I got my most recent blood work back and have an A1C of 5.4%, the one before that was 6.0% I was really pleased when I heard that but then I wondered if it really is good enough. Do we ever get happy with our numbers? I just don't want to "settle" I guess but then I have to remember I didn't think I could get below 6% a year ago. Always something . . .

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No harm trying to always improve if it doesn't involve excessive lows but you have every right to be happy and proud of a 5.4. And if you can't go lower you've already achieved more than most of us ever will.

Congratulations!

Maurie

I guess you would have to define excessive lows. If I wake up and I am 65 - I don't consider it low. I don't really consider anything over 60 low unless I have IOB. My old endo would probably be giving me a hard time right now.

I achieved a 5.8 A1C at my latest and used a similar range that you describe here -- I considered 60-65+ an "allowable" low for me. But I'm just back from the Diabetes Ed Clinic where they gave me a hard time about being too low overall and too often too low. The nurse went through my log with a neon highlighter strictly marking anything under 72 and the advice is less insulin. Hmm. The range they prescribe is 72-130 premeal & 94-180 postmeal - even if it's a spike that goes the whole range. Following this, I know it will be an A1C over 6. Wow, I'm just shy of a year into my T1 diagnosis, but sure seems like a juggling act that you just win with :S Great job to you, Kelly on your low A1C and kudos to all who have been managing their diabetes for so many years!

I was taught in the Joslin DOIT program that the goal is a 30 point rise postmeal. If you start at 95 and go to 180 that's not OK. Not that it won't happen on occassion but that's a problem to fix not a result to accept.

I'm willing to take a 60-65 but I don't really want to spend much time there. Those regular 62s can turn into regular 57s pretty quickly.

I think the nurse educator was wanting to be firm in her encouragement that I could accept a bigger range than the tight control I'd been working with -- but it's a good reminder that while it happens, a big spike is still not so ok..

For me, I think it was a subtle and over time situation to start accepting 60-65's -- it's also a good reminder that this situation can turn into accepting lower #s... thanks for sharing this 'food for thought' :)

( and above I mean: "just *can't* win with.." )

Kelly,

That is a GREAT number! Congratulations !! If you are constant in your levels, without too many lows or high you are on your way to being as non-diabetic as possible. Great work!

Brian Wittman

Congratulations on this super result.

What do you think are the biggest factors in your improvement (although 6.0 was a good number also)? How long have you had Type 1?

I have had type 1 for 20 years. I think why I have been able to get such a low A1C is because of my CGM. I also am really aggressive with my numbers, pre-bolusing and correcting helps a lot. If I am really high like 200 or so, I will a syringe bolus into a vein (I think I got that from Bernstein, it really works to bring numbers down fast). I think I have been a lot less tolerant to higher glucose levels because of being pregnant, I just don't want to have any complications related to diabetes so maybe that has given me the extra push. I hope I can continue doing this, if I have done this for 7 months it should be habit by now, right?

Great Job!!

I'm happy with my numbers but am always fiddling around trying to improve them. If A1C is good, if you can or if you have a gizmo that figures it out, you can work on lowering your SD.

Or pushups. Pushups are another fun number to play around with!

yea, my SD is not awesome (33 with avg of 90), but I am blaming my diet on pregnancy. I have an aversion to vegetables (which I used to live off of). First trimester all I could get down was starches. The one time I forced myself to eat a salad it came right back up :(

awesome a1c!! congratulations!
tell me more about shooting up directly into a vein, tho!

The veins on top of my hands are very easy to find so that's what I use. I insert it at a 45 deg angle. It took me a few tries to get the right depth down. If you miss the vein, then your skin puffs up like you got a TB test. I found that the insulin still works quickly if you do that by accident, it just hurts more. I can only use those needles one time though because blood usually gets back into the needle. If that happens I know I at least got it right. Then I sit around and wait for the down arrow on my CGM.

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