Kangaroos and armadillos – a story of HbA1cs

By | 21 June, 2010

Beware, what follows has somehow turned into a slightly bizarre piece using animals to illustrate HbA1c result variations. I don’t know where in my mind this came from but bear with me, the real point is that my pump and CGM have made a real difference to my long term diabetes control.

A year ago I graphed my HbA1c results for the first timeand was pleasantly surprised (read absolutely gobsmacked and delighted) with the results my pump and CGM had helped me to achieve.

Pre-pump the graph looks like the results of an Alison vs kangaroo wrestling match. If I tried really hard I could tie that kangaroo down and get my HbA1c around 6.5. Once, I managed a particularly brilliant left hook and floored it to 6.2. Sadly, as kangaroos and HbA1cs are apt to do, the damn thing always bounced back up to around 7 whenever I took my eye off the metaphorical kangaroo.

Then I got the pump and CGM and the graph looks like I taught the kangaroo to ski (yes, I am starting to regret this bouncing kangaroo analogy but its too late now). The downhill ski slope 4 months after starting on the pump was the last significant gradient. From then on the kangaroo lost it’s bounce and became more of an armadillo, wandering gently through the meandering flatlands that made up the next 2 years. My HbA1c flatlined, the slight twitch as it varied between 5.5 and 5.8 the only real sign of life in the graph.

Recent forum debates about whether anyone had graphed the impact of pumps on HbA1c prompted me to carry out my first annual graph update. The result leaves me feeling a bit like Mary – just a little contrary.

I’m delighted to see that there’s been no change; I’ve flatlined for another year with HbA1cs between 5.6 and 5.8 and no significant hypo issues. If I didn’t know better I’d swear I must be dead, such HbA1c consistency is not something I’ve been used to over the last 27 years of diabetes. I still have bad days, random blood sugars, hypos, times when I forget to bolus and times when I’ve had enough of the whole thing, but they’re much rarer now. I’ve found the tool that lets me manage my diabetes as I want to and the kangaroo, if not quite dead, is certainly enjoying a long hibernation period.

So why do I feel so contrary? It leaves me with little more to say on the subject than I said a year ago. What use is that when I’ve got a blog to populate?

Category: Living with diabetes Tags: , ,

About Alison

Diagnosed with Type One in 1983 at the age of four, Alison’s been at this for a while now. She uses Humalog in a combined insulin pump and continuous glucose monitoring system and any blood glucose meter as long as it takes five seconds or less.

22 thoughts on “Kangaroos and armadillos – a story of HbA1cs

  1. Kaitake

    It’s so nice to see some real tangible proof of how a pump and CGM can actually make a difference. I’ve always been curious to know just how much difference a pump would make, but this is pretty dramatic. Congratulations 🙂

  2. Cecile

    Delighted with your skiing kangaroo! I’m stuck with being Ckoei, so that makes me a hippo in quicksand: since 2007, I’ve slowly sunk from middle sixes to 4.8 (which might be bedrock, I’ve been there the last 2 visits). I can’t point a blaming finger at pump&CGM, though – currently suspicion rests on chicken-hearted thyroid(confirmed) and adrenals(to be tested on 20 July) that are being bullied by overzealous immune system.

  3. Mike

    Fantastic graph @Alison. Still working for my inner Armadillo 🙂

    Wondering how much of a factor the CGM is? Do other shoot-up pumpers all have similar success stories with or without CGMs, or does the CGM make a sizeable contribution to the alpine kangaroo -> armadillo transformation?

    1. Alison Post author

      @Mike I think I would have seen significant improvement with just the pump, but I think it’s been easier having the CGM aswell. I’ll write a post on it.

  4. Michael

    Love the animal analogy. But even more seriously, I’m jealous of even your trained kangaroo before it evolved into an armadillo… No idea what kind of animal my 7.7 might be, but it’s most likely an untamed jungle cat that I’ve managed to get a handle on periodically but just won’t learn the lesson. Oh well… Thanks for sharing and great job on the A1Cs.

  5. Mike

    @alison Would be interesting to read your thoughts. I’ve a blog post brewing myself on the very same subject from an MDI perspective, of course…

  6. Mike

    @alison That is brilliant, but after what Tim told me I’d would be naive to expect anything less! 🙂
    Although I would suggest we panic if those were the results from an ECG test!!!! hehehe

    As for my inner HbA1c animal, well perhaps I should leave it up for you guys & girls to decide…

  7. Mike

    @alison Nothing but sparkling compliments and wonderful words!! Seeing as you have a law degree as well I will shut up now! Enough whole digging for now! 🙂

  8. Tim

    @mike – One of the attendees at Shoot Up nights out (but who rarely posts here, despite my protestations) swears by CGM and thinks even sans pump it makes a huge difference to her control.

    The problem, though, is getting your hands on one. Getting them on the NHS is difficult and self-funding expensive.

    1. Mike

      @tim That’s pretty much exactly what I’m beginning to think would apply to me. I’d quite happily save them all that cash on a pump to swap a large number of test strips for a bit of CGM goodness

      1. Alison Post author

        @mike Does your hospital not have a CGM you could borrow for a week to try it out? Or try Medtronic, they should give you a trial to see if it’s worth you fighting for funding for it.

        1. Mike

          I’m deffo going to ask the question. Sadly though I hear from many online d-types everywhere that it’s pretty much impossible to get one without a pump.

  9. Mike

    @tim Thankfully your words! hehe

    If I had to choose between a Pump and CGMS I think I would with the latter. To me, a cgms would help me gain control, finally!

    @alison Is you graph above recreated or straight from the software that you use for your pump/cgms?

  10. Alison Post author

    @mikeinspain The graph is just from Excel, the CGM doesn’t record HbA1c results (although it does give me a 31 day BG average which I use to keep track of things).

  11. Angie

    It is rather spectacular when you have a visual reference for how much a pump/CGMS can improve your diabetes wrangling!

    I’ve had my pump (no CGMS) since January, and I don’t know what effect it’s had on my HbA1c yet, but I’ve been plotting my weekly average blood sugars in excel, and you can see the difference even on that. My average blood sugar has dropped about 2 mmol/l in that time, and I’m dealing with less lows. Considering I was writing my PhD thesis for a good chunk of the past five months, I’d put that firmly in the win column!

  12. Hairy Gnome

    As I use the excruciatingly excellent Accu-Chek® Compact Plus BG meter (sorry @Tim ;)), I upload my data into the Accu-Chek® Compass Software at the moment but it’s a bit old fashioned and pedestrian and has no means of recording HbA1c results. Courtesy of Accu-Chek® though, I have some new software on the way which is supposed to be more customisable, I’ll let you all know how it goes…

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