Friday, April 20, 2012

Sharing A1C's? It's complicated.

I read a great post over at The 'Mine today about A1C's andthe efficacy of sharing them.  I began a comment on their blog and after the second paragraph realized I should probably take it over here.

What is an A1C? says this:  Hemoglobin A1C is the amount of the protein hemoglobin that has combined with glucose in a person's body. Diabetics test their hemoglobin A1C levels to monitor the average amount of glycosylated hemoglobin (glucose attached to hemoglobin) that has been in their blood over a two- to three-month period.

Basically, the A1C is thought to give you an average blood sugar number from the past three months or so.  It is considered in wider circles to be, "The diabetic's report card." 
Or in my case, "The mommy report card."

The thing about an A1C is you can get a number a couple ways:

By having sugars go up and down in wide swings.

Or by having them vary in smaller swings up and down.

Both can yield the same result.  Both have the same average blood sugar number.  Both have their own story.
One can also achieve a certain A1C from being low most of the time, or by being high most of the time.

I think that is the most important thing to note here:  There is a story behind every A1C number. 

So is it a good idea to share said number without sharing the story too?  Unfortunately, I think there is no hard and fast answer to that one.

There are the amazing A1C's.  (That number varies according to who you are and where you are in your life.)  If one receives the news of an amazing A1C, or even a better than expected A1C...doesn't one want to share this information with the world?  Can we fault them for wanting to?  Absolutely not, but the problem lies behind the story.  The way to that amazing A1C could have been reached in four different ways.  1) They are obsessive about blood sugars and check themselves or their child every hour on the hour.  Their life is completely absorbed in numbers and perfect A1C's.  2)  They have balance.  They or their child is not growing.  The numbers are falling into place like a magic puzzle.  There aren't too many lows, there aren't too many highs.  Nirvana.  3)  They are CONSTANTLY battling lows and spend their life feeding them.  4) Luck. Divine intervention.

Now writing down that your child has an A1C in the 5's or 6's  can get you the adulation you deserve, but it can also give many people the impression that this should be easily attainable.  "If this family can do it, why can't we?"  The fact is every person and child is different.  Every person reacts differently to food.  Every person reacts differently to insulin.  Why does my son B have the higher A1C of all my boys EVERY SINGLE DANG TIME?????  He has the same brilliant doctors, he has the same diet.  He has the same mother telling him what to do.  He is my most conscientious diabetic.  Why must he always be higher?

Because we are not the same.

A1C's.  Blood sugar numbers.  They are not one size fits all.  What works for one person may not work for another.  B can eat pasta ALL DAY LONG and not spike.  L on the other hand goes through the roof.  It's a crapshoot for J.

Comparing is dangerous.

But support is not.   In fact, it is essential.

Some people have spent years fighting to get their blood sugars down to their personal holy grail A1C number, and once they get there, don't they deserve a cheering section?  Some people can't get their or their child's A1C below 10.  Shouldn't they be able to share that heartache and receive the unwavering support they need so terribly? 

There is no easy answer to this one.

Sharing is important.  But it is important to share responsibly. 

 And as with anything in life:

Buyer beware.  There is a story behind every A1C number...and trust me, it isn't a short one.


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