My latest A1c

In a previous blog entry, I mentioned that I was nervous about my regular quarterly A1c test, which I had last week. It was a fasting test that checked my A1c, cholesterol, triglycerides, albumin, liver and other things. I visited my endo this morning for the results.

And?

Everything is absolutely fine. The best news is that I’m still in the 5% club. Whew! I was expecting my A1c to be at least 6%. Given the leg injury, the surgery, the leg inflammation that went on for a few weeks, and the lack of exercise (hopping about in crutches may have built my arms and shoulders for the summer tank top, but my physical activity was almost non-existent), all contributed to my difficulty in getting a grip on my blood glucose. I decided to lower my carb intake while recovering in order to: one, control my BG and two, not gain weight. It worked.

But, still, one has to wonder. Given that my BG was generally higher right after the injury and surgery and was unruly for the following few weeks, I was shocked at my A1c. How could it be in the 5% range? I tried to process this today, and came up with three possible explanations:

1.     I read in a diabetes board that the A1c tends to favor the last few weeks of the 3-month period preceding the test. I have not confirmed the basis of this claim, but it may explain my bizarrely magnificent A1c result. As my leg was healing and getting better, as my A1c test date got closer, my BG was also getting better.

2.     The A1c is a 3-month average. It does not measure each day’s levels, much less hourly levels, or even every pre-meal and post-meal (or snacks) level.  Now, I do not test 8-10 times a day, but while I was recuperating, I did more “meal spot checks” than I used to do. Many of those tests showed a generally higher BG level. But, if my 3-month average was less than 6%, and I know that my testing meter showed many high results, then it stands to reason that I also had generally more low BG levels than I thought. I believe it helped that I cut my carb intake, so my post-meal BG was more manageable that I had imagined. And as I said, my BG was improving as my leg was healing. Hence, the average could indeed be lower than I expected.

3.     l could have a blood condition that results in my getting an unusually low A1c. That’s a possibility except that when I was eating massively high amounts of carbs, my A1c was correspondingly high. Although I have not taken some possibly expensive tests to sort out a possible blood condition, I’ll rule this out for now.

There may be other reasons I haven’t thought of yet. But I decided not to spend so much time thinking about it or imagining it was a deceiving fluke. I’m just glad to have good test results.

My endo was so impressed that he offered to cut my metformin from 1,000 mg a day to 750 mg a day. I happily said “No, thank you.” We tried 750 mg once before, and I was extremely unhappy with that dosage because I had to be really careful of what I was eating and drinking, much more than the 250 mg. difference would suggest. So, if one additional pill lets me indulge a bit more, then I’m happy to swallow it. Mind you, I’m not talking about eating whatever I want. But just enough for me to enjoy life without massively depriving myself or being bored with eating, while at the same time keeping a handle on my BG within a comfortable level (around 140 mg/dL post-meal).

So, as I’m writing this, I’m celebrating with a glass of Sauvignon Blanc.  My apologies if my writing slurred.

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4 thoughts on “My latest A1c

  1. Allison Nimlos

    I can explain your question in #1. Red blood cells live for approximately 3 months. Each week old RBCs are dying and new RBCs are being formed, so the farther back your “bad” BGs were, the more likely it is that those RBCs have already died. If you have a period of 4 months between appointments, then all of the RBCs that were around during the first month are gone entirely by the time of your appointment. Does that make sense?

    Reply
    1. runningwithoutsugar Post author

      Hi. What you wrote makes a lot of sense. But it doesn’t apply in my case though because my previous A1c test was 3 months before (my endo is strict about my quarterly A1c and annual tests), and my leg injury happened 2 weeks after. So, the “bad” BGs were part of the average. This experience has reminded me not to rely only on A1c tests, but to do self-testing as well.

      Reply
  2. Phil Ruggiero

    I am incredibly impressed. I made it to the 5% club once, but for the last year have been at 6.1%. When my doctor suggested I stop taking Metformin I was shocked. I loved my Metformin. Like you, I could eat a few things here and there. But, my doctor pushed me a bit and I agreed to leave my Metformin. My lovely Metformin. And, yes, I had to be more careful about what I ate, but you know what? My A1c did not change. Not a bit. The pharmacist that writes for my blog tells me that studies have shown that the lowest effective dose of Metformin is 1500 mg per day. You are already well below that, as I was before stopping the medication. I’m just saying…

    Thanks for stopping by the blog.

    Phil

    Reply
    1. runningwithoutsugar Post author

      Thanks for checking in. It is possible that when I was diagnosed, my insulin resistance was not a more progressed stage. Another factor could be my physical activities, of which I am a big fan. But I also know from experience that reducing my metformin will not work for me. I hope you find a control regimen that works for you.

      Reply

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