I had my 6 month endoc appointment last week. My A1C was 7.0. I usually hover closer to 6.5, but the 7.0 was not unexpected based on my meter lately. Doc briefly looked at the very recent history on my meters and let's just say it had been a bad night/morning. Mystery mexican meal not long before going to bed (135) resulting in a lousy midnight high (350), which I brought safely down to 112 by morning. Then out for my morning run, and dropped to 65 in the first couple miles, so gobbled a few shot blocks went on a nice rebound (252) by the time I arrived at the endoc appt. So she looked at the last few meter readings I had taken, and we talked about the volatility and how that's bad, the possibility of restarting my CGM, and scheduled the next appt.

When I got home, I looked the printout from the visit, and under "Impression" it included the words: "Type 1 Uncontrolled". I supposed if you only look at those few recent numbers it could leave that impression. And in her defense, I had not done a good job of preparing printouts and such for this appt. But had she at least downloaded my meters to see more than the last 24 hours, I think it would have shown a more real picture.

19 years of dealing with Type 1, and this is the first time (that I know of) that I've been labeled this way. I've tried the mental cheerleading approach, you know..."I'll use this to motivate me to get back closer to that 6.5". I've also tried the "It really doesn't matter what label some relative stranger puts on me, it's my life, and my job to deal with this as I see fit". But so far I keep coming back to being angry and frustrated with being labeled. I test my BG an avg of 7 times/day, do my best counting carbs and bolusing appropriately, train for triathlons and running races almost every day, and "uncontrolled"? Really?

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Comment by Megan S on September 26, 2012 at 2:44pm

I feel your pain. I keep trying to remind myself that diabetes is a marathon, not a sprint and that it's the long term trends that count more than the occasional spike or drop.

I think generally the community of people on TuD are a proactive, well-educated and researched bunch. I think this is why we so often feel frustrated by the doctors, because we're actively working to control our D 24/7 and they're making snap judgements after seeing us for less than an hour. I know it's frustrating, but try not to take it personally (I know - easier said than done). The label is the result of an imperfect system and is not the most accurate assessment of efforts.

Comment by Brian (bsc) on September 26, 2012 at 2:56pm

Please don't necessarily take this seriously. Doctors "code" you with diagnostic codes for insurance purposes to make sure you get proper consideration for coverage. The ADA A1c goals is 7% and the AACE goals is 6.5%. If you don't make that it is general practice to "code" you as "uncontrolled." But you aren't out of control and unless you doctor looks you in the eye and tells you that you are out of control you shouldn't think of it that way.

Personally, I don't have any problem looking you in the eye, looking over your A1c of 6.5%-7% as a T1 of 19 years and declaring you as a model of good care. Next time you see him, ask him what he meant by his comment and tell him what I said.

ps. I've been "coded" all over the place, as a T2 as a T1 and uncontrolled as well. All that really matters is how I feel about myself.

Comment by Kathy on September 26, 2012 at 4:19pm

C - I'd be furious, enraged, ready to push someone down and step on their head!
But as Brian said, it's just a label and doesn't mean a heck of a lot.
Still......

Comment by acidrock23 on September 26, 2012 at 4:21pm

I'm not sure I'd give an A1C when your BG is @ 250ish a lot of credence? I think it gets skewed a bit by whatever your BG is at the time you test. A bit OT but I pretty much avoid the shot block things as I've found the maltodextrose (or that's my assumption anyway...) seems to crank my BG up pretty significantly starting at the end of the run. I only eat them if I'm running like 2+ hours and then I try to time them so I'm still running 2 hours later, when the stuff peaks. It might be interesting to try another test and see how you come out when your BG is more stable?

Comment by Clare on September 26, 2012 at 4:36pm

I was labeled "erratic" as far as control was concerned. And to be honest I probably was "erratic" at least as far as the ups and downs were concerned. I was initially a bit pissed off at the endo, but a number is just a number and it doesn't reflect on me as a success or failure it is just a number to use to direct me to better take care of myself.

Comment by Progress Trumps Perfection on September 26, 2012 at 6:58pm

Thank you all so much for the support and encouragement. Helps just being heard by people who understand. Kathy, your comment made me laugh. I can just see you doing that (not). Hopefully I won't either, but with my middle aged female hormones I'm less than sure sometimes.

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