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I just had my A1C done and was looking over the blood work. My fasting BG was 139 then off to the side it gives normal range of 65 - 99. I have always been told that if your under 140 it is good but the lab work says I'm high.
For the A1C I am at 6.9 and off to the side it says normal is 5.7 or less. And again I have always been told I need to keep it below 7.0 and that is good.
I am wondering if the lab is right in there range or the doctors I see? Now I know why I stay confused all the time.
Those are good goals and I try to meet them. I was actually given a pre-meal target of 100 with no more than a 30 point rise which is not all that different. Higher goals aren't bad if they are used to help a person get down to 120 from 150 or 180. Once that is achieved, one can take the next step and I really believe that nothing succeeds like success.
I am getting the dp effect.
Do you "tune" your pump with a basal "bump" in the early AM hours, to cover DP? My pump trainer recommended that and I've done it ever since. DP suxx as it sort of starts every day on a sour note. I still get it sometimes and have to adjust the bump but bumping seems to work pretty well?
Yeah, you are, and you CAN fix it with a pump. It's so much easier than if you were on Lantus once a day. Starting around 3 AM, increase your insulin. Start by a small amount: .1 or even .2/hr (I'd start at .2, myself; you wake up pretty high.) Check your blood sugar in the morning for a few days, Adjust accordingly. You probably need a bigger increase than .2.
[[Like I said above, I aim to keep my fasting <100, ideally more like 70-80. And my DP is WICKED in pregnancy -- the placenta pumps out crazy anti-insulin hormones. So I have to adjust my early AM basal like every few days. I do it a tiny bit at a time: .1/hr, for example. My overnight basal is now about 3x what it was before I was pregnant (as is my total daily dose...)]]
Numbers are numbers, and yes, they will vary based on the lab and the lab equipment used.
Speaking from vet med... in chronic disease states, there might be a particular lab value or set of values that we are looking at when we run repeat bloodwork every so many months. We are looking at trends. We are looking at whether or not that number is good for that animal with that disease state.
We have no hidden agenda of hiding the truth from our patients. In fact, we might say something like, "Well, the XYZ lab value is still elevated above the range of most normal animals, but this is actually a very good number for a patient with this disease. Here's what we might do if you want to try to make it better, but realistically..."
Given that I was just diagnosed with 'the big D' a few weeks ago, I realize I haven't had near the personal experiences that almost all of you have had with this disease..
But I think it's important to remember that your doctors are probably not trying to hurt you, and that they realize some of these numbers may be the best that someone may be able to get with the big D. And if you have concerns that they are hiding things from you or that you aren't getting the whole story, just ask. Really. Don't be afraid to ask if it's possible to have an A1C of 5.whatever... and ask how many non diabetics actually have a 5.whatever A1C.
Also, just as an aside.. there is currently research going on with A1C and figuring out whether it's actually as valid as everyone thinks it is in people... In animals, we measure fructosamine.. and there is some suggestion that measuring fructosamine in people may provide a superior snapshot as compared to A1C (one of my docs told me this, but I haven't looked for any of the papers on it. Just food for thought.)
There's a reason why they call it 'practicing medicine'... 'cause it ain't ever gonna be perfect, there's too many variables! And things change ALL the time.
palominovet; We just found out our Maine Coone Cat is diabetic a few weeks ago. We take her back for a test on Monday morning to find out what her status is. Right now we are giving her 1 unit in the morning and 1 unit at night. We are hopeful she want need to continue on insulin.
Good luck with her. Kitties can sometimes do much better with weight loss and diet changes which improve insulin sensitivity. Sometimes they can become insulin dependent. And still yet other times they just can't make up their mind!
10 years ago my HMO used to measure fructosamine not A1C, I think it covers 1-2 months rather than 2-3 as A1C does. I don't know why they changed.
Would be interesting to find out. If I learn anything I will share. :)
My doctor has used the fructosamine when my A1c seemed repeatedly "off." There have been fewer studies to establish what a good range is and how the frutosamine maps to average blood sugar.
paliminovet - I got better advice about diabetes from my cat vet than I ever have from a doctor. The vet assumes that I will take care of my animal if I have correct information and good instruction. Why can't my doctor give me the same credit for having a brain, and at least some reliable information about taking care of myself?
A very good question indeed. It's almost like "If you were dumb enough to get this disease, then you can't possibly be smart enough to understand what I should tell you Let alone take care of your health." I know that is how several professionals came off to me.