Yesterday, six months had rolled around again and it was back to the Royal Infirmary for my bi-annual check up (odd word ‘bi-annual’, does it mean twice a year or once every two years? One to ponder. Or not.)
The very familiar waiting room was the same as always and the goldfish in the remarkable well maintained fish tank were looking very spruce. I idly wondered if they were diabetic fish – the waiting room of a hospital diabetes clinic would after all be the best place for them – and, if so, how their daily injections would be administered. But then I abandoned that train of thought, mainly on the grounds that it was silly.
I also amused myself with the usual waiting room game of “Type One / Type Two?” Using inaccurate and crass diabetes stereotypes I use the formula “younger and slimmer = type one”, “older and fatter = type two”. I also played the variant of the same game “Newly diagnosed diabetic / Diagnosed for years diabetic” which usually uses the formula “looking stressed and bewildered = newly diagnosed”, “relaxed and reading a good book = diagnosed sometime in the dawn of time”. This easily filled a good 90 seconds and I spent the rest of my wait reading the BBC news on my phone.
Anyway, eventually off we went to have blood pressure taken, to be weighed (very heavy boots) and to have a finger-full of blood extracted – all accompanied by the usual chat about the weather and holidays.
We then reconvened and, as I’m part of the pump clinic, I now get to see not only a consultant, but also my DSN, in addition to the dietician and – this time – a student nurse. Four against one.
My DSN did mention that some people thought that one diabetic versus four staff might be a bit intimidating for some. However, I said it wasn’t intimidating enough and suggested they should adopt an Apprentice-style boardroom, with huge throne-like chairs for the doctors and tiny, rickety stools for the patients. Sounds good to me – it would add much-needed drama to check ups!
Anyway, we went through a few bits and bobs – my pump settings, the fact that I just can’t get my temporary basal rates right while exercising, dry skin caused by high blood glucose levels (eugh, I know) and the intricacies of the dual wave bolus.
One quick foot check later and we were ready for my A1C results – 7.3, down from 7.4 six months ago.
I’m happy enough with this but it’s not as low as it was when I was on MDI, where I hovered around the mid-sixes. I know the pump has allowed me to have considerably better control than MDI and my levels are much more consistent. I suspect my A1C is higher because I’m having far, far, far, far fewer hypos.
So I’m not sure that the A1C is the best method of measuring the “success” of one’s control – it’s just far too crude by itself. We need something involving more blood glucose readings and standard deviation or something like that. But my basic arithmetic is so poor that such heightened mathematics are far beyond my ken. Ho hum.