A1c Celebration (?)

I should be celebrating — shouting from the rooftops!  But instead I am stunned. Confused.  Filled with skepticism.  Those of you who’ve been following my DexCom adventures here know how frustrated I was when I couldn’t seem to get my A1c below 7.1, despite a lot of diligence and aggravation.

But something weird happened.  I had my A1c tested again about a month later, and about 10 days after I’d set the DexCom aside for an extended break.  My result was 6.5!  Impossible, I thought.Perfect  That last month was not a good one.  I spent far too much post-meal time over 200.  How could I possibly have dropped to a happy and healthy “therapuetic target” of <7% in that time?!

I was so suspicious, in fact, that my co-author Dr. Jackson made a bet with me: go back and get another A1c test.  If it’s under 7, I owe him dinner; if it’s over 7, he owes me dinner.  Good deal.

And guess what?!  I owe him dinner!  My A1c as of Dec. 1 was 6.3!! 

I still can’t quite make sense of it; things didn’t seem to be going that much better than a few months ago.  But who am I to argue with success?

Dca2000productNOTE: We’d all have real reason to celebrate if only the new DCA 2000 Blood Glucose Tester became standard equipment at most labs.  I recently read about this device which measures your A1c with a single drop of blood. No more painful blood draws!  And you get the result in minutes.  But even though it’s priced at less than $1,500 (Internet quote), it still seems to be out of reach for most labs and clinics. Or simply not a priority.  With at least 20 million of us out there requiring regular A1c testing, we ought to be lobbying somebody on this! 

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15 Responses

  1. Sarah
    Sarah December 13, 2006 at 7:43 am | | Reply

    Amy, my clinic has one of those handy a1c machines, and I find that it usually clocks my a1c in a tad lower than the blood draw. Just my experience, though!

  2. Nina
    Nina December 13, 2006 at 7:54 am | | Reply

    Congratulations on a fantastic result Amy! I actually had no idea that people get their blood drawn for an A1C and that you have to wait for the results. My doctors have all had that little machine in their offices that give you your number in 7 minutes. I wonder now if what Sarah mentioned is true though – that they clock in lower than a blood draw test? I hope it’s not a big difference.

  3. Scott
    Scott December 13, 2006 at 8:22 am | | Reply

    The problem with A1Cs are that they are an average, rather than a true measure of control. They fail to measure the standard deviation from normal blood glucose levels, and hypos will dilute your average. This was a matter of some debate among clinicians at the 66th ADA Scientific Sessions in Washington (I met you there, but I’m not sure how many of of the sessions you had the opportunity to attend). Of course, there can be variances in tests based on the sample and lab that performs the tests.

    For what its worth, you might ask for a fructosamine test as well. The American Diabetes Association (ADA) says that a fructosamine test may be useful in measuring rapid changes in diabetes treatment, as that enables the measurement of diet or medication adjustments after a couple of weeks rather than months typically required for the A1C.

  4. Kelsey
    Kelsey December 13, 2006 at 8:53 am | | Reply

    Congrats on the great A1c!

    I would love my labs to invest in that kind of testing equipment. Those blood draws are the thing I dread most about diabetes!!

  5. Kevin
    Kevin December 13, 2006 at 9:12 am | | Reply

    That’s awesome news!

    As I think I’ve shared with you before, I too have had similarly perplexing A1c results and haven’t been able to get my reading below 7.1 for the past 6-9 months that I’ve been working my tail off for.

    Oh, I hope I get hit with a string of 6s like you have!

  6. Vivian
    Vivian December 13, 2006 at 9:51 am | | Reply

    Amy, I am really glad you owe him dinner. What a great number. (throwing confetti)
    I don’t know if it is because it is a ped office but both of the clinics Daniel has been to have had this machine. They always take a drop and we know the results by the time the doc comes in the room.
    Vivian

  7. Megan
    Megan December 13, 2006 at 10:01 am | | Reply

    My office uses a DCA 2000 and I have to go to a lab and get my a1c drawn, because my last a1c was suspiciously low as well, causing me to question the DCA’s accuracy.

  8. Anne
    Anne December 13, 2006 at 10:05 am | | Reply

    I didn’t know an A1c like that was possible for type 1. Amazing! Congrat’s. I’m curious what your exercise regimen is like, and how you keep your BG’s good before, during and after. That’s a pretty big question, I know!

  9. Carey
    Carey December 13, 2006 at 12:37 pm | | Reply

    I was very surprised to learn that the reason my son’s endo doesn’t have a device like this is because they don’t have the funds. Pathetic. We told them we’d raise the money. Not sure what sort they were looking at, but if only $1500, then it’s seriously pathetic that so many of their patients have to go through such a horrible experience with blood draws. Thanks for this post.

  10. Elizabeth
    Elizabeth December 13, 2006 at 1:56 pm | | Reply

    Amy- my first diabetes center (the Barbara Davis Center for Childhood Diabetes in Denver) had one of those A1c machines. I had only known it to come up immediately and it was much to my surprise when it took my doctor in Cleveland a week get my results. I am so happy for your falling numbers!

  11. Scott K. Johnson
    Scott K. Johnson December 13, 2006 at 7:55 pm | | Reply

    Way to go!!

    I usually have to visit the lab about a week before my appointment, just so the doc can have my results in order to discuss them.

    What’s really shocking is when I see what has been submitted to my insurance company for that little two-minute blood draw! Usually on the order of over $400!!

    Though, they are testing more than just my A1C (cholesterol, etc). Who knows how that figure breaks down, it just seems like a lot of cash. Couldn’t do it if I had to pay out of pocket.

  12. Kim
    Kim December 14, 2006 at 8:30 am | | Reply

    That’s an AWESOME A1C, Amy!! Yahooo You!
    If anybody can find out if the DCA runs lower than a “legacy” A1C test, I know you can. I’ll be reading to find out!
    Does this make you reconsider taking a break from your DexCom?

  13. Kevin
    Kevin December 15, 2006 at 5:08 am | | Reply

    I’m amazed to find not everyone is using that machine. I have been having my A1C done on that since AT LEAST the year 2000. My Young Person Endo office had one, then bought 2. Then when I turned 22 and graduated college and was forced to an Adult Endo they also had 2 of those. Results in under 8 minutes and every time I have felt the result was accurate.

    My current endo told me they have a higher variation that a lab A1C (allow about a .3% variation), but cost alot less to the end user, especially without insurance.

  14. Kassie
    Kassie January 1, 2007 at 1:57 pm | | Reply

    late to the party, here, but my new endo told me that they don’t have an in-office A1c because they are affiliated with a hospital, and the hospital has a lab, and an in-office machine would take business away from the lab.

    Sigh.

  15. LB
    LB January 25, 2009 at 7:07 am | | Reply

    Nice site you have!

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