Missing the A1c Grade


It's amazing to me how every facet of my life is marked by numbers. Professionally, I monitor the number of leads we provide to our sales team on a daily/weekly/monthly basis. I do a lot of things at work but at the end of the day, that's the most important thing.

Running-wise, my brain is always preoccupied with pacing and mileage -- how much this week, how much today, how fast to hit my goals, eet.

And then, there's diabetes, which I have called a lifetime sentence of doing third-grade math 24/7 for the rest of your life. The A1C serves as a diabetic's test in how they did last semester. And yesterday, for the first time in a while, I didn't ace it, coming in with a 6.6.

Understand: a 6.6 isn't horrible. It's barely a notch above the 6.5, which is recommended by a group I can't recall at the moment, and it's a good bit below the 7.0 recommended by another group I can't recollect. But the point is, it's the first time in a while I've been above 6.5 and I want to tell you there's no good reason for it.

But that would be a lie, because if you want to know where the 6.6 comes from, all you need to do is look at the data, to see for yourself.

This chart shows my past 8 weeks of blood sugars and it shows me three things:

1.) I'm doing a great job of managing hypoglycemia. If you want to "cheat" your A1C, you can do so by having lots of lows. Problem is, a 6.6 can't kill you overnight, but a low can, so avoiding lows is a good thing, and I'm doing a great job of it. A good friend and diabetic athlete blogger, Gary, reminded me of this last night when I was whining on Twitter. I appreciated that.

2.) As you can see, though, I'm spending too much time hanging out at 120-135, rather than 100-120. All those black dots that are within the green? That's good, but they're at the top of the green bar. If I want to lower my 6.6 (which corresponds to an overall average of 143), I need to push those black dots lower.

Action step: Raise basal rates across the board with the goal of hanging out closer to 100 than 130.

3.) Unbeknownst to me, my afternoon blood sugars have been running high. This is a difficult one for me to believe, as it comes after my running and lunch and I was surprised to see myself out of the green (out of the money, so to speak) during these periods. But the best part about data like this: the numbers don't lie.

Action step: Bolus more for lunch. Test more in the PM.

So the bad news is I didn't ace the test this semester. The good news? I'm still in school, and still learning.

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