Focusing on the numbers
Recently I put together a table for my endo. It showed how my blood glucose numbers had changed month to month since I started using the Dexcom. I was able to use the Dexcom software to get this information, based on its readings.I wanted to show it here for a few reasons. (And apologies to anyone who is vision impaired. Blogger does a lousy job with tables, so I had to post a screen snapshot of this.)
First of all, my average (Mean column) is improving most months.
My standard deviation (SD column) is also improving. Here standard deviation indicates how tight my control is. It is now more accepted that tight control may mean less complications. If I can keep my standard deviation to about one-third of my average value, then my control is tight. And I'm nearly there.
In the last column I've shown my A1C values. Again there's improvement there, but not as much as the averages would predict. A blood glucose value of 135 mg/dL should give me an A1C of about 6.0%.
This is why I believe the Dexcom readings are lower than my true blood glucose values. And I blame that on the meter it's being calibrated against. Hence my impatience for the new Dexcom model.
It still amazes me how much those of us with diabetes focus on numbers. It's not like we have a choice. We test several times a day and then do some calculation with the numbers to decide how to correct (carbs or insulin). We try to guesstimate the amount of carbs in the food we're eating and how much insulin we need to cover this. We're constantly calculating to try and be substitute pancreases.
I look forward to the day when we're no longer forced to be math geniuses.
Labels: A1C, control, Dexcom, diabetes
posted by Bernard @ 12:01 PM
12 Comments:
Bernard,
I am still somewhat new to blogging so you may get two postings instead of one. I started a blog a couple of weeks ago and am enjoying the ability to express myself and hopefully I bring some motivation and inspiration to someone else through my experience.
I can connect and empathize with having to be a math whiz to deal with diabetes. I can see the pained look on the faces of family and friends when I bring up something related to the diabetes. I know they love me and would rather forget about it. They say I look too healthy to be "sick". First, I don't consider myself sick. Secondly, it is difficult for the subject to not come up. As you mentioned, after measuring your blood sugar several times a day, recording the results, taking medication, recording that and then watching what eat, exercising, drinking enough water and getting enough sleep, there is hardly much else to think about. It can be all consuming. A nurse friend asked me some years ago, "what is the worst thing about being diabetic"? I said, "its very inconvenient". It is difficult to be spontaneous, I have to plan for it now.
Thank you so much for your blog. If you get a chance please check mine out and provide some feedback.
www.livingasweetlife.com
I look forward to that day, too, Bernard. Someday, Lord willing, it will come. :)
I majored in music. Sometimes I wonder if my "left-brain" even EXISTS in that head of mine!! This chart is cool. I finally got my software downloaded on a PC (I'm a mac girl, so I had to wait for a friend to donate to me an old IMB laptop) and you are right.... it stinks. Especially for someone who hates numbers and charts. It's a new goal of mine to force myself to learn how to make sense of these numbers.
Oh, I am speaking of my Dexcom software FYI
Windy,
I am a CPA a numbers cruncher by trade and still find it difficult to be inundated with them morning noon and night. I agree with your bio that says you aren't going to let it dominate your life and what you want to accomplish.
I wish you lived in AZ I need a piano teacher. I am trying to reactivate that side of my brain.
www.livingasweetlife.com
I'm going to have to find a conversion chart. We're using different numbers! If TJ's sugars were above 20 for more than 24 hrs she'd be in hopsital.
I do the number crunching here being the left brained one. But it's very different to deciding if a house is going to fall down or not - that doesn't happen several times a day every day. And I havn't done that for years now anyway.
Thanks for stopping by my blog. In answer to your question TJ's on injections.
I hear you loud and clear on this one. I've struggled with the same conundrum (see here, or here, or here, or here, for example).
The trouble I see, is that adding in an additional variable (the Dexcom) sadly doesn't clear things up -- it only makes it more opaque.
Now you don't know whether:
A) You have a problem with your OneTouch meter (NB: the issue of standard deviations being larger than we'd prefer only has an impact on our day-to-day management -- whether there is any bias in the readings is the real issue re: A1c correlation),
B) The A1c test is flawed,
C) The Dexcom readings are goofy, or
D) The estimated relationship between "average glucose readings" (whatever that means) and A1c isn't worth a damn.
Sorry to be a cynic, but I doubt a new Dexcom will solve the puzzle.
Dude -
Like While.E.Coyote
U are genius
Kelly K
I can't imagine what it must be like for diabetics who have difficulty with math. I work with numbers for a living, and Daniel is advanced in math, and we still screw up. AGH!
There's no perfect solution yet. Or cure. But I hope we're getting closer each day.
Bernard,
I think my minilink is the opposite, it runs higher than my blood sugars typically.
Bernard (aka Dude),
Everyone has their own unique 'glycation rate'. The research has been out for quite some time that states how we all have our own unique rate at which glucose binds to our red blood cells.
We are all built differently (duh).
So, it reasons that the all of these standards based numbers are really meant for the average person and not necessarily for the individual.
I wouldn't get too hung up on your A1c as a number but rather how it's relating to your efforts. Looks to me like everything is getting tight (decreasing SD) meaning that your work is paying off.
We hope to get busy on a project soon that will allow everyone to know what their own unique glycation rate is as a factor which will then allow the labs to translate a raw A1c # (or mean average blood glucose #) into a standards based number. Does that make sense?
Anyway, you're doing great!!!
Hi Bernard,
I've been behind on my blogging and reading... Hope you've been well! That table is really amazing to see, you have made such steady progress with the standard deviation and average. I may need to do the same.
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