I spent part of my morning at the Niagara Diabetes Centre. I love going there because they always seem really happy to see me. Perhaps because fit diabetics who take an active role in their diabetes maintenance are rare in Niagara, or maybe I'm just so damn cute, but my doctor and nurse are always pleased to see me. Other staff will occasionally pop their heads in to ask about running or tell me about a cool website that I should check out.
Aside from the social chatter and ego boost, I actually go there to get my quarterly blood work results and find out how I've been doing.
Before I reveal the results, I thought this might be a good opportunity to provide a little diabetes lesson. For those of you with the diabetes, it may be a good review. For those of you without it, it may help clarify a few things.
Blood Glucose Testing: Ever seen a diabetic pull out a little contraption, prick their finger, put a drop of blood on a test strip and wait for a beep? That's blood glucose testing. What we're doing (in simple terms) is checking how much sugar is in our blood at that moment. It helps us figure out why we might be feeling weird or what our number is because we need to calculate how much insulin to take for the meal we're about to eat.
Someone without diabetes would have pretty stable numbers (betwee 4-6 normally) and these numbers wouldn't change much even after having a big piece of chocolate cake. Trust me, I've tested people right after dessert - it's ridiculous how little their blood sugar changes. Someone with diabetes can see all sorts of crazy results. I've personally seen 1.2 (which is scary low and feels horrendous) and I've seen 30 (which is scary high and feels like a totally different kind of horrendous). Sometimes we check to confirm what we already know, other times we check and are shocked by the results. It's not always easy to feel how we're feeling.
I test fairly frequently - probably 10-12 times on any given day. That may seem like a lot but it still means that there is a good part of every day when I don't know what my blood sugar is doing. Is it climbing, dropping, staying still? Hard to say. You can miss a lot of highs (and even some lows) simply by not testing at the right time.
(Aside: yes, there are continuous glucose monitoring devices out there but I've found them too expensive and too inconsistent for my lifestyle.)
So, to recap, blood glucose testing tells you what's going on at a given moment but not how you're doing overall.
That's where Haemoglobin A1C comes in. This is a blood test that gives an average of our blood glucose level over the past few months. Someone without diabetes would have an A1C of between 5.0 and 6.0. Someone with diabetes has to set the bar a little higher than that depending on all sorts of other factors.
My doctor has me aiming for 7.0. Anything lower would mean that I've had too many lows and anything around 8.0 is just too high.
Now, here's the trick. I can get an A1C within range two different ways. First way: I can have lots of highs as long as I have lots of lows. Remember: A1C results are an average. The second way is better and much less dangerous. Ideally, I get my A1C as close to 7.0 as possible without too many lows because that means that I didn't have too many highs either. It takes a lot of monitoring, planning and control. It's worth it in the long run because consistently good A1C results means lower risk of complications. Not no risk but lower risk. Heck, I'll take what I can get.
Today's result? 7.1