Highest A1C in Six Years

My quarterly endo appointment brought news of the highest A1C I’ve seen in six years. More than six years. Ouch.

I actually got a peek at the lab results a day or two before seeing the doctor, so I had a head start on the emotional trauma and troubleshooting. I think this was good because I wasn’t completely shell-shocked when receiving the news, and I’d already started troubleshooting by the time the doc and I spoke about it.

Why so high?

Reviewing the past few months I can name at least three things that are different and unhealthy. I want to take a short look at each of them and talk through some thoughts on changes that I hope will help.

Lack of exercise

A few months ago I completed my first half marathon. On a scale of one-to-amazingly-hard, it was pretty much off the charts. But I worked hard during training and had a lot of support from many of you (thank you!). Unfortunately, I hurt myself during one of the training runs and was diagnosed with proximal hamstring tendinopathy. Basically, I hadn’t focused enough on proper running form early in my training, and as my mileage increased and I fatigued, my form fell apart, and boom – I tweaked something. My hamstring.

Or what I thought was my hamstring!

I ran the race injured, and after the race, I stopped running. I think it’s pretty normal to take a break after a big event, and maybe especially so with an injury … but not for this long. But every time I tried running again, it hurt. Even playing basketball was pretty miserable, which is a really bad sign.

I went from running 2-3 miles, or more, then playing basketball, 3, 4, 5 days a week, with a long run mixed in there somewhere, to suffering through one basketball session each week with my buddies on Saturday mornings.

So for the past few months, I’ve spent a lot of time not exercising.

Stress

I know – who isn’t stressed these days. But for some reason, I was really feeling it.

No major issues, but I’d been feeling like I wasn’t getting the right things done, or that I didn’t have enough time to finish things, or that my work wasn’t the quality I wanted, or that I wasn’t getting back to people fast enough, or, or, or…

There are a million things any of us could add to that list. Stress is funny in that when I give it any room inside my head it just goes on a rampage. I have to make a very conscious decision to say “NO” to the things that aren’t important, or that I just can’t do, and focus on what I can do. And be very clear about not stressing out about the rest of it.

I need to follow my own “NO STRESS!” rule…

What’s one of the best stress relievers?

Exercise…

Shorting my sleep

I need 8 to 9 hours of sleep each night. I’m damn sure I need more than the 4-5 I’ve been getting for the past few months. That’s been the norm until I crash hard every 4th or 5th night. It’s a bad thing when your 8-9 hour nights are sporadic, and your 4-5 hour nights are regular.

Everything suffers when I short myself on sleep. You know what I usually notice first? High blood sugars and stress levels. Imagine that.

This has a lot to do with being stressed and trying to do too much (or too much of the wrong things). I often stay up into the early morning hours working on stuff, but my productivity is severely hampered because I’m tired. But I think that I need to just “push through this last task” or “get this last bit done” before turning in for the night.

I need to recognize that I’m more efficient, productive, healthier, and happier when I’m getting the sleep I need.

What’s one thing you can do to improve your sleep habits?

Exercise…

About the exercise

It’s clear that exercise is a huge problem area, and is also a big part in the other two – stress & sleep. But how can I exercise if I’m still so uncomfortable from the injury?

My endo asked if I’d like to see a physical therapist again, and I immediately said yes. In fact, I walked directly from his office on the 5th floor down to their office on the 3rd floor to schedule an appointment. A week later, there I was.

I spent about an hour with the therapist. After trying a million different stretches and poses and lifts and pulls, the therapist twisted my legs like a pretzel and I finally did a stretch that hit the spot that has been bothering me – and it felt amazing!

I’ve been doing exercises and stretches for three months trying to find that spot and nothing worked! Because I’ve been targeting the wrong thing. It’s not a hamstring issue at all – it’s piriformis syndrome (affectionately known as runners butt)!

Now I have correctly identified the issue, and have a plan – complete with a set of physical therapy stretches and exercises.

It’ll take a bit of time to feel better, but I’m so thrilled to have found the right problem and to have a plan of action. I can already tell I’ll be feeling great again in no time.

I have no plans on running another half-marathon, so don’t even ask. My goal now is to get back to where I was feeling my best, and that was running 2-3 miles before playing basketball. There’s no good reason to do more than that.

Hopefully, this will help with the sleep and stress, and everything together will help nudge my A1C in the right direction.

Closing

I have to admit that I chuckled a lot trying to think of safe, but somehow still slightly inappropriate “runner’s butt” images to use for this post. In the end, I wimped out. I hope you’ll forgive me.

As always, I’d love to hear from you guys. Stress tips, sleep tips, productivity tips, and runner’s butt tips, let me know if you have any words of wisdom for me!

Thanks!


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57 thoughts on “Highest A1C in Six Years

  1. With being a sophomore in college with type one diabetes, stress is always causing my blood sugars to go crazy. Also, lack of sleep is a huge problem for me as well. I will go for a week where I only get about four or five hours a night, then I sleep for like ten hours all in one night. I’ve never correlated my lack of sleep to higher blood sugars, but after reading your post, it occurred to me that I do tend to have more unexplained highs when I cut myself short of sleep the night before. As for the whole exercise thing… I 100% agree that exercising more would help my A1C immensely, but I never seem to have enough time to fit it into my schedule between classes, music rehearsals, Greek life, and my job. Or maybe I’m just not making it a priority. Either way though, I need to find a way to exercise more to get my A1C back into range since mine was the highest it’s ever been at my last endocrinology appointment, besides when I was diagnosed. Thank you so much, I really enjoyed this post!

  2. Scott,
    you are such a “sweetie” (sorry for the really bad pun
    As you already know, many of us know EXactly what you mean about”emotional trauma”
    This post is so heartwarming to me that you are so transparent .
    We D,s have all been there.
    try try try try try again……=) right?

  3. Thank you so much for sharing this, Scott. It’s weird, that A1C monster that makes us feel this way even before we step into the doctor’s office. When we’re doing “good” we feel this way, and I have found that when I am not up to par on my D-management I feel this way even more even though I’m not going to be surprised; it’s just the A1C reaffirms how crappy I’ve been doing. Even with your “highest in 6 years” and the struggles you’ve been going through with exercise, that serves as an inspiration for me because it helps me on the “me too” train of thought. That all the successes certainly aren’t silver bullets to the struggles that pop up every so often, and we do need that time to not be on top of our game. That motivates me, to think that there’s not some podium of awesome exerciser and that means I won’t ever slack again. It seems cliche to say, but You Can Do This and just reading your tips and plans is evidence you’re already moving forward. It’s normal and real life, and that’s huge for people to see. So thanks for that.

    • Thanks, Mike. I always appreciate your support and wise words.

      I think these measurements we have are a real mixed bag. I mean, what happens when you have the BEST one you’ve ever had? You feel INCREDIBLE for a little while, until you realize that the pressure is on to maintain that from now on… it’s a real tricky thing mentally to find a balance.

  4. hay scott i feel your pain dude i have a bad l4-5 in my back,bad knees,{cause of my weight 350+},along with numinous other health issues. may i ask what was your a1c. i started about two years ago trying to bring my down been diabetic for at least 10 years dr has tried numinous things including exercise programs but because of the pain exercise is a problem pt didnt work for me and until disability kicks in i dont have the money to go to anything besides the clinic i’m go to for mu other health issues right now i using insulin therapy along with pills to control my a1c and it is coming down i thank my was like 8.4 last time i went they usually check it each time i go

    • Hi John!

      Thanks for stopping by!

      A1C’s are somewhat relative, and can be a sensitive issue for some, so I didn’t list mine in the post on purpose. But I do publish them elsewhere on my site, which you can find in the menus at the top of the page.

      I’m sure you can relate really well with the things you’re dealing with! Back issues and knees make so many things unbearable! There was a great person who commented on a facebook thread recently who mentioned something called “suspension training” saying that was the only exercise she could do without serious pain. Sounds really interesting, doesn’t it? I haven’t had a chance to look it up yet, but I’d like to. Maybe that would be an option to explore for you, too.

      Good luck with everything, John! Thanks again for taking the time to read and comment, I appreciate it!

  5. Really enjoy the post. I am having so much trouble getting under control since moving to Kuwait. It is nice to hear that all diabetics struggle with the same issues. I can’t exercise here because it gets up to 120 degrees with almost 100% humidity, it is crazy. Sleeping is hard since sun rises around 5 am and I rise with the sun always. Also, no supplies for my insulin pump over here so it is back to injections and finger pricks, I feel like I have gone backwards in time. All these issues in a country that has one of the largest percentages of diabetics in the world. Smh.

    • Hi Melanie! Thanks for reading!

      Seeing that so many of us struggle with the same things is one of the biggest helps to me – I don’t feel so isolated, you know?

      I can’t imagine how difficult things must be for you right now – not just the diabetes parts of life, but lots of things about what you describe sound pretty hard! Trying to manage diabetes on top of all that … boy, what an ordeal. And you’re right, such conditions seem really crazy for a population where diabetes is just going crazy.

      I hope that you’re able to find some relief or a nice recipe of “ok enough” to get you by. Please don’t hesitate to reach out if I can help.

  6. Same here Scott. I am pretty sure my current Hb1c is much higher than those from the last years. And for the first time, i did something really uncommon for me. I canceled my doctor appointment. Just because i am a little bit afraid of the numbers. Stupid, hm?
    And the reasons for my bad BGs at the moment are almost the same. Stress is the main probelm at the moment. Some days before at the airport i forgot my day of birth when the lady at the counter asked for it. Don´t know if this is funny or sad.
    I signed up for a 12k run next week. But did not train at all. No time.
    In case of stress, it does not matter if i inject insulin, water or diet coke. The result is the same. That really sucks.
    Tip against stress: diet coke. more than usual. And chocolate. Of course 😉
    Tip against insomnia and less sleep: warm milk with honey or a glas of red vine before bedtime.
    Tip agianst lack of excercise: bury the car keys somewhere in the garden. 😉

    All the best from Germany,
    Ilka

    p.s. i really love your new blog design!

    • ….A1C was what? How often do you check FSBG? bottom line is this….I can fix or ameliorate your problem….paramedic, life coach, degree (bs) in bio med, biochemistry, four years of medical school and i can come to you for 3 weeks at 1000/week….doug

      douglas w morrison on FB

    • Hi Ilka!

      No, not stupid, it’s something many of us do I think. It’s hard to cope with the judgement, even if it’s just perceived, or in our own heads. And I think your birthday memory issue is a sweet combination of both funny and sad…

      Good luck with the 12k – I’m sure you will do amazing, because you are amazing! Remember to go slow, like you’re running with Scott! 🙂

      I love your tips!

  7. Hi Scott,
    I read this and started nodding. No, I did not hurt myself preparing to run a half marathon. I hurt myself by not doing so.

    You see I haven’t exercised — really exercised — in years. At my last employer — where I worked for 10 years before being shown the door — we formed a small walking group. Everyday, we walked the almost 2 mile circuit of the mall.

    Ever since I started consulting I stopped walking. I hate winter. I hate the cold. I live in the north east where there are maybe four good outdoor months in the year. Summer is overbearingly muggy and hot.

    I also started drinking more beer over the summer. Too much. I’ve developed a beer gut. Ugh!

    The stress of consulting and being the main breadwinner for a family of four is also taking it’s toll. I sleep less and less well.

    Add all of that up. When I see my new endo in November — my old endo quit her practice in June just before my next appointment — I’m sure my A1C will be way over 7.

    • Hi Khürt!

      I really appreciate you, and have been meaning to tell you so for days now (no specific reason – or lots of specific reasons, not sure which), so it was timely for your comment to come through. Thanks for taking the time to read and share your thoughts.

      It’s so incredibly hard to defend ourselves against the “creep” of these things, isn’t it? It’s like project scope creep, but just life stress creep – and we think we’re doing the right thing for a while by working a little harder, or skipping something (like exercise, or a little sleep) to get a bit more work done. And I’m also way guilty of trying to convince myself that this isn’t the way it’s going to be forever – that I just need to get through this little spurt of busy/stress/hurt/whatever, then I can “get back in the routine.”

      What I’m coming to realize, again, is that I have to fight fiercely for that routine.

      Easier said than done.

      Thanks again, Khürt. Here’s to us getting ourselves back where we want to be!

  8. Hey Scott! Love the article. 🙂 Really getting into reading your emails every time you send them out. Lots of great information. And I LOVE mySugr, which I finally got this last week. Getting myself up and going on the whole package. Excellent app! I’m constantly researching ways that stress effects both T1 and T2 Diabetes. It’s been a passion for me, because I’ve always tried many different stress relief techniques and some help and some don’t. But it’s a never ending education. I love the app from Calm.com…if nothing else, just go check out their website, but they have apps for both devices now. Beautifully done mindfulness meditations. I have some stuff I’ve done. Music and video that my CDN has told me I needed to share. So I started a site last year called Diabetic Stress Relief. I made some calming meditative space music and did some fractal animations over the last few years to put it all together. Videos are free to stream on YouTube and the music is free to download from Bandcamp if anyone wants it. Some folks like it, some fall asleep to it. I did it for myself as a way to relax, because I did not like a lot of music out there. I did the videos because I loved animation of fractals, and they mixed really well, so that’s where the project came from. I’m working on CD 2 now and a new set of fractal videos as well. Check them out sometime if you need to unwind. No binural beats are used, so you won’t be thrown into an uneasy feeling of alpha waves or theta, like some folks do. 🙂 (if that made any sense to you at all. LOL)

    Anyway. thanks for reading my rambles. Keep writing!

    • Holy smokes, Dave! This is AWESOME!! I’ll definitely check it out! Thanks for letting us know about it!

      And I’m so glad to hear you’re enjoying the newsletters – I’m counting on you guys to let me know what you like and don’t like, so don’t hold back, Ok? There’s no such thing as unsolicited feedback in my world! 🙂

  9. I spent my time reading all the replies, harvesting some good information, and now I have to go to bed and get the optimal amount of sleep, and not stress about the list of things I did not get done today. They can wait. Thanks for your posts (thanks to all who comment too!). Y’all get a good nights rest. 🙂

  10. So here’s what I think, Scott. Sometimes you need a not-so-desirable (I shudder to use the word “bad”) result to put the other ones in perspective and make you appreciate what it really takes to achieve it. Rather than look at this as “highest in six years”, why not think of it as “in six years, all but one of my A1cs were lower than X”. Even though I don’t know what “X” is, that sounds quite good!

  11. I’m so glad they found the real problem so you can work on healing it and getting back to the things that make you feel good.
    Re: A1c in advance… My endo at PNC does the in the office version now vs in the lab so he and I find out together shortly after he comes in the room. I can’t remember the last time I had that done at the lab.

  12. Scott, thank you for sharing after long time, it seems, how you are doing personally. Among all the great advocacy activities that you were obviously doing over the last months, I was sometimes wondering if you could still take enough care of yourself?

    I´m glad to read that you already found some of the factors that need more of your attention.

    That sounds like quite a package to deal with! Pain, no basketball, long long working hours, little sleep, all intertwined – and then a sobering number that ties the package together.

    You know, I am with Laddie in that I needed complications coming up to take back control over my BG and BP levels. When that happened last year, I was overwhelmed.
    What helped me and continues to do so every single day, is to break things down into tiny steps.
    To look at today rather than pondering about how to ever get down the next A1C in three months. Or, if today is asked too much, just now. Next fingerstick. Next correction bolus. Do I really need that sugared coffee right now? Or … would a nap be the better source of energy?

    I don´t mean I´m good at this. For my part, I find it still easier to solve too high BG values — at least they come as concrete numbers — rather than to silence the invisible inner voice that makes me work long hours and run on adrenaline all day …

    Thank you for making me think about this again and remember that, for me, it means to make small decisions again and again just for now.

    I wish you all the patience that will be needed for your healing and hope it won´t take too long anymore until you can return and enjoy dunkings on the basketball court!

    • Always good to hear from you, Viola (not Vila? 🙂 )!

      I think you have a great point about breaking things down into tiny pieces – just the next BG, or next bolus, or next little decision. And you’re so right about the concrete things rather than those invisible voices (I love the way you phrased that).

      Thank you, as always, for everything. Hope to see you again soon (though there’s nothing on the calendar yet)!

  13. And this is where you remember that diabetes is a lifelong journey (until it’s cured) so you are supposed to have ups and downs with your A1c.

    Kudos to you for pausing amidst the never ending demands on your time and energy to do some great self analysis! Even better: you took action immediately instead of spinning by thinking about it too long. Way to go!

    Hope the PT helps you get back on track.

    Let us know how to get great at “no” and “bed on time.”

    • Thank you, Tavia, you’re so right. And I’m already feeling better from the PT – stretching that muscle was heavenly!

      Working on “no” and “bed on time” will be a bit harder… 🙂

  14. Scott,

    I am right there with you, my last 2 a1c’s have been the highest I’ve had since I started pumping 6 years ago. Combination of stress, depression, and a general burnout on doing anything more than absolutely necessary to get thru the day… but on a good note, I’ve started using Victoza a few months ago and it has really helped level out my numbers, check my dex reading last week and my standard deviation is in the 40s but still want to run high

    • Hey Scott, at least we’re not alone, right? That’s one of the best parts of the community, IMO.

      It has to be encouraging to see that great standard deviation! Knowing that if you can slowly working on knocking that average down you’ll be in good shape.

      Here’s to both of us getting closer to where we want to be!

      P.S. – I really enjoyed what I saw of your MedX stuff. Really proud of you and so thankful for all you are contributing.

      • umm, i’m confused. but then, i’ve had T1 for 36 years this month. so my brain is meh.

        i have stress levels that are making me loony (yes, pun intended), i never get more than six hours of sleep every night, and i’m not eating enough because i’m not hungry anymore (all the way back to mid-May…and i’ve told my endocrinologist about this twice).

        and yet, none of this has any effect on my A1C: 6.0, 6.2 and 6.0. i know i’m lucky. OTOH, i passed out again yesterday, thanks to my hypoglycemic unawareness. i’m so looking forward to moving back to Minnesota and giving up my car.

        • Hi Meredith,

          I’m sorry to hear about you passing out yesterday.

          I’m not saying any (or all) of these things create high A1C’s, but rather that these are what I’ve identified as differences for me over the past few months.

          • oh, i forgot to mention that my endocrinologist did tell me that i’m one of weirdest T1s (in regards to my health) that he’s ever had to deal with.

            personally, i want to have a research study done with me…and i want Joslin to do it.

  15. Two comments. 1) Some of my biggest improvements in diabetes management have come as a result of a bad lab test or a threat of a complication. Sometimes we need to get knocked in the head with a hammer to get motivated to make some changes. Or even after our million years of diabetes, sometimes lightbulbs continue to come on in our brains as we learn something new.

    2) I dealt with something similar to runner’s butt a few years back. Once I found the one exercise that finally stretched the right thing, I almost wrecked my knees because this exercise stressed them. (We’ll have to compare exercises at Panera today! As if we don’t embarrass ourselves enough when we’re there….) I had found my exercise online after a few worthless visits with a physical therapist. But glad you’re having a good experience with a PT and hope you have a quick recovery-

    • Great seeing you today, Laddie! Good points on the exercises, and I’ll be sure to watch my knees. I think the stretch I’m doing is a little different, but it’s good to be aware of the possibility.

      I love, and agree with, the idea of lightbulbs going off in our brains continually through our journey with diabetes. Seems I never go through a day without learning something new.

      Thanks again!

  16. Scott this is so very true to all diabetics exercise, sleep and stress aside from nutrition can all effect A1C! Great post reminding us all to stay commited to managing out numbers! Kinds relates to the DSMA chat this past Wednesday also!

  17. I’m incredibly proud to call you my friend and to have seen your amazingly hard work building up – and beyond – to the half marathon! And, for someone who started running to help recover from a nasty knee injury…I totally understand, especially the perfect storm of physical pain impacting exercise, stress from all areas, and trying to get enough sleep. Thanks for sharing your experience and learnings, and for always inspiring me (and others) to keep moving!

  18. Ebb and flow, my friend, ebb and flow. Sometimes life just gets in the way of the goals we set, but you’ve already gotten a HUGE part of it out of the way by recognizing what had changed. I’m so glad you shared this – all of this – with the the same level of honesty that’s in so much of your writing.

    Hang in there. Tomorrow is a new day!

    Dayle

  19. Scott! I have so much I can share with you about this. First, every hour of sleep before midnight counts as 2 hours of sleep! So ideally, even getting to bed at 11pm (my current goal…) is WAY better than 12 or after! And I can really feel the difference especially if I hit a cushy 1030pm or so.. Second, we are in a similar boat. I’ve had plantar fasciitis the last 1.5 years — sucks!!! What I have been asked is to walk less or at times not at all (bg’s through the roof) or to do other exercises that do not flare up my feet. Like cycling or the elliptical or swimming. Are there other exercises that will not flare up your runner’s butt?? Good luck to you. You will get things back under control. If I do not get enough sleep one night I go high the whole next day. Hope to see you tomorrow – will come if I am feeling enough energy! ps. LOVE the idea of reading your post. This is BRILLIANT!!! Hope you won’t mind if I might implement this too?! And I might need a few tips from you on how to do it! Sorry for long comment (posting here & Facebook – not sure where you prefer comments). 🙂

    • Super valuable information on the sleep, Cynthia. Thanks for taking the time to share it in both places – I really appreciate it! I think I’ll be good to go now that I have the right PT exercises. I’ll let you know after I give it a go at basketball tomorrow! 🙂 Remember NO STRESS about the meetup! Haha! Thx again!

  20. no real advice, just to say I have been having a lot of the same issues. Now that the weather is not as nice, I haven’t been riding my bike as much, and really need to get on an exercise schedule. Going to sign up for spin classes at the club near my house. I Don’t like the teachers as much as other places, but it is convenient and that means I will go.

    • Hi Beth! Oh boy, the weather turning is a huge deal for me, too. Convenience is a huge deal – I hope the teachers are at least tolerable. Thanks for reading and commenting, I appreciate it!

  21. As someone who tore a hamstring about 17-18 years ago, all I can tell you is it will take time before you feel 100 percent again. But it will be fine.

    I completely agree about your ideas for removing stress, or at least holding it at bay. When I start to feel the stress of getting everything done, I try to purposely limit my time on work. I set a deadline, and finished or not, I stop when the deadline arrives. It’s hard at first, but after a while, you realize you didn’t lose out on anything by waiting another day to complete your task.

    Now, if you’ll excuse me, I need to sign up for that newsletter… Thanks!

    • Thanks, Stephen! It helps to know that it’s a long process (I’m so impatient…). Working at home makes it even harder for me to set those limits and boundaries – it’s an area I need to work on more. Maybe frequent napping is a strategy I should try! 🙂

  22. One question, bubba – how did you get a peek at your A1C beforehand? DI you look at the My Chart on the Park Nicollet website? I can never see my labs until the doctor releases them, and they never have until after the appt.
    (I was on the 3rd floor yesterday – at the other end (behavioral medicine) ).