What is Control?

It’s been a hectic few days for me.  My home area was hit with a tornado last Thursday evening, leaving us without power for three days.  Joe and I spent the weekend looking after my niece + nephew which was the best time ever, but if you’re not used to having children in your care, it’s exhausting 🙂  Then the anticipated visit with my new endocrinologist this afternoon.

I was seeing my old endo for about 10 -11 years.  She’s the first “adult” endo I saw ever.  My diabetes management has changed so much for the better since I first started going to her and she saw me through it all.  She knew me.  We worked well together.  When I found out Dr. R was leaving the practice I was very upset.  She moved to another practice in a different borough so it wasn’t too practical to follow her.  Plus I have a good relationship that I’ve built over the years with the office staff and educators.  I decided to stick with the practice and see her replacement. My first appointment was today.  I was so freakin nervous to meet this new doctor.  I had no idea what to expect.  But overall the visit went well.  I had to keep reminding myself that this new doctor doesn’t know me, she doesn’t know my history and has different practices than what I’m used to.  That being said, my a1c was 6.9 which is around what I was expecting based on my 9o day Dexcom average of 139.  (My meter averages were 112-125 but that just goes to show what you don’t see when not testing)  When I was brought to the lab to get a flu shot, but not blood work (strange no?) I looked at the paper she gave me with the diagnosis codes.  And I couldn’t believe my eyes:

I think that is the first time I’ve ever been “classified” as a person with controlled type 1 diabetes!  I don’t know the criteria for using the different categories but this was a first.  And one that made me grin.  But then I started to think what does controlled really mean?  Sure my a1c has improved but do I still have high and low blood glucose readings?  Hell yeah.  One of the definitions of control in the dictionary is power to direct or determine. Do I necessarily feel like I have the power to direct or determine my bg?  I certainly wouldn’t say so.  Sometimes maybe but most of the time not.  I guess I’m doing some things right since my status has changed and I will continue to do what I’m doing.  But what I’d love to know is type 1 diabetes really controllable by the definition of the word?

9 thoughts on “What is Control?

  1. Funny that. I noticed my diagnosis was 250.02 this time around – but it’s the first time I’ve noticed. I’m thinking they need to code me that way so insurance will cover an endocrinologist for my T2 self.

    Glad you feel the appt went well.

  2. Yeah… when I went to the e.r. with bad ketones (because my pump set was bad) they marked on the sheet as the cause: “uncontrolled t1 d.m.” I think my reaction was something like “oh f#uck no”. Gotta love stuff like that. But I am soooo glad you are doing so well… I know you work really hard.

  3. p.s. They also told me that if it happens again I shouldn’t go back to their e.r. I should go to the e.r. that is 20 minutes further away… BC that one is connected to my doctors. Say WHAT?

  4. Yay!! I am so glad to see that A1c Stacey! Still I see your point about if you are indeed “controlled”. I think control is something we definitely can’t count on at all times. Still be proud, you worked hard for that number. The Stacey I met on MS years ago was NOT controlled. This Stacey, yeah I’d call her controlled.

  5. You have to be careful with labels. They can be helpful, but also hurtful. I see our management as fluid. NO ONE is ever controlled, by dictionary definitions. But, we know we can be in the “controlled” range. Congratulations on your better numbers. Keep it up, keep this label, and don’t be so hard on yourself if you lose the label. Be fluid.

  6. I *think* controlled = a1c under 7, at least for insurance purposes. Congratulations on that!

    I guess I’ll never know, though – the one time I managed to go to my endo with a 90 day 24/7 dexcom average of 136, dead-on matching almost every fingerstick, I was told my a1c was 9.2. WTF???? I’ve told my endo as far as I’m concerned my a1c is just a random number and I refuse to pay any attention to it – I go by what my dex says. I’ve just resigned myself to never ever seeing “controlled” on anything I do.

  7. Stacey-

    Congrats on the A1C!!! You’re doing such a great job!! The control marking on the lab slip is amazing. Come to think of it. Mines always get marked uncontrolled?!? Lol o’well I know what I am so I’m not going to get upset.

  8. Under 7% is controlled by code. But last time, when my 6.9 had climbed to 7.1, my endo said, “Don’t worry, it’s really about the same.” I think she just felt bad because she knows how hard I work at being an artificial pancreas and we were both frustrated by the A1C. You’re so right about the meter average not being that helpful. I use a rough metric of adding 25-30 points to my meter average (I check about 8 times per say) to estimate my A1C.

    Nice work on your diabetes efforts, no matter your A1C!

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