On Wednesday, I had my latest endocrinologist appointment. I was DREADING this appointment because I thought my A1C was going to come back even higher than last time. Postpartum my results have been 6.1 then 7 and I felt like it was going to be even worse this time. Seven is actually pretty amazing in my book but my husband and I are thinking about getting pregnant again so our kids are close in age and because of this, I really need to keep my blood sugars in tight control (below seven).
The last few months have been a whirlwind. My son and I have been doing a ton of activities like music class, library story time, Mommy and Me groups, etc so we keep busy. I have also been trying to work, take care of the house, run errands and keep to a strict sleep schedule for my son so it’s been pretty darn exhausting. Thankfully, my son is now sleeping through the night pretty consistently and taking fairly good naps during the day so I can catch up from all those months where he wasn’t a great sleeper.
However, all of these activities have prevented me from really taking the time to take care of myself. About a month ago, I grew very frustrated with seeing high numbers all the time so I made a ton of changes to my rates, both basal and bolus. I didn’t really follow the rules when making the changes. In the past, I would analyze my data, make one change, see how that change affected things and moved onto the next change once I felt like the first change was good. This time I didn’t do that. I made a bunch of changes all at once and hoped for the best. However, I don’t feel like the changes made too much of a difference. I was still seeing high blood sugars.
Well, I’m not sure what happened but I got my latest A1C result and it was 6.5!!! I was shocked. I thought my doctor must have read the results wrong. I was expecting a 7.2 or 7.3 based on my CGM data. I still don’t know how it was a 6.5 because I didn’t think my recent blood sugars correlated with that average but I’ll take it. I was using expired test strips so I am wondering if that was playing tricks on me, thinking I was having higher blood sugars than normal. (*No, I don’t usually use expired test strips but I was trying to finish up the last remaining strips I had from my One Touch Ultralink meter that I have since retired).
In terms of how the appointment went, I was again surprised. My doctor actually told she was worried that my A1C was too low (although she did start by saying that it was fantastic). She said she was worried about me having too many low blood sugars. This irked me somewhat because I really don’t have lows too often and if she had taken more time to analyze my numbers she would see that I rarely have lows. Because she was worried about lows, she wanted to change my target blood sugar from 90 (where I currently had it) to 100. After giving birth, I had changed my target to 100 mg/dls but a month ago I changed it back to 90 (where it was when I was pregnant) because I want my blood sugars to be under tight control for when/if I get pregnant again. So even though I changed it to 100 during the appointment, I actually changed it back to 90 when I got home (oops!).
This appointment left me at a weird spot with my management. My whole life I was trying to get my A1C lower. Whenever I went to the endocrinologist I was always told it needed to be lower. I’ve finally achieved getting an A1C in the 5’s and the 6’s but now (or when I’m done having kids) what should I be aiming for? If my doctor thinks a 6.5 A1C is too low but above 7 is too high, am I to be aiming for 7 on the dot? That is such a thin line to be walking.
Instead of my doctor telling me she was worried that my A1C was too low, I wish she had just said good job. Looking over my numbers, I don’t feel like my blood sugars are too low at all. I was actually going to the appointment hoping she would see some areas that needed to make tweaks to get my blood sugars even lower, but instead we just changed my target blood sugar on my bolus wizard and left my rates alone. I’m a little confused on how to proceed: should I make any changes on my own to get better blood sugars or should I be happy with where I am? But I will say that I was very pleasantly surprised at my last endocrinologist appointment and it’s nice to have some good diabetes news for once!