I’ll be interested to hear what readers think about this one. The a1C is such a touchy topic, and impacts us in such a profound way. Let me know what you think.
I recently took on the project of sorting through old files on my computer (I am definitely a data hoarder). I came across an email that I’d written almost a decade ago, and it made me cringe.
I was bragging – no; crowing – about my daughter’s 6.2 a1c. I was lording it over the other parent like I was some kind of supermom. I’m sure at that time I didn’t think it came across the way, but looking at it today, the older, wiser me can see that’s just what I was doing. I can only thank goodness I found it in a draft file. Oh, how I hope I did not send that.
Because I think we, as a diabetes community, are a bit messed up when it comes to how we discuss, share, and yes, wield, our a1C. Be it our own or that of our children, a1c’s somehow feel like judgments. Heck: sometimes they feel like sentences.
And I would go as far as to say this is not because a high or low a1C is good or bad; it’s because we wrap our entire “diabetes being” up in that number. I wish we could change that.
First, off, I’m not telling you an a1C is not an important measure of how things are going for the person with diabetes. It absolutely is. There is no doubt (and study after study after study proves) that a lower-range a1C is just plain better for a person with diabetes. That’s not what I’m talking about at all. What I’m talking about is how we share it as a community, toss it around at one another and hold it up like a trophy when we can.
I don’t think that’s good. In fact, I’d go as far as to say I’d love a diabetes world where everyone just kept their a1c’s to themselves, other than extremely private conversations.
Okay, truth: My daughter’s a1C, after being “magnificent” for years, suffered in recent years. Lordy: I can still remember the first time she creeped up over 7.1. I almost had a heart attack. I must have studied her log books and pump history and activities for days, trying to figure that thing back down to 7 or lower. And yes, it was because I care, deeply, about her long-term health. But let’s be honest here: part of it was my ego. I wanted to be Super D Mom. I wanted to be the best. Just like battling for the highest GPA in high school, I was on a mission to prove I could outsmart anything. And from that horrible draft email I hopefully never sent, clearly, I was a bit taken by my a1C-awesomeness. And I’ll be honest with you now: should her a1c be 7.1 any time in the near future, I will do a full-on jig on City Hall Plaza. And I don’t even know how to dance.
But here’s the thing: diabetes cannot ever be completely controlled. Well, I guess if you locked a person in a hospital room and had a drip of glucose and a drip of insulin you could but for now, beyond that, there’s really no way a person can maintain a sparkling, championship-cup like a1C for ever and ever. Because it’s hard. Because we are human. Because sometimes, the body plays tricks on us. Because sometimes in our D-lifes, we are just not up to the extremely hard work it takes to stay in a low a1C range.
But here we all are, viewing the a1C as either a golden medal or a scarlet number: depending on where we are at.
So what if we took the shame out of the a1C? What if, instead of calling it out “report card,” (and I’ve done that many times over the years. The analogy does make sense. It’s comes along just about quarterly and says something about how you are doing overall.) we just kept it lumped in with our other labs, something for us to go over with our medical team and work on. Look, you don’t often see someone crowing about their lipids, right? Or their TH1. But those are labs most people with diabetes have done regularly.
This is why I think we should change how we discuss and share our a1C: because even when it’s a “good” one, we’re placing judgment. On the parent. On the person with diabetes. On the entire family. And believe you me, that kind of judgment seeps into a kid as the years go on. My daughter will be 21 soon. She’s a rational, smart, confident young adult. But she almost shakes as she heads into the endo’s. Not because she doesn’t like her endo; she does. Not because she doesn’t want to talk about how her life is going; she wants to figure things out. It’s because of the GD a1C. No matter what it is, it just feels like judgment to her.
What if we stopped sharing it, and instead we shared just how our D-lives are going and what we are struggling with?
When my eldest daughter was in high school, she was in the scrum of kids battling for the top spot in the graduating class. It was obvious, from the beginning of junior year, that it was going to come down to one botched project or one not-perfect grade. Each semester, the moms would almost dash to one another at events to share their child’s current GPA; to see who was on top at the moment. My advice to my daughter? Just walk away. Keep your GPA to yourself. No matter how high it is or how much it might slip in one term, it’s personal. She didn’t graduate as #1, or even #2. But at convocation, when the Principal announced the name of the prestigious “President’s Award” for the best overall student, my daughter’s name was called. One mom, a real “GPA sharer,” turned around and gawked at me. She said “Really? I had no idea.”
Nor did you need to, oh Competitive Mom. Because my daughter was much more than that GPA. She was a volunteer. A helper. An athlete. A nice person.
The same goes for a1C I think. You – or your child – might not be the “champion low a1c’er,” but there are plenty of other things to celebrate about you. You might be funny. Or driven. Or compassionate. Or good at making the best of out a busy life with diabetes on board.
An a1C does not define you. At least not in my eyes. I dream of a day we don’t share it in quite the same way.
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