had lab work run to review with my new primary care physician (my previous one, after only a year, is leaving the practice, which sucks because she was great, but thankfully, the new guy seems cool, only he wears a bow tie and I'm not sure how I feel about that, or how I feel about this massive run-on sentence). It was standard stuff, including an A1C, and my new doctor and I reviewed all of the results at my appointment this week.
And for the third time in a row, my A1C is at a level I'm happy with. It could drop a small bit, but if it stayed where it is for the rest of my life, I'd sleep fine. But what makes this recent run of decent A1Cs different is that this time, the number is reflective of real numbers, instead of the averages of highs and lows.
Here's what I mean: I've had A1C results that were higher, but that number was a reflection of a lot of normal to high blood sugars (100's to 160s), with some true highs thrown in (over 160), and very few lows. Conversely, I had really, really low A1C results during my pregnancy that were the direct result of running low all the time. (ALL THE TIME, like bowls of cereal eaten without a bolus and I'd still end up at 60 mg/dL kind of lows. Crazy hormone town.) After a low over a year ago that really threw me for a loop, I was very edgy about low blood sugars and actively avoided them. This meant a higher average run, and few lows due to a lack of aggressive corrections. My endocrinologist suggested that I raise my blood sugar "correct to" goal to something in the 140 mg/dL range, instead of 100 mg/dL (where it was before, during, and after pregnancy).
Over the course of a few weeks, that hypoglycemia fear eased back a bit and I felt comfortable with a lower blood sugar goal, but I was still edgy about lows. I started being more vigilant about tracking and correcting highs (thank you, Dexcom, for giving me a heads up on those highs as they start to creep in, versus finding out about them once I'm already high), which began a steady, but slow, decrease in my A1C.
And this is why I'm fine with my A1C result, as it stands right now. Because it's not an average of a pile of lows and highs and some in-between numbers. It's a reflection of blood sugar values that are, for the majority of the time, in a range that's on target, without throwing in a bunch of lows to cause the drop. It doesn't mean I have anything remotely close to figured out, but for this moment in my life, I'm not actively fretting about my A1C. (This is a novel feeling.)
"So what you're saying is that you're fine with this number? Because I'm fine with this number," my doctor said, fiddling with his bow tie. And then he paused. "Not that I need to be fine with it, though. This is your diabetes."
This is why I'm okay with my A1C right now, and with my new primary care doctor.
Only I'm still deciding how I feel about the whole "bow tie" thing.