I’ve been working on bring down my Hemoglobin A1C for about the past ten years. It hasn’t been easy; shift work, stress and basic lifestyle make it somewhat difficult to maintain decent blood sugars at the best of times. This was one of the main reasons behind why I decided to start on pump therapy. Over the past five years or so, I’ve been slowly creeping my way down.
For those of you who don’t speak the Diabetes dialect, Hemoglobin A1C (or simply A1C) is a measurement of the average blood glucose levels over three months by measuring the percentage of glycated hemoglobin in the blood. Anything over 6.5% is usually indicative of someone who has Diabetes. Anything below that is generally considered normal. There can be some exceptions to these levels, but it’s pretty basic and has been one of the most-used evaluations to measure how controlled someone’s blood sugar levels have been.
The big problem is that in the past five to ten years, improving A1C results have yielded to increasing one’s blood sugar’s “time in range.” That is to say, maintaining more time between 5.5 to 7.0 mmol/L. The big problem is that one’s A1C level can be manipulated over three months thought extreme highs and lows. Time in range cannot. Keeping your blood sugar in range can’t be manipulated, which is where my new pump and CGM come into play.
Auto mode on the new Medtronic 670G (or newish to me, at least) uses continuous glucose monitoring to verify my blood sugars every five minutes. That means that my blood sugar levels are measured 288 times a day, assuming the sensor and auto mode are working right. The best I’ve ever managed is about once an hour, without taking into consideration that I try to sleep for eight hours a day and work. Meaning that I may get lucky and test my blood six to eight times in the course of a day with a traditional blood glucose monitor.
Combine the fact that auto mode works to correct blood sugar levels with each and every one of those readings and you greatly increase your odds of improving your time “in range.” Listen to me, I sound like a damn infomercial. I should be getting commission from Medtronic for endorsing their products. But seriously, my insulin pump and CGM have been great tools for helping me lower my A1C’s over the past few years.
Just to give you some reference, I started out with an A1C of about 8.4% five years ago. At those levels over an extended period of time, this A1C level will eventually cause vision problems, blood vessel and organ complications, heart disease and stroke. It stands to reason that I would want to try and lower it. But considering what I wrote in the previous paragraphs, why am I still focused on A1C’s? Shouldn’t I be working on “time in range?” Yes. Yes, I should. That’s why I’m doing both.
Better time in range means a better overall A1C. So the bottom line is I’m working on both. A week ago, I visited with my endocrinologist and was advised that my A1C level was at 7.2%, which is the lowest it’s been in years. My overall goal is to get to at least 6.9%. That would be a feather in my cap, as my doctor would say, and is hopefully a goal I will be able to achieve by my next appointment in March. ☯
The Blogging Buddhist 