In search of a low A1C

This winter has been hell on my A1C. Fortunately, I've got a few months to work on it before I go back to my endocrinologist.

Keeping my A1C below 7, and hopefully lower than that, is why I run, cycle and workout. Diabetics are all too familiar with this magic number, but non-diabetics probably don't know how important it is. Most people know that diabetics test their blood sugar to keep it in an acceptable range. For simplicity's sake, let me say this is around 100. Lower than 70 is too low, and my doctor likes me to be under 140 before I have a meal and take on insulin.

The A1C is different. It's a measure of how your blood sugars are trending over a period of time. In the most recent issue of Diabetes Forecast, the American Diabetes Association magazine, there was an interesting question posed to the Ask The Experts column. The question was about having too low an A1C.

The expert in this case, Sue Kirkman, MD, raised a few good points about A1C levels in her answer.

Kirkman notes that it's more important to know how that low number is derived. Frequent episodes of low hypoglycemia are not good, but tight control, especially a younger person with more time to theoretically develop complications from disease, should adhere to a number lower than 6.5. (A number in the 5s for non-diabetics is common, by comparison).

This is called tight control, and it comes at a cost. One cost can be those frequent low episodes, which are an acute problem. Low blood sugar can lead to coma and death, and anyone who has recently been diagnosed and knows how a low episode feels knows that new diabetics tend to over compensate to prevent these situations. I still have a snack before bed because of the one time I woke up with a 47, my lowest blood sugar ever. It was not pleasant. Shakes. Sweat. Not pretty.

High blood sugar kills you slowly.

There is a financial cost too. I've tried, and I have to say am succeeding, at keeping in tight control this week as I head into summer. That means testing several times a day - those test strips are expensive, even with insurance It also means taking extra insulin to correct for extra carbs at a meal or a higher than targeted blood sugar before a meal. That means more insulin used, meaning the prescription must be filled quicker - you get the picture. I have also upped my slow-release insulin, which I take twice a day, so have more "background" insulin on board.

This has led to late morning lows - 60s, which I feel (some don't) and so that means slamming a Gatorade or having some orange juice before heading out to the park with the kids.

And that's why I do all this. For my kids. I want to be around when they graduate college and get married decades from now. So for me, shooting for tight control makes sense.

And that's why I run and ride!