Ok, so that picture I posted yesterday showing my A1c….I don’t agree with it. I’ve had A1c levels in the 5s before. I should not have one there now. Especially 5.5, as my lowest before this was a 5.6.
My control has greatly slipped due to a ton of stress, lack of sleep (holy insomnia, Batman!) and overall lack of activity due to no longer constantly moving to keep up with 18 5-year-olds all day.
My eAG, based solely on my meter readings, has always been a good indicator of my A1c. Not perfect, of course. Typically my A1c is lower than my meter would indicate only because in the middle of the night I correct lows without checking my BG – just a bad habit, but one I’ve never been able to break. However, my meter average this time around indicates that for the last 90 days my eAG should have converted to an A1c at least 1.5% higher than it came out. That’s a huge difference. Huge.
All conversion charts sort of disagree, but from what I can find an eAG of 112-119 would convert roughly to an A1c of 5.5%.
My eAG is 160, for the last 90 days. My 60 day, 30 day, 14 day, 7 day….not much different.
I was expecting an A1c of 7%, minimum. Maybe 7.1 or 7.2. Not 5.5. No way.
So I started asking around on FB and Twitter to see what the DOC thought. I got back a lot of the responses I expected, and one I wasn’t expecting:
‘Your A1c is highly influenced by the past few weeks – have you been having a lot of lows?’ – No, I haven’t. In fact, I’ve had a lot less lows than normal. I used to have them daily, sometimes multiple times a day. Now I can go days without even a mild low. Heck I can go days without seeing a meter reading below 200.
‘Maybe you are running 80 mg/dL all night and that’s pulling you down?’ – Hmmm, possible, but I think highly unlikely. I usually go to bed slightly high with a little IOB, and wake up around the same number or even higher. I’m waking up in the night to pee, to get a drink – indications that, if anything, I’m high not low.
‘Maybe you’re having a lot of lows in the night you don’t know about?’ – Again, possible, but I think unlikely. I wake up for lows. I’m an extremely light sleeper anyway.
‘Maybe you are anemic, because I’ve heard that can give a false low on an A1c test.’ – Ok, I won’t lie – this one could be a legitimate problem. I already know I have other imbalances – for example my potassium levels are always on the low side, and if I get dehydrated it can take DAYS of tons of extra potassium just to regain the extreme low end of ‘normal’. Could be genetic, as my mom has very very low potassium too (she actually takes GIANT potassium pills RXed to her). So being anemic might just be another thing for me. And I looked up the symptoms and I have about half of them. But I attribute a lot of them to my IST (inappropriate sinus tachycardia) and always have. I’ve had tons of labwork done in my life and no one has ever said that I have low iron. Then again, there are other factors that cause anemia, so it might be something to talk to my doctor about.
Then I thought – what if it’s my meter? What if my meter is just way off? What if a 5.5% is really my A1c level? So I did an experiment of sorts.
I first tested on my Verio IQ (173) against my old Ping (131). Holy cow! This fell in line with my theory that my meter was reading high and I was maybe really a lot lower than I thought much of the time. But then….my experiment fell apart completely and I disproved myself.
A few hours later I checked on my Verio IQ (120) against my old UltraSmart (129). Hmmm….my Verio was lower now. Then again, you have to know that my UltraSmart is old. Like….I’ve had it for at least 8 years. At least. I got it when it was new and cost nearly $200 (don’t worry, I qualified for a free one!) So I take any result from that meter with a huge grain of salt.
Next time I checked my BG I did it on my Verio IQ (186) against one of my UltraMini meters (199). Ok….Verio was lower again.
My conclusion? Just what every diabetic already knows. That our meters are, in essence, total crap that don’t give us nearly the accuracy we want or need or deserve. We make important decisions that affect our immediate health, based on these meters, and they’re all total crap. I’m sorry, but +/- 20% (heck, even 15%) from a lab result is UNACCEPTABLE.
Hey, OneTouch (and Accu-Chek and Bayer and AgaMatrix, etc etc etc) are you listening???