Tag Archives: Diabetes and A1c

Why Testing is Queen and What Docs Should Know

 

Ok, weird title, I know.  Let me make sense of it.  For us type 1 and type 1.5 diabetics and some type 2 diabetics, Insulin is king.  We need it so bad we can’t live without it.  And In my opinion, testing is queen.  We don’t stand a good chance without testing our blood sugars every day.  Just look at what happens to the insulin dependent diabetics in 3rd world countries.  They don’t live very long.  Some don’t get enough insulin and most don’t have a personal glucose meter to use.  They’re blind before blindness sets in.

I’ve long tried to understand why I rarely meet a doctor that is okay with me testing frequently (8-12 times a day).  They have told me “it’s an exaggeration”, “it’s not necessary”, and “four times a day should be sufficient”.  Well, Doctors…it’s not an exaggeration when I say to you, “It is necessary, and four times a day just isn’t as good as 8”.

I wish I could sit down with all the doctors who have felt this way and explain to them a typical day of mine.  I’d include the way I feel when I’m not in range and how it affects the way I do things.  I’d talk about how low and high blood sugars really hurt my quality of life.  I don’t test more than four times a day because I enjoy it.  I have small hands, small fingertips, and I favor two fingers on each hand for testing and believe me it hurts.  Not to me mention how awkward it can be to test in the middle of a dark theater using the small light from my cell phone, hoping no one will notice and get me kicked out or be offended.  I test more than four times a day because catching a 150 before it becomes a 250 is priceless.  Because finding out my blood sugar is 70 before carrying my 25 pound twin babies down three flights of stairs and to the playground is just being safe.  And because I’m the one with the kidney failure, blindness, and amputation risks hovering over my head each and every day. 

No.  I don’t test because I want to, I test because after 16 years I’ve tried it all.  I’ve tested 4 times a day, 12 times a day, and 0 times a day.  And in the end, my blood sugars speak the truth.  They tell me testing more equals better blood sugar management. 

How come famous type 1 diabetic athletes have doctors supporting them when they test 25 times a day?  They’re not more special than the rest of us and even though I’m not trying to win an Olympic medal, I am trying to stay at the top of my game of life.  And I refuse to settle.

I will say, I can have pretty good glucose control with 4 blood sugar tests a day IF I limit variables within my control.  For example, If I do the following: 

-Eat the same exact meals each day, at the same exact times each day.

-Do the same exact amount of exercise and type of exercise at the exact same time each day

-Go to sleep and wake up at the exact same times each day

-Test at the exact same times each day

Now, since many of us can’t or don’t want to live this way, 4 tests a day isn’t going to cut it.  And this doesn’t even begin to mention sick days where diabetics may have to monitor their blood sugars much more frequently nor does it take into account stress and hormone fluctuations that cannot be controlled like a machine.

I used to keep a reasonable amount of routine in my day because it does help avoid unusual blood sugar surprises, but for me personally, and I’m sure many others, every moment is changing and lots of variables come into play.  It’s just not possible.

Another thing:  Why would I be told to test before getting into a car and driving and before each meal and before physical activity and then told to only test 4 times a day?  I’m not too good with math but, even I can see this doesn’t add up.

Dear doctors, insulin dependent diabetes is dependent on quickly adjusting the sails from breezes that come in from all different directions.  Testing is how we adjust the sails.  Insulin is our boat.  We are the captain, and you are our trusted advisor and mate.  Please listen and consider our words.  I don’t like feeling hopeless, like I should just jump ship over some little test strips you won’t let me have.

Friends, if you’re in the same situation as me or if you have a loved one who is or if you care about your fellow diabetics, please read Wil’s important reporting on what the new plans will be for testing supplies and medicare patients and find out what we can all do to help.   Read: The New Minutemen and a Completely Different Kind of Tea Party. 

Endocrinologists, you know better than the General Practitioners and Internists out there when it comes to diabetes and testing and I hope you’ll fight for us on this, too.

I leave you with another enlightening article from Wil over at his blog, please read: Meters Matter.  I highly recommend it to all persons with diabetes and to all doctors.  He gives 10 can’t-ignore reasons why meters matter to all diabetics.

If we choose not to fight for our rights to test as needed, we are starting to see ourselves as undeserving of excellent health and that should never happen.

Latest A1c Results

 

Before last week, my last A1c was a 5.3, taken just at the end of my pregnancy last year.  So after almost a year and a half I was definitely due for the A1c test again.  I know diabetics are supposed to get it done more frequent than that but, I have had a busy year with my twins and feel I don’t absolutely require an A1c telling me what my blood sugars are…my meter does that pretty well.  And since I test a lot, I have a good idea what my A1c is before getting back the results. 

Last week I went to the doctor, a new one I thought I’d try out.  This new doc pretty much let every diabetes stereotype and “no no” slip from his mouth.  For example, he refers to patients not doing well with their diabetes management as his “bad patients”, and he says that “technically, you should only be testing 4 times a day”.  I couldn’t help but laugh to myself and wonder what he meant by “technically”.  I found it ironic that I, according to my A1c would probably be considered a good patient and yet at the same time, by the number of blood sugar tests I do, maybe be considered a bad patient, too?  Why do so many doctors not understand that my testing directly correlates to my A1c and successful diabetes management?

My A1c was once again a 5.3.  I had estimated it to be between 5 and 5.5 and I am pleased to be pretty close. 

Please don’t feel I’m trying to sway you away from getting an A1c done.  I typically get two a year because it is a handy tool and a good back up to the meter (what if it’s off?).  I just like making the point about how important testing is, how it hides no secrets, and how testing during off times like the middle of the night can do wonders to troubleshoot ways to improve blood sugar levels. 

One quick question.  When you get back great lab results, do you get congratulated?  All I got was a “All your labs are ok.”

Gee…thanks Doc…