Post-Holiday A1c Update and New Diabetes Management Plan

As I mentioned in this post, I had a hard time keeping my fasting blood sugar in range over the holidays. I eventually discovered that I had been eating dairy unknowingly. I was snacking on York Peppermint Patties and chocolate covered acai berries (in small amounts so the carbohydrate amount wouldn’t affect my blood glucose too much). In my effort to be like my Grandma, having candy dishes all over during the holidays, I accidentally sabotaged my gut. Oops.

There’s no need to cry over spilt milk. Now that I know where those higher than usual numbers are coming from, I’m back on the dairy-free wagon! I am still working to keep my lifestyle and diet in line so I can keep my pancreas alive and live a full, healthy life.

I was curious/concerned how these higher than normal blood glucose levels would affect my A1c. I was eating those dairy candies for about 8 weeks before I discovered the issue. The A1c tests 2-3 months prior to the test. So I messed up pretty much the entire time frame!

My quarterly check-up with the endocrinologist was Monday, January 29. The office tests my A1c levels every 3 months and uses that along with daily blood glucose checks to make sure my type 1 diabetes stays in check. Since my diabetes management plan is so different than most, I wanted to test the accuracy of the home A1c test and come up with a new diabetes management plan.

Home A1c Test Experiment

I decided to try one of the home A1c kits from Walgreens before this visit. I wanted to test the accuracy of the home kit against the doctor’s office. In my revised diabetes management plan, I’m hoping to stretch out my office visits, and in order to do that I need an accurate way to check my A1c.

After reading many reviews on many brands of home A1c test kits, I was not very confident in this product. Each kit comes with supplies to run 2 tests. However, the failure rate (getting an error message or no reading at all) seemed to be right about 50%. It seems very easy to mess the test up, even when the instructions are followed to a T!

So you can imagine my nervousness in trying this test! I decided it was worth $42 just to try, even if I’m not successful.

Each kit comes with the following: a meter, 2-#1 bags that contain the blood collection supplies (lancer, siphon, and shaker), 2-#2 bags that contain a cartridge that inserts the blood sample into the meter, and of course, instructions. Read the instructions carefully, my friend, if you try to do this!

The #1 bag is opened first. Wash your hand thorough and dry them. Use the provided lancer to prick the side of your finger. Work a good sized drop onto your finger then gently touch the sample collection device to the drop of blood. Continue to touch the blood drop until sample is full. Squeeze out more blood as necessary.

I had to set the collection device down, squeeze more blood out, then continue to fill it, and the test still ran just fine.

Insert sample collection device into the shaker tube. Twist and push until full inserted. You will hear a “click.”  Then shake for 5 seconds. Set the tube upright on its cap and get meter ready.

Open the #2 package, remove the cartridge, and insert into the meter. Make sure the codes on the left hand side are both on the left and that they match! My code was “Y5.”

Wait for the meter to say ready. Remove the end cap of the shaker tube and press onto circle of the cartridge. Remove quickly when the meter says “run.”

Wait 5 minutes for your result. The meter will count down the 5 minutes, and the result will be shown on the screen for 60 minutes after the test is complete.

6.3!

Not bad for messing up my diet over the holidays, huh?

Now I didn’t take this result with full confidence because some of the reviews said the test was way off.

I was going into my endocrinologist that morning, so I knew I’d get an official A1c test there, and I’d have a good idea of the accuracy.

The endocrinologist’s A1c result was 6.5. Nice! Very close! I haven’t researched the margin of error on these machines, but that seems good to me. My endocrinologist thought the result was close enough too.

Now that I have an accurate way to test my A1c at home, let’s chat about revising my diabetes management plan.

Type 1 Diabetes Management Plan

I am planning to stretch out my check-ups to once every 6 months (with my doctor’s approval). Disclaimer: I’m not recommending you do the same unless you are very disciplined, your diabetes in very much under control, and you’ve discussed your plan with your endocrinologist.

My methods for managing my diabetes are so different from the norm with type 1 diabetes that I don’t think I need to be in the endocrinologist’s office ever 3 months. If you’re curious, here are my reasons for stretching out my visits:

1. Health Care Expense – Each office visit costs between $70 and $150, depending on if I see a doctor or physician’s assistant. This does not include any labs outside the office visit. I have a high deductible health plan, and since I’m not on expensive medication (insulin!) or testing supplies (I have an annual subscription to One Drop.), I do not hit my deductible each year. I like to keep my out of pocket expenses as low as possible.
2. A1c Home Test – I can test my A1c levels at home much cheaper than the ones administered by the endocrinologist’s office. This is similar to #1, but it is important that I stay on top of my diabetes, not letting my blood glucose levels creep up over time. If I couldn’t perform this test at home, I would still be going in to the office every three months.
3. Diabetes Education – I am educating myself by reading journal articles, books, and blogs. I know why I am managing my diabetes the way I am, and it is working. I am an intelligent, educated individual, and I believe I can understand and apply scientific studies and journal articles to my own life. My endocrinologist’s office, while supportive, has not read the research I have. Any help I get from them in the way of education is usually not in line with what I’ve read and am practicing.
4. Diabetes Products – Each time I visit the endocrinologist’s office, they are pushing a new diabetes management tool. Each visit a new and improve or cheaper version is recommended. Although I’d like to give them the benefit of the doubt, it does feel like the pharmaceutical companies are influencing the “standard of care.” I have been able to find diabetes management tools on my own that are not only accurate but fit my budget (One Drop, Home A1c Test Kits).
5. Tracking Physical Symptoms – At each visit, the endocrinologist tests my feet looking for loss of sensation, nerve damage, development of callouses, wounds not healing, etc. I know how and do track these at home. If I miss something, I believe a visit every six months will catch what I miss.

I’ve read and re-read, carefully worded and re-worded what I’ve typed above. Please know I am in no way against doctors. I believe in doctors and modern medicine. They have literally saved my life. I do think our healthcare system is flawed and overworked. The best solution is to take control of your own health. That is what I am doing: take control.

I do my own research. I do my own tests. I make my own conclusions.

I do fill in my doctors, and they are supportive (some more cautiously than others!). At the end of the day, I take responsibility for my own health. I do not think it is my doctor’s responsibility to make my life as full as it can be. That is on me, and I aim to live the fullest, healthiest life I can.

Won’t you join me?

Are you a buck the trends kind of person? I haven’t always been, but this health journey with diabetes is changing me! What have you learned lately that has challenged what you always thought to be right?