A1c: And…. Exhale

It’s hard sometimes to really keep track of diabetes control when you’re right there in the thick of it. When you’re testing more than 10 times each day, and wearing a CGM that gives you a new number every 5 minutes it’s easy to get lost in a sea of data. It can be hard to view the bigger picture and not get bogged down with minor imperfections, or the things that just aren’t going so well.

The more effort I put in to controlling my blood sugars, the worse I am likely to assess my control as being. Even when the figures clearly suggest that things are pretty stable, I always seem to view them as less stable than they were in the two weeks, or two months, before now. Maybe I’m just a pessimist. Or maybe I do it to protect myself from disappointment. Or to motivate myself to keep trying harder.

This week I visited the local Diabetes Centre for the first time since we moved out of London, and I transferred my care. Most of my pregnancy and diabetes care is being handled at the local hospital, but they also have a brand shiny new clinic in the centre of town. I didn’t really know what to expect on my first visit, including whether I’d be able to get an instant A1c result.

I must admit, I was impressed with the centre. It really is brand new, very light and spacious. And also incredibly quiet. Which is a change for someone used to busy teaching hospitals.

I met with my nurse specialist and we reviewed my DexCom data and blood sugars, went over basal rates and made a few adjustments to deal with late evening lows and early afternoon peaks. She tried to reassure me that I was doing just fine.

“So, when did we last have an A1c?” she asked, scanning through my records.

“It’s been a few weeks. It was at twelve weeks I think, and I’m sixteen now.”

“Shall we get one today, then?” she asked.

I genuinely think I’d have been able to say no. It was much more of a question than a statement. For a moment I deliberated. On the one hand I was pleased they had a machine on site, and I really wanted to know where I was at, to make sure I was on the right track towards keeping our baby as safe as possible. But on the other hand I was pretty scared. Scared of a result that was higher than I’d like, conscious of the fact that things hadn’t felt so stable lately. But even I had to admit to myself that it’s the only way to really get an objective idea of how things are going. So I agreed and we headed to lab room.

Two minutes later, my sample was in the machine and we were chatting about this and that as it counted down. We chatted about how big babies can be caused by all sorts of things other than diabetes, and I shouldn’t feel guilty or judged if my baby should end up being larger than average. We chatted about how big babies are usually perfectly healthy, and that actually a bit big is preferable to too small.


The result flashed up on the screen.

I let go of the breath that I hadn’t realised I’d been holding.


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