Latest Endo Appointment

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Last Friday, I had my latest endocrinologist appointment.  I went into the appointment nervous because I’ve really let my diabetes care slack the last few months.  While I have been testing pretty frequently, I haven’t been uploading my CGM data to review so I haven’t been making any necessary adjustments.  I also haven’t been sleeping very well and I think that is wreaking havoc on my blood sugars because the lack of sleep makes my blood sugars higher and I snack a lot more when I’m tired which also contributes to higher blood sugars.

The appointment went OK.  My endocrinologist remarked at how well I am testing my blood sugars, saying that a lot of new moms end up just going by their CGM instead of pricking their fingers (or doing neither and just bolusing off of CGM).  The blood work showed that I was somewhat dehydrated but everything else came back perfectly.  The doctor told me she had never seen cholesterol as good as mine (yay?).  One thing that wasn’t perfect, however, was my A1C.  My latest A1C was 7.0.

My endo was perfectly happy with a 7.0.  I guess I should be too because it could have been a lot worse.  However, after spending the last year at 5.5 or 6.1, it was hard to accept the 7.0.  Also, my husband and I might start thinking about a second baby sometime in the near future so I need my A1C below 7 (ideally below 6.5) for that, so I have a lot of work to do.

She quickly reviewed my numbers but said that I didn’t need to make any adjustments.  I was a little perturbed by that because if my numbers were so good, my A1C would be lower, right?  Now I realize that A1C is just a number and I shouldn’t put too much weight on it but I have felt like my blood sugars have been a lot higher than they should be so I was hoping to make adjustments to get my blood sugars lower.

I like my endocrinologist a lot but I did notice that I had an 11AM appointment and the next appointment was scheduled for 11:20AM, so they are only allowing 20 minutes per appointment.  I feel like that isn’t nearly enough time to address issues, which is probably why we didn’t really analyze my blood sugars too thoroughly to make adjustments.  I guess the onus is ultimately on me so I will have to be more diligent in analyzing my CGM data so I can get my blood sugars lower.

Overall though, my endocrinologist told me I was doing a great job.   She said the blood work showed my kidneys look great and she tested my feet for neuropathy and that was good as well.  She said she was really surprised by my latest eye issues since I don’t really have any risk factors associated with diabetic retinopathy (high blood sugars, high blood pressure, smoker, etc.). A lady (hi June!) posted a comment on a previous blog post about how maybe doctors don’t know all they need to know regarding what causes diabetic retinopathy and I would have to agree because I don’t fall into the high risk factors, other than having had diabetes for 20+ years.  I do remember my high-risk OB warning about eye problems and mentioning something about how drastic changes in A1Cs, whether good or bad, could cause it so maybe when I went from 6.8 to 5.5 or when I went from 5.5 to 7.0 could have done a little damage, or maybe just the pregnancy hormones really did take a toll-who knows!

I feel like I have a lot of room for improvement but I’m happy that overall everything is looking good.  I’m going to really try and get better at checking my CGM data, carb counting and not snacking too often so I can try and get my A1C below 6.5 before my next appointment (and before trying to conceive again!).


5 thoughts on “Latest Endo Appointment

  1. Yay for a godo Endo appointment! Don’t be too hard on yourself. I do get it though, wanting to get back to a lower number you were able to attain and sustain before. Going through the same with my daughter. That being said, it’s important to understand that we may not be able to achieve the same results under different circumstances. Especially when you have a child, it’s so much harder to control the many variables that affect BG, and just take care of ourselves period.

  2. From my (very distant) perspective, things are going well. If your A1c isn’t where you’d like it to be, I’m sure you’d be much more comfortable reaching that decision on your own than by having a doctor scold you over it, and I’m sure your doc knows that the proper encouragement is to reinforce what you’re doing well and not to try to pick out what room there may be for improvement — you’ve already shown that you know that. As for minor adjustments, I don’t believe that changes in rates and ratios are needed — it’s all about the counting and timing and stuff. The hard stuff.

    This story resembles a lot that goes on in my own endo appointments. I’m harder on myself than he is, and he knows that I know what I need to work better on (typically self-discipline). I think he’s a bit bothered, actually, that he’s done all he can and the rest is up to me.

  3. Two things: An A1c of 7.0 reflects an average glucose level of 140 mg/dL. Also, studies have shown that someone with an A1c of 7.0 may have numbers below 80 mg/dL up to 40% of the time.

    So i think you’re doing great, even if that number isn’t exactly where you’d like it. And I have no doubt you’ll be working hard to bring it down soon. Thanks!

  4. Good for you! trying to get below 7 again with a baby sounds tough, but you can do it! I’m trying to get below 6.5 before trying to have my first child so I look forward to your future posts. If you can post more about your diet or exercise tips for controlling blood sugar that would be great! 🙂

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