{Diabetes Management} The A1c…It’s All Relative

by Leighann on April 29, 2013

8.0 A1c

What do you see when you look at this photo?

Some d-parents look at it and see a victory, some defeat.

For some families an 8.0 is hard-won. For some it brings up more questions than answers.

Some d-moms sigh in relief because their hard work and sleepless nights have paid off. Some moms go home and cry because they feel that they have failed their child.

Whatever your reaction to the number you see in this photo, I want you to remind yourself that you are doing the best you can. Sometimes it’s good enough, sometimes it falls short. But you can’t beat yourself up about it.

I have a philosophy that blood sugars and A1c’s are not grades or judgements. They are information. You see a number, you deal with it, you move on. That simple.

That doesn’t mean that you shouldn’t take the time to look for trends or see what you could have done differently. But we have a lifetime to deal with our child’s diabetes (and, of course, empower them to take over as they grow older) and we can’t get so damn emotional all the time.

Dust yourself off and get back in there.

I’m curious: How do you tend to react to all that numbers that diabetes throws at us?

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{ 12 comments… read them below or add one }

1 Katy April 29, 2013 at 6:44 am

and some parents think…what is that machine? and then think: it must be an A1c machine! and then: our endo’s machine doesn’t look that nice. and then: I bet that’s some super-accurate machine that the people who know what they’re doing know to insist their endos use.

also I think: pretty much every number used to make me worry but with our Dexcom, I feel much less anxious. Still feel graded and judged, still feel failure/brief rushes of swagcess. But the arrows really help the brain

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2 Billie sue April 29, 2013 at 7:14 am

Agreed. Thank you for your encouragement but I will still feel like a failure if its not down. I dread the appt for a week in advance and normally feel bad or deliriously glad a week after. Dexcom helped us shave an 11 down to 10 but we haven’t budged since. Trying new things and hopeful.

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3 Robin April 29, 2013 at 10:03 am

Having a cgm really helps….we actually play “Guess the a1c” on the way to the endo….we are usually pretty close! I think already having an idea of what it is going to be relieves a lot of the pressure. In terms of day to day, BG, again the cgm helps…not afraid to make corrections for fear of overcorrecting etc.

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4 Joy April 29, 2013 at 10:29 am

I noticed our endo team didn’t even share my son’s A1c at our first appointment soon after diagnosis. I imagine they didn’t want to give us any more discouragement when we were juggling something so new. Bless them for that.
Thanks for the great perspective on this.

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5 Sarah April 29, 2013 at 10:41 am

Our son has been diagnosed since July. His diagnosis A1C was a 7 something and the two since have been a 6.5 and a 6.6. Although I thought these were great numbers, the endo started telling us that we must be missing a bunch of lows and that they wanted the number higher. I thought it was a great number, then quickly felt defeated. I think there is just so much that I don’t know and understand.

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6 Shelley April 29, 2013 at 12:28 pm

Sarah,

My son is 4 and the range for him is 7.5 – 8.5. If it is lower than that they worry that there are too many lows and you know what 1 low can do.

Hang in there. As they get older, they will probably tighten that target up and that A1c will be perfect.

Our best A1c is 8.1 and that is after 18 months. So, good job on the A1c. They just want to make sure your child is safe.

Hope that explains a bit.

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7 Lisa April 29, 2013 at 10:41 am

I’m wishy washy! With blood sugar #’s that come up on his meter, I take the “its just a number, lets figure out how we got here and how to fix it” approach. But with his A1c, I freak out! I take that # very personally and beat myself up over it. I vow to do better next time, shed a few tears if its not to MY expectations etc. Its a hard balance that I’m still obviously trying to figure out.

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8 Jillian April 29, 2013 at 12:19 pm

I can agree with the strong emotions of a mother, it is very personal because we invest so much with our time and emotions (as well as keeping the house running and maintaining the health of our families). But I’m curious as to how husbands and fathers react, are they as affected by the A1c?

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9 Heather April 29, 2013 at 2:41 pm

Maybe it is because we are still new, but I think of all the numbers as a way to gauge how Kyli is feeling. Moreover, I can generall guess if it has gone up or not based on the sugars we have had at home. I just want Kyli to be healthy, but diabetes can always throw a kink into the “plan”, sometimes we just have to shrug it off. We are just getting started, Kyli is only 3yo, so if I stress too much about it now, I cannot imagine what I will be like when she is a teen…

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10 Kelly April 29, 2013 at 9:37 pm

My son’s last A1c was the highest it has ever been and it was tough to take. We knew his numbers had been running higher than usual but hoped it wouldn’t be as bad as it was. It’s hard not to worry what complications may come from his blood sugars not being in better control. We just try to adjust and hope at the next appointment the A1c will be better.

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11 Allison Nimlos May 1, 2013 at 12:16 pm

Throughout most of my childhood, 8% is what we aimed for. Lows were considered bad for children, and I think there was the thought that we would “grow out” of any high blood sugar doing any damage. There was some thinking that children were protected from complications and so it wasn’t as necessary to be strict. I don’t know if that’s still the thinking (no longer a child, and I don’t have a CWD). I think that — at any age — doing the best you can do is the name of the game. As a wannabe CDE, my thinking is that effort is the best thing you can do. Good effort + good treatment protocol = Good A1C. So if you’re putting in good effort, then you look at what kind of basals and bolus ratios are going on. She’s a growing girl and changes happen so fast. It made it exceedingly difficult, so then you have to remember what influences an A1C. It’s NOT just you. I think that always helps me feel better when I get an A1C I “don’t like.”

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12 Alissa Conn May 1, 2013 at 1:53 pm

While I haven’t had Naomi’s A1C go up since she was dx’d it’s held very steady for the last year, just like my effort with her diabetes care. I have taught Naomi that her A1C is somewhat like a grade on an assignment in school. We do our best and hope for the best, if we aren’t happy with the result then WE work together to make it improve the next time as much as WE can. Sometimes in school you turn in a project and you think it’s worth an A, but you get it back with a B. Maybe it is not from lack of effort, maybe it is or maybe there are a few things that could have been done differently. I’m teaching her this perspective of her A1C in hopes she’ll grow up taking it in consideration when she is the one caring for herself. Let’s hope I get an A. 🙂

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