“7.4 A1C! Are you kidding me?!?”
That was my first thought last Tuesday when my doctor told me my bloodwork results from January 5th.
My second thought was, “Diabetes sucks and can kiss my ass.”
For those of you who may not be familiar with diabetes-lingo, an A1C a measurement of how much glucose (blood sugar) is in your bloodstream over a two- to three-month period. A reading under 5.7 is considered normal. A reading of 5.7-6.4 is considered “pre-diabetic” and anything over 6.5 is considered diabetic. The American Diabetes Association recommends that diabetics strive to keep their A1C under 7.0, although more stringent physicians can work with patients to get their A1C to 6.5 or better.
For years, I was the “poster child” for good diabetes management. My A1C was between 6.1 and 6.5.
But then Jason and I decided to make a big life change – retire from the Army and move to Tucson to pursue his second career by attending the University of Arizona. Since making that decision around Christmas 2013, my A1C went from 6.2 to 7.2 in six months, and since that time, 7.0 is the lowest it’s been.
I don’t blame the move. It was one of the best – and most rewarding – decisions we’ve made in our lives.
But with the move came a lot of stress. Even good stress is still stress, and I know stress has played a huge role in how I have not managed my diabetes fully. And that stress has led me to be less stringent in my diet – not horrible – just lax. Lax to me means eating one piece of Dove Dark Chocolate a day, usually after lunch, or splurging on eating another slice of pizza. While most people wouldn’t blink an eye at those changes in diet, for me, those small compromises mean that my blood glucose level isn’t as controlled.
Apparently, more stress and a less stringent diet, for me, equals a 7.4 A1C.
Crap.
My Diabetes Management Plan
When I was first diagnosed with diabetes in August 2007, I chose to try to manage my disease with diet and exercise. I did this because when I was diagnosed, I was only 35 years old, and I didn’t want to take a handful of pills every day at such a young age. Thankfully, my doctor agreed to let me try this course of action first.
What was interesting is that me being Type II baffled every health care provider I came into contact with because I didn’t fit the model. While I was about 25 lbs. heavier than I am now (I weighed 165 at the time I was diagnosed), I wasn’t technially overweight. Most people who have “adult onset diabetes” are much heavier.
Additionally, while I wasn’t super active, I was not sedentary, either. We had two English Labrador Retrievers that needed walks a few times a day. I loved being outside doing yard work, and hubby and I hunted, fished and hiked pretty regularly. Heck, taking the pooches down to the river to throw a stick and play in the water was a weekly occurrence in the summer. In other words, while I wasn’t out running marathons, I wasn’t sitting on my ass, either.
I just didn’t fit the typical Type II diabetic profile.
But once diagnosed, no matter how much I watched what I ate or how many miles I put on my sneakers, every morning I woke up to a 150+ blood glucose reading (normal is under 100; pre-diabetic is 100-124). It was frustrating.
In August 2008 – after a year of struggling with my fasting number and trying to tackle my disease with diet and exercise alone, I was sent to an endocrinologist at Penn State Hershey who told me that I suffer from “the dawn phenomenon” (sometimes called the dawn effect). This is when your liver, which stores glucose, has a mind of its own and dumps sugar into your bloodstream while you sleep. Not all diabetics suffer from this syndrome, but those of us who do understand how frustrating it is. No matter how vigilant you are during the day, your body will do what it wants overnight.
I was put on 1000 mg of Metformin to be taken at bedtime to calm the dawn effect.
That, along with continuing with my diet and exercise regiment, worked fabulously!
But I was warned that at some point, my body may decide not to cooperate again, and when that happens, I will need a new diabetes management plan, which may include more medicine (including insulin).
My Diabetes Plan Moving Forward
I am not taking this news of my A1C jumping to 7.4 as calmly as it may appear.
I am pretty upset, actually.
And I am pretty pissed at my body. In the last year, I have lost between 5-8 lbs., gained muscle, lost 4% body fat and exercised religiously because I finally found a program I love – kettlebell training. Thank you, Tucson Strength, Home of Evolution Fitness!
So why is my body revolting?
I don’t know, but I do know that in the last three months, things have been quite stressful in our lives.
I had a ton of work that kept me sitting at my computer at least 6 days a week from Labor Day through the New Year, our black dog (Aura) passed away in early December after 15 years of companionship, and we decided to spend time with our families over the holiday season (as our Christmas presents to each other). This meant a trip for me back to Pennsylvania to see my family in early November (Jason stayed in Tucson because he had classes). And then for Christmas, we drove to Seattle (and back) so we could spend Christmas with my in-laws. Those trips were amazing, and I am so glad we had those opportunities to be with our families, but juggling a full work load along with those visits = stress. Remember, even good stress is still stress (and shows up that way inside your body).
So once I processed all the information, the jump in A1C from 7.0 to 7.4 these last three months is quite explainable.
However, there is a part of me that is horribly afraid that my body is taking the big nose-dive that my doctor warned me about. My fear is that my pancreas (the organ that creates insulin) is conking out on me, and I’ll have to start insulin shots.
But we aren’t there yet, and I need to continuously remind myself of that.
So moving forward, here’s my plan:
Back to Basics.
I am going to go back to basics with my diet. This means no more dark chocolate after lunch, but more important than that, I need to count carbs. It is true that you forget what you eat as the day goes on, so it is easy to overeat and not even realize you are doing so.
I am also going to log my food and glucose using an app called MyNetDiary. That way, when I see my doctor (see below), I will have an electronic record of my diet and my blood glucose readings to share with him/her.
Consult a Professional.
I will also make an appointment with an endocrinologist when the referral arrives. As my hubby noted, “Right now, with what your body is telling you, you can’t do this alone. Plus, it has been nearly a decade since you last worked with one.”
Don’t get Discouraged.
Finally, I know that the worst thing I can do right now is to get down – or stressed out – over this development. Instead of worrying about what I can’t control (like whether or not my pancreas is conking out or if my liver is dumping grams of sugar into my bloodstream when I sleep), I’ll focus on what I can control: diet and exercise.
I’ve got this! I mean, what choice do I have, really? I will always BE a person living with diabetes.
A Version of Wit 