Sunday, 23 September 2012

Blood Tests Don't Lie

When I was younger I used to imagine up BSL numbers and add them to my log book. I quite clearly remember doing it. I'd fill in my log book with all my "real" numbers and then go through and add more numbers to show I was testing more often that I actually was.

I look back on it and just shake my head at 16 year old me. Making up numbers helps no one! And given insulin ratios are adjusted based on my numbers it could have been very dangerous. It wasn't something I understood back then but I do now.

But at the end of the day, blood tests don't lie. Not like imaginary log book numbers. Even though HbA1c isn't completely accurate and has to take into account you might be swinging between lows and highs to reach that number, it is the main measure of control that we have.

My HBa1c has never really been that controlled. I think I've jumped around 7 - 10 quite a bit. At the end of last year I had an incredibly shocking number (Cringe, 12) which was a result of an extremely stressful and busy year. The whole A1c numbers jazz has mixed opinions in the DOC. I've read some people that see at as incredibly personal and something that doesn't need to be shared. Juice Box Diaries has a really good blog post about it. For me, I do see it as a personal number but also something to share. The whole reason I started blogging was so I could document my experiences and look after myself better. I get inspired on a daily basis by those online who have numbers under 7 and feel hopeful for other people, who like me, are trying to look after themselves better. It's a constant battle of balance.

I'm very happy to report I had a blood test recently and it has jumped a lot lower than my last one. In NZ we are measuring with the new way - from percentage to mmols/mol and I've gone from a 112 (12.3) in November last year to an 81 (9.5) so I'm happy with that change. Very happy and relieved actually. I know it's not ideal but I feel glad to have a significant change. It was very much my win for the day/week/month. I don't feel as if that number entirely reflects what I have been doing, the average on my meter is 11 but that A1c reflects an average of 14.. So that could be for any number of reasons. But for now, I am just very happy to have that drop. I just feel as if I have a new burst of encouragement within myself to keep going with that constant battle of balance.


Jonah said...

Congratulations on the drop.

I always feel that blood tests do lie. If I test my blood sugar twice within a minute, it's not likely I'll get the same result twice... and sometimes the numbers are really far apart. To me, it's more that blood tests rarely tell big whoppers- if I think I'm low but it says I'm 117 (6.5 mmol/l) then I'm not low. But if it says I'm 360 (20 mmol/l) I might be there. But I could just as easily be 306 (17 mmol/l.

The A1cs are usually more self consistent, but the idea of telling people that their A1cs match to a particular average blood sugar- that's really bogus. Even with CGM users, some people get higher A1cs and others get lower A1cs with the same blood sugar averages. Sometimes a lot higher or a lot lower.
My A1cs, except for those done the week I was diagnosed, have all been in the 6s and 7s. I get a lot of metaphoric pats on the back for that. Because my A1c is down in the prediabetic range despite full blown type 1 diabetes, medical people assume I know what I'm doing. But it would be entirely possible for someone with my blood sugars to get an A1c of 7.2% instead- and that person wouldn't get the same praise.

I always figure that an A1c gives you a range of where that person's average blood sugar might be. For me to be pretty sure that somebody runs higher average blood sugars than I do, their A1c has to be about 2 full points higher than mine (from my 6.2% to an 8.2%). As much as I really want to see an A1c in the normal range (that is, less than 5.7%), I don't assume that people with A1cs in the 5s are actually maintaining better blood sugars than I do.

S said...

Ha, I've been meaning to write a post about the inaccuracy of meters. Sometimes it can be ridiculous! Meters definitely lie! I'm amazed that there can be such a range in results.

Congrats on your A1cs :)

I think it is important to remember that A1cs reflect a range. As I said it is a constant battle of balance and A1cs don't show you if you are winning that. It might just be that your control is swinging from high to low on a constant basis. I know I still have a way to go with getting better control but I'm taking it one day at a time. As long as it is coming down!