Posts filed under ‘hba1c’
My six-month mail-in A1C results from the Stanford Healthier Living with Diabetes Self-Management Program arrived in the mail today. My HbA1c was a new personal record: 4.8! Of course I’ll want to get this one confirmed at a real lab, but last time the real lab number was only .2 points away from the mail-in result, so I guess I’ll go ahead and celebrate! w00! Thanks go out to Starlix for allowing me to eat, to New York City and Brooklyn for being so darn pedestrian friendly, to my usual low-carb (and more recently, Zone-favorable) diet for the obvious, and to Crossfit for kicking my ass left and right and keeping me coming back for more. 🙂
Late last week I got my “real” lab results back from my doctor:
The doctor called my HDL “superlative” and says he’s never seen that high in a patient, ever. Thanks pecans, almonds and fish! I was a little suprised by the A1C but I think it just goes to show how much good all this walking is doing me.
My latest round of labs arrived in the mail today from my Stanford Self-Management program 6-month check-in. Before I spill them, though, I have to confess that I accidentally left the little card that you drop your blood on out to dry for way longer than I was supposed to… about eight hours longer. Therefore I’m not very sure about the accuracy of these numbers, particularly the A1C, which came in at a surprising 5.2, which according to this chart puts my average blood sugars around 108 mg/dl.
On the cholesterol front, my HDL came in at 91 mg/dl, which is fine, but my LDL was a slightly disturbing 132 mg/dl, far above the target 100mg/dl or lower. My total cholesterol was 235 mg/dl, which is well above the target of 200 mg/dl or lower. I’m not freaking yet, though, because Thursday I finally took my fasting butt to a Quest Diagnostics for the large round of tests that my doctor ordered when I saw him well over a month ago. So sometime in the next week or should have a second set of numbers to compare these with and will then either keep on keeping on or make some adjustments.
Speaking of cholesterol, this New York Times article from August, Looking Past Blood Sugars to Survive with Diabetes, is a great read and raises a good question – are cholesterol levels that are OK for non-diabetics really OK for us diabetics?
Things are continuing to improve on the insulin front. I had a follow-up with both the dietitian and PA last Wednesday, and left with two prizes: an A1C of 5.8 (I was expecting higher) and an I-Port.
For those of you not familiar, the I-Port is a neat-o insulin delivery device that gives you one place to inject into for 72 hours, after which it is disposed of and a new one is installed. You inject into it rather than your skin, so there is no pain involved other than the normal sting associated with the insulin hitting your tissue.
I’m on my fourth day and second I-Port, and the novelty of feeling a bit bionic has not yet begun to wear off. I adore not having to hunt for injection sites, endure bruises, and remember to rotate. It’s too soon to say whether its having any affect on my BG control, but expect a full review and more photos after I’ve spent a bit more time with my new, button-esque friend.
Today I started an online diabetes management workshop. I haven’t mentioned it before because I’m not sure how much I’m allowed to discuss it while the workshop is going on, but I have to at least mention this: before the workshop started I had to send in some blood work for A1C and cholesterol but had forgotten about it. Today I found out my A1C result… 5.3. This is the second to lowest, if not lowest A1C I have ever had. Of course this only makes the little voice inside my head that all weekend has been asking “what the @#$@ are you thinking changing your diet and going on insulin when you are having the best blood sugars of your life?” even louder.
My visit with the PA went well. My A1C was not surprisingly down to 5.7, which is not exactly a dramatic improvement from the 6.0 of my last visit, but is still good and is still in the 5s. I discussed my concerns with Starlix potentially causing long-term damage to my beta cells with the PA. She said she is unsure that there is really anything we can do to stop the progression of my diabetes (BS!), so I asked her to explain the exact mechanism by which MODY diabetes progresses. She explained how type 1s progress but admitted she didn’t know how MODY progresses and agreed with me when I said that maybe the “progression” of diabetes in MODYs isn’t progression at all but the result of high blood sugars causing insuling resistance over the years, which would mean that the “progression” is completely preventable through tight control.
She commended me for being in control of my diet and blood sugars, but was also a bit critical of my low-carb diet (which is not even that restrictive or completely carb-free) and expressed concern over me being “too obsessive” with my diet and cutting out too many carbohydrates. She insisted that I need carbohydrates to be healthy, which I also questioned, so she is sending me to a dietician, something I haven’t done in 10 years.
She suggested three or four possible alternate treatment routes: insulin, Amaryl, Januvia and Byetta. She is unsure if the last two will work for my type of diabetes, but added it to the list of things to discuss with my doctor when he returns to the office. I told her that I was not very interested in going on any of the newer drugs (Januvia and Byetta) since I am considering having children in the next few years and don’t want to do anything risky to my body. Amaryl has been around for 10 years or so, so I will read up on it this week, but am still a little unsure about changing my treatment to a different drug when I’m going to have to go on insulin sometime in the next few years. I hope it didn’t sound like I was asking for insulin, because I’m not – I just want to do what is best for my body long-term.
She also ordered a C-peptide to get a sense of how much insulin I’m producing vs. the last time I had a C-peptide which was almost 5 years ago, so that should give us some guidance as far as what damage the Starlix might be doing. She also OK’d me trying a meal or two without the Starlix to see exactly what affect it has on me, but she is doubtful that we’ll be able to control my diabetes without any medication or insulin. So in the meantime, she’ll be discussing all of this with my doctor and doing some homework, and I will continue my current diet and treatment. Oh, and a CGM wouldn’t be covered by insurance unless I was on insulin and having problems with lows or if I was pregnant. So overall it was a good visit – I didn’t expect her to be able to answer all of my questions without consulting with my doctor, so I’m anxious to see what he has to say about it all.