Well, I had my appointment with the endo yesterday. It went fairly well, I guess. I deal quite extensively with the folks at the Youville Diabetes Clinic, including my wonderful Diabetes Nurse Educator, Michelle Chrisp, so most of my micro-managing and problem-solving is done outside of my endo appointments. As a result, my doctor is quite happy to look at my diabetes management from a pretty high level and leave the nitty gritty for Michelle and me – which is fine with me. So she didn’t really have anything to say about my records, other than it looked like I knew what I was doing. There were a few too many lows going on, but they follow a pattern (i.e. they’re either after correcting nighttime highs, or after an overly aggressive suppertime insulin:carb ratio), and I have some solutions in mind – plus they’re not extreme lows – so she didn’t spend too much time on that either.
My A1C was 7.1.
Now, I know some of you are thinking “Wow! I’d kill for that A1C!” I used to be one of those people. For most of my life I never even dreamed of having an A1C in the 7s, let alone the low 7s!
I also know that some others of you are thinking, “Bethany, you’ve still got some work to do if you want to get it into that non-D range!” This is also true.
**Aside: Has anyone else ever heard the band called the D Rangers? Super fun music! **
My own feeling about this number was this: Damn, I thought it would be in the 6s this time! (I was in the 6s for most of my pregnancy, so I know I can do it!)
Those were pretty much my exact words to my endo, and she countered by pointing out that it’s not really that big of a difference from a high 6 to a low 7 and that it was a great result and I should be happy with it…which I am, don’t get me wrong…. It’s just that I was 7.0 last time, and I’ve had so much success with this low(ish) carb diet, and my meter averages are way down, so I expected my A1C to be down too.
And I think next time it will be, but there are two things that threw it off this time:
- I’ve been gradually weaning my daughter in the last few months, and every time I cut back on breastfeeding, my insulin requirements go up. Of course, every time my insulin requirements go up, it takes me a while to catch up with them, so I end up with a few days of higher-than-desired bloodsugars.
- I can’t seem to get my nighttime levels down. I jack up my nighttime basal on a regular basis, and then in no time I’m back to 9s, 10s, and 11s at night (that’s 160-200 for those of you doing mg/dl). It’s SOOOOO frustrating! The end result is that I’m spending about 8 hours/day too high (in addition to any other daytime highs I’m having). And it’s barely affecting my meter average because I don’t test very often at night. But the impact on my A1C would be significant because that’s 1/3 of my day! (Bethany hopes to herself that she did that math right since she’s an accountant and making a math mistake here would be embarrassing.)
I have every reason to believe that #2 is a direct result of #1, actually. As of this week, my daughter is fully weaned, so hopefully I”ll be able to nail down some nighttime basals that will actually stick for a while now that my hormones won’t be fluctuating so dramatically. Then by my next appointment I should be able to better see the results of my “diet” (have I mentioned how much I hate that word) on my A1C!
The other interesting thing that came up at my appointment is that my thyroid results were a bit wonky. (Yes, “wonky” is the official medical term.) Apparently it’s common (and I did not know this) for diabetic mothers to develop thyroid problems within a year of having a baby. My endo called it “post-partum thyroiditis”, I believe. She said it’s very mild in me, so she’s not worried, but she wants to check my thyroid again in a couple of months. I guess because it’s so close to the end of the first year (my daughter turns 1 at the end of May), and because the results weren’t too bad, she thinks it will resolve quickly on its own. In the mean time I’m supposed to let her know if I develop any symptoms (I’m currently asymptomatic), which would include fatigue, constipation, etc.
She also said I am definitely not supposed to get pregnant while I”m having thyroid troubles! For the record, I currently have zero interest in getting pregnant because of my eye troubles – and also because of my very active 10 1/2 month old who keeps me on my toes well enough for the time being. So this shouldn’t be a problem…
Anyway, I suppose it was a pretty good appointment overall. I can’t complain. Hopefully by the next one the A1C will be into the 6s and the thyroid problems will have resolved!