The Truth In Numbers

I was diagnosed almost twenty years and in all that time I have never had an A1C under 7%.

And this fact fuels shame and embarrassment like you wouldn’t believe.

In these past twenty years, I have had more than 7,000 days and more than 175,000 hours worth of diabetes experience. I have interviewed world-renowned physicians like Francine Kaufman, Steve Edelman, and Bruce Buckingham. I have attended two ADA Scientific Sessions, three AADE annual meetings, and three Friends for Life conferences and countless scientific updates from ADA and JDRF. I have visited the laboratories Ed Damiano, Denise Faustman and the Diabetes Research Institute. I have researched articles for Diabetic Living, Diabetes Health, JDRF, and of course, Diabetes Mine. And I personally worked with the AADE Diabetes Educator of the Year, Gary Scheiner, on and off for the past 10 years and I faithfully see my endo every 3 to 4 months, who answers all my questions and treats me like I understand diabetes because I do.

107_0807fWhen it comes to diabetes, I know my shit.

And yet here I am, sitting at a 7.7%, wondering how it is that in twenty goddamn years I haven’t achieved this goal once.

The more I thought about it, the more I realized that this mirrors exactly my experience in losing weight. It’s not that I don’t know how someone loses weight, it’s that I don’t ever do all that it takes to actually do it.

Knowing what to do and doing it are two wholly separate things.

Because doing the things you know you are supposed to do is hard.

Here’s my repetition: I go to the endo or I get on the scale and I realize that my A1c/weight is too high. I have to do something about it. So I count carbs/eat healthier/exercise more/check my BG more often/look for trends diligently (ever notice how similar the things for weight loss and A1c loss are?). Then I go back to the endo or get on the scale and I see that my A1c/weight has dropped. Yay! What I’m doing is working! Woohoo! So then I stop paying attention as much. I figured what I was doing is what I’m “naturally” going to keep doing. And slowly but surely I get a little lazier.

“One more won’t hurt.”

“Oh, my BGs are mostly good, this high BG is a fluke.”

“Actually, I think I’m going low a lot these days.”

“I definitely ate really healthy today.”

“It’s a special occasion.”

Or simply: “I want this.”

And so then the next time I go to the endo or get on the scale, I find out my A1c/weight has gone up. I have to do something about it! And the cycle repeats itself. Over and over again.

I think that for me, I keep thinking that once I start moving in the right direction, I can go on autopilot. But that doesn’t work. Habits are incredibly hard to break and it takes way more than 21 days or however long they claim it takes to form a new habit. When it comes to my weight and blood sugar, it takes a heck of a lot longer than that. I have to pay attention more diligently. I know this probably sounds like a lot of “duh” information, but for me this doesn’t come easy.

My twentieth diaversary is January 27, and shortly after that, I will have another endo appointment (sometime in February or March). My last endo appointment, yesterday, had me at an A1c of 7.7%. My goal is for my first A1c of my third decade with diabetes to be under 7%. That is a big drop, but last winter I dropped 1.1% (from 8.3% to 7.2%). I think I can do it. But I have to be diligent about it. I can’t get lazy and just think that whatever I’m doing is just going to keep happening without me thinking about it. And like weight loss, it’s going to involve hard work, sacrifices and planning.

I’ll be talking more about my strategies in some upcoming posts.


Have you ever made a significant reduction in your A1c between appointments? What were your strategies?


11 thoughts on “The Truth In Numbers

  1. I’m right there with you. My 20th diaversary is in December and in 20 years I have never had an A1C below 7. I get my A1C checked this week and I’m crossing my fingers I will be under 7.

    Don’t get discourage though. I personally think that an A1C in the 7’s is good! The only reason I’m trying to get below 7 is because I’m hoping to get preggers soon, otherwise I’d be happy in the 7s. I don’t think you are doing anything wrong, having diabetes isn’t easy! I got diabetes when I was young and for whatever reason my parents thought it better for my blood sugar to stay high (I think they were lazy and didn’t want to have to deal with a low child) so I’ve always tended to be on the higher side. I think it’s harder for people who were diagnosed younger to break habits that they have spent years building.

    You can do it though! I think my A1C might finally be under 7 but that’s after way too many basal tests, cutting out a lot of carbs (something that I love!) and running a ton…it isn’t easy! An A1C in the 7’s is something to be proud of though!

    • An A1C in the 7s is good… if I stayed there! But I don’t. I fluctuate between the upper 7s and low 8s almost constantly for the last 5 years. If I knew I just stayed put, that would be one thing. But I don’t… I’m on a constant roller coaster and I don’t like it one bit.

  2. I’ll be 18 years on Oct. 26 and can completely relate. In 18 years I’ve had 1 A1c under 7. I think we’re all from the generation that was taught it’s better to be high than low. Nowadays, families are trained to be aggresive with diabetes managment right out of the gate. To Kelley’s point, we have to retrain ourselves to think numbers above 150 (as an example) are actually high blood sugars.

    I had labs drawn on Tuesday morning and for the first time I think it’s coming back under 7. I’ll post more about it once I know the result, but the one and only thing that has made the biggest difference is really limiting how many carbs I eat per meal. It’s not so much low carb, but rather spreading the carbs out. It’s a hell of a lot of work, but it’s working for me (at least, I think so…here’s hoping the labs confirm).

    • Eating less carbs has definitely helped in both the A1c and weight goals, and so that’s something I’m planning (fingers crossed!) to keep doing moving forward.

  3. Allison, I hope you make it! It took me 18 years to get an A1c under 7 (my 23rd diaversary is January 30). Just keep doing what you know you need to do and reach out for support when you need it. Aaaand, remember that it’s just a number and it doesn’t define your worth in any way, good or bad. Thanks

    • I definitely don’t take it personally, but as someone who wants to be a CDE it’s a bit of a source of embarrassment that I can’t do it even *once*.

  4. You can do it! Great post!!!

    The key for me has been getting back on the pump and my Dexcom. I went from 7.9 to 6.8. When I first started on the Dexcom, I babystepped the high alert down. So I kept it at 200 for a few weeks, dropped it to 190, then 180 after a few more weeks, etc. I think this helped me to not feel like a failure and quit after a few days of trying. It’s been great.

    • I’m working on getting my Dexcom back (the transmitter was lost a few months back and my warranty just now expired). So I haven’t really seen it in full action. But of course, reacting to the highs and preventing them in the first place will be the main challenge. I like your idea of baby steps on the alert. Good idea!

  5. I really admire your honesty. I am there too. My lowest of all time is 7.8. I have those cycles also. It is like I expect my habits to have space like properties, you send something in a direction, and it will just keep going that way for eternity.

    I believe in you and will be excited to read whatever you write in January.

    Even if you aren’t under 7, you kept trying all this time and that matters more than anything.

    You’ll be #winning no matter what.

    Great post.

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