Tuesday, February 21, 2012

A1C Me Go!

During that routine physical last summer, my nurse came into the exam room and told me there were traces of sugar in my urine and she'd like to get a blood sugar reading.  She appeared startled at the meter's output.  She looked at me and said, "You have a blood sugar of 465."  I looked back at her and said, "Okay."  What did 465 mean?

My nurse proceeded to tell me what a normal blood sugar should look like.  I proceeded to think, "Was it that big slice of cake I ate last night?"  I thought the diagnosis was a mistake.  That you couldn't possibly know from one reading that someone was diabetic.  I just didn't understand.

I was admitted to the hospital and had lab work completed which revealed an A1C of 12.  RL circled where on her chart my A1C fell in relation to the desired range.  I wasn't even close.  Was it the pancakes I had every morning for breakfast?  The energy bars I gobbled down between meals?  The sandwiches?  Endless sandwiches?  Before I was diagnosed, my stomach felt like a bottomless pit.  I was hungry all the time.  I would no sooner finish a hearty breakfast than be snacking again.  Usually dense, carbohydrate-rich foods.  I had thought if I only ate enough high-energy, high-carb foods, the fatigue and the weakness would go away.  I'd stop falling.  I'd stop needing to grip the shelves at the grocery store to pull myself up from a crouching position.  Had I brought this disease on myself?  

RL assured me that the cause of Type 1 diabetes was unknown and unrelated to my lifestyle.  Effective diabetes management, on the other hand, was closely linked to the choices I would make around diet, exercise, sleep, and stress.  Several months later my A1C dropped to 8.  Then 6.1.  I was so close to that magic number, that 6 that would offer a safe environment for the baby I would someday carry.

I looked up recommendations of the American College of Obstetricians and Gynecologists for optimal pre- and post-meal blood sugars and have been tracking my sugars more closely to keep them in line with these recommendations.  It's been discouraging at times since my honeymoon period is coming to an end and my carb ratio has been changing dramatically over the last few weeks.  I no sooner find the carb ratio that keeps me stable after meals than I get a dramatic and inexplicable spike after a meal I've eaten many times before.  And I need to begin the adjustment process all over.  It's also starting to look like my insulin needs are higher first thing in the morning and lessen as the day goes on.

Each time I feel frustrated at the effort required of me to manage my diabetes, I...let myself feel frustrated. And I talk to M about the frustration.  And he listens each and every time.

How do you manage the frustrations?  And celebrate the successes?

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