Who doesn’t love a Thursday – hump day has been and gone, a Friday night glass of vino is just around the corner, and it’s the perfect excuse to #throwback to the good times. Well I’m going to mix things up a bit this week, and instead of ‘throwing back’ to pictures of me and my girlfriends dancing on tables in a grotty old bar in the Algarve when we were 18 (don’t worry – these will inevitably resurface again soon enough), I’m going to go back to something a little less fun – my old HbA1c results.
For those of you (understandably) thinking ‘what the heck is she on about?’, a HbA1c test gives us type 1 diabetics an idea of how good, bad or ugly our blood glucose control has been over the past 2 – 3 months. This differs from the daily blood glucose level tests we do, which only give us a snapshot of our levels at that moment. For those interested in the ‘sciency bit’ – HbA1c stands for ‘glycated haemoglobin’, which is complex formed when glucose in the bloodstream ‘sticks’ to the haemoglobin in red blood cells. Put simply – the more glucose you have in your bloodstream, the more that’s going to stick to your red blood cells. Now, because these fellas survive in your body for a few months, measuring the percentage of red blood cells which have glucose ‘stuck’ to them (known as being ‘glycosylated’) gives us a pretty good idea of how high/low our blood glucose levels have been for the past 2-3 months – and that’s exactly what the ‘HbA1c test’ tests. Cool. Complicated bit over. Still with me? Awesome.
The HbA1c test itself is something we can’t do ourselves (weird for people who are used to managing their condition independently 24/7), and usually comes in the form of a letter through your door, around every 6 months, telling you it’s time to hit the hospital, pee in a pot and get a blood test. Unsurprisingly, this is isn’t the sort of letter you’re excited to see – ever. It’s more the kind of letter I imagine the home shredder was invented for. Mainly because after being pricked (and of course bruised) in a couple of veins for the morning, the joy continues a few weeks later when you have to sit down with you doctor, face the music and get the results. You know when you prep really hard for an interview, give it your best shot and think, ‘oh that wasn’t so bad’? It’s like that – except more like the bit a week later when you get told that it was actually kind of bad.
So here’s my throwback – my HbA1c results for the past six years in all their glory:
To explain the bunch of numbers above – the HbA1c % tells me what percentage of my red blood cells have glucose ‘stuck’ to them – so, in December 2015, 8.1% of my red blood cells were ‘glycosylated’. That doesn’t sound too bad right? Exactly – that’s what I thought too! But then one day, I found this little bugger on the internet – and my thoughts started to change:
I’ve circled all of my HbA1c percentages in blue on the chart above – which tells me that my control over the last six years has been mainly ‘poor’, with a dash of ‘very poor’ and a glimmer of ‘less than ideal’ back in October 2011. To add salt to the wound, I then thought I’d try and find out what the ‘recommended target HbA1c’ was for us T1’s (in hindsight, not the best idea):
6.5% – that’s a whole 8 boxes away from my ‘7.3%’ personal best, 2 colour codes up from my not-ideal ‘less than ideal’ label, and basically nowhere near what I’ve achieved in the last six years. Perfect.
Now I’ll be honest here – whether or not I wanted to admit it at the time, I knew back in March (when I started looking into all this) that I wasn’t exactly in the running for ‘Britain’s Next Top Diabetic’. I’d just finished 4 (fabulous) years of university, where, for example, drinking (most likely) sugar-filled drinks and dancing till 2am, often then followed by a Subway sandwich (yessss), wasn’t uncommon 2-3 times a week. Granted – it was hardly a textbook scenario for ‘how to take control of your Type 1 Diabetes’. But I think what got to me is that I have always tried to look after myself – I’ve never been one to skip injections or go on ‘fad diets’, I’ve had no qualms over the years about testing my blood sugars 4+ times a day, and I’ve been running (albeit on and off) for a good few years now. On top of this, each time I’ve been to a ‘HbA1c review’ appointment, the response from my doctor has always been along the lines of ‘not bad – could be better, could be worse’ – until this year, there’s been no mention of an insulin pump, no real ‘push’ to get me on a DAFNE course, and no real sign of alarm. So to be honest – I’ve kind of just been ‘carrying on’, with what I believed was OK control. But as it turns out – in actual fact, all of this ‘OK control’ has probably been leading me down the route of later complications which, as most T1’s probably know, aren’t so OK.
BUT – drumroll please – it’s not all doom and gloom – and that’s the point of this post. Yes, it might have taken me until the ripe old age of 24 to get my act together and decide that I wanted my blood glucose control to be better – and yeh, it’s hard work, frustrating, and now involves more hypos, more injections and less carbs – but if my latest HbA1c result is anything to go by, then if you want to improve your control, you really, really can:
YEP. You read it correctly. The magic number. The one and only. The DREAM OF DREAMS. A HbA1c of 6.5% – and do you know what? Hearing my nurse go, ‘Wow – you’ve really sorted this out, haven’t you?’ felt PROPER good. So if anyone else is giving this whole ‘being a good diabetic’ thing a try – keep going – because it is achievable. It just – like anything worth having – takes a bit of persistence and willpower.