7.5%
As I expected, my A1c went up. I just didn’t expect it to go up *that* much. For almost two years, my A1c has been below 7%. It’s a lot of work, but totally worth it.
I admit that I rebelled a bit. I also got lazy. I was just so tired of the tight control and limitations. I went a little nuts. I have the weight gain and lousy A1c to show for it.
All other tests were good. BP was “excellent” according to Dr. S. He also said that I’d *lost* two pounds since my last appointment. This just doesn’t seem right, but I wasn’t about to argue. He gave me a list of group meetings and events (read: support groups) for Type 1s and encourage me to attend. I don’t know if I will – I admit that it would be nice to meet some other Type 1s in person, though.
As I mentioned yesterday, I wanted to talk to Dr. S. about Symlin. After looking at my A1c, Dex graphs, and logbook, his initial feeling was to further increase my basals. Since I had decided that I was not going to let that happen, I needed to find an alternative. See, *I* think my basals are too high as it is. The highs I’m experiencing aren’t the result of too-low basal settings; it’s because I’ve been eating like shit for months and, more often than not, SWAG bolusing. So, I’m high because I didn’t count carbs correctly. Sure, I correct, but once I’m high, it’s so hard to get back down.
Which, once again, led me to the Symlin talk. I’d tried it once before and gave up after a few days. I was told that it is not indicated for pregnant women, and since we were actively trying at that point (and blissfully unaware of our fertility issues), I decided that it was best to stop. To be honest, I was not heartbroken to lose the awful nausea that accompanied it. But, the thing is, I never really gave it a chance.
In preparation for my appointment, I did a bunch of research. I learned that the nausea goes away pretty quickly and that the key is to stick with it. I learned that some people have lost huge amounts of weight thanks to it. I learned that most decrease their boluses by at least half. All of these facts solidified my resolve to give it another shot.
So, just before dinner last night, I dialed up the minimum 15mcg and gave myself the shot. I ate my meal slowly (I did notice that I got fuller faster) and waited. I carefully calculated the carbs in what I ate (49 grams total), and programmed a 60-minute extended bolus. And I waited.
Sure, I felt a little nauseated, but nothing too extreme (I definitely didn’t feel like I was going to puke or anything). I wasn’t hungry either, which was nice. I often feel hungry even after eating a decent meal. Dex showed almost no movement in my BG for over an hour. Since I was super exhausted yesterday, I went to bed early.
At 11:53pm, Dex beeped. The dreaded low alarm. I looked at the screen: 68 mg/dl. Not too bad, but I did a finger stick to confirm: 66 mg/dl. Since Dex indicated a downward trend, I decided to drink a juice box. Then, I did something really stupid. I programmed a temp basal of 50%. I was spooked; I admit it. I didn’t want to have a horrible low that would be difficult to treat because of the Symlin (I’d read that this happens). I wanted to play it safe.
Just as any sane person would expect, a few hours later, my BG started to climb. Nothing drastic – I was sitting at 150ish. Then my usual Dawn Phenomenon kicked in (I have a basal rate that is more than two times greater during the hours of 5am-8am). A temp basal of 50% was not going to make a dent in that train wreck. After my shower, I was sitting at 180 mg/dl and climbing.
Since the pod was due for a change, I swapped it out and canceled that stupid temp basal. Now, as I write this at 9:16am, I am at 189 mg/dl. This is despite two decent correction boluses. I know the crash is coming, and I’m ready for it. I’m just pissed off at myself for giving in to the fear. It’s the fear of lows that gives me a 7.5% A1c. It’s unacceptable.
Ugh, diabetes, I hate you.
**UPDATE**
As I wrote this post, I got a call from the fertility doc’s office. They wanted to tell me that they’d received a copy of my A1c (which the nurse described as “elevated”), and that for conception, they want it to be under 6%. As if I didn’t already feel shitty enough.
Themocracy
UNDER 6%? I know that standards are always changing, and mileage varies, etc., but my CDE said under 7 would be fine. And I’m sticking with that story.
Diabetes TOtally sucks.
I agree with Jacquie, “under” 6% seems dangerous to me. I would check with your Endo or a high-risk Obstetrician.
((hugs)) Hang tough.
I have also heard that under 6.5 is more of the normal requirement. Mine was 6.2 or so when my doc gave me the green light, and he was really not too concerned even when it was 6.7.
I would say 7.5 is great considering all you’ve been through lately!
Have you thought about Metformin for the insulin resistance? This is something I want to try, and I see that they now use it during pregnancy, too.
Thanks, guys. I really feel like under 6% during the TTC period is just too low. I mean, I’ve been TTC for over two years – I don’t know of any T1 able to maintain an A1c under 6% for over two years. These people have no idea how hard that is! Grrr …
From what I could tell, my CDE saw more danger in the hypos that would result from me trying to get under 6% than she did in my getting pregnant around 7%. I’ve been trying to do the baby thing for a while; last check was 6.8% and there wasn’t much concern.
No matter what number you decide on, though, I’m sure you can do it. It’ll suck, but you can do it.
I feel like an outsider, not being diabetic and not really having known anyone with diabetes (my dad’s tested pre-diabetic, but it’s not the same). So, I stop myself from leaving comments most of the time. I hope you will take anything I say with the tiny font underneath that states, “I might sound ignorant but I mean well.”
Is your OB a high-risk OB? I always go for the second opinion if after all my research, my doctor’s opinion is a 180 degrees off from mine. Good luck with it all.
Don’t sweat it, Sylvie. I forget that I have non-diabetic readers, so I’ll throw out diabetes-related terms with abandon. If you ever have questions, just fire away.
My regular OB *does* handle high-risk pregnancies. I’m confident in her abilities, and she is the one I want delivering any child. The fertility people are the ones insisting on the high-risk OB, separate from my regular OB. So, I’m going to humor them by having a consultation with a high-risk doc. If she feels strongly that I need that level of care, I’ll stick with her.