Is Your A1C Test Pass/Fail?
Why you shouldn't let A1C results define you or your loved ones.
By Tom Karlya
November 2012 — There seems to be an ongoing trail of similarities in many of the comments I have read of late in various parts of the diabetes online community when it comes to taking a child to their doctor. It seems one of the biggest fears is discussing our kids' A1C blood tests.
Just some of the comments:
"Seeing my daughter's endo tomorrow, I'm so worried because I know her A1C will be bad."
"Wish me luck — blood test and A1C tomorrow… I know it's going to be bad."
And my favorite: "Anyone know how to lower an A1C in 24 hours? Taking my son to the doctor tomorrow, it's not going to be fun."
I think I missed the memo that MUST HAVE gone out stating that A1C is a judgment stick against those with diabetes and also against us, as parents, for "not taking better care of our kids."
In a recent meeting with one of my children and their endo, the doctor stated, "Your A1C is not a very good grade. Just like in school, we have to do a better job." We have been part of this practice for years, and they have had a sterling reputation. I was not just going to let this go by me.
"Excuse me, doctor, it's not a grade. It might serve us all better if you explain how one would feel if we all worked toward better glycemic control, and how less swings might make one feel better. Let's leave the pass/fail approach in the classroom."
The doc's approach changed in one big hurry.
Here is the deal. Stop beating yourself up over your A1C or your child's A1C. At the very least, always remember that if diabetes was not the new normal in your household, this A1C would be nothing more than two letters and a number.
There is an incredible scene in one of my favorite movies, Good Will Hunting. This scene, I am convinced, is the reason that Robin Williams took home the Oscar for best supporting actor. It is the breaking point in Will's life when Dr. Sean Maguire just keeps telling Will that everything that he is or has become is not his fault. He says it over and over and over again, "It's not your fault." The scene wrenches my heart.
To those who live with type 1 diabetes and to their parents (and for those who have type 2 that could not avoid it), I say, "It's not your fault." Forgive yourself and stop living as if your A1C is the only bar for which you are measured while living with diabetes every day. It's not, it shouldn't be, and whether it does or not is really up to you.
Now do not misunderstand what I'm driving at here — it is extremely important to strive for good diabetes management, and it is an ongoing battle. I also do not have diabetes and can only judge as a parent — I cannot even imagine what this battle means to those who live it every minute of every hour of every day. It's exhausting. There is no better goal than to continually strive for better management. Things such as insulin, the artificial pancreas, as well as other important tools from meters and strips to pumps and cgms all play a role in helping caretakers and people with diabetes achieve better glycemic control — to FEEL BETTER!
But know this — the A1C is a gauge. Use it as another tool in the diabetes tool box, whether it is high or low. Work towards making the adjustment to help better gauge YOUR (or your child's) DIABETES. It is NOT and SHOULD NOT ever be used as a reflection on anything… It is a tool. An important tool, but a gauging tool none-the-less.
And the next time someone says anything to you that makes you feel like the A1C is a passing or failing grade? Punch them in the nose and say, "It's not my fault."
I'm a Diabetes Dad.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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