As I do every three months, tomorrow morning I will go get my a1c test and tonight I am feeling the same nervousness I feel every time I have my "diabetes check in". For those of you not familiar with what an a1c test is, it is a test that shows your average blood sugar over the past few months and in my mind it is my "diabetes report card". Every three months I experience the same feeling of nerves and worry as I get the blood work done and go to my routine endo appointment for my check up and to hear the results. The test is supposed to be the best indicator of how we are managing our diabetes overall and there are many studies that show the benefit of having low a1cs in terms of reducing various complications. As I sit in the office waiting for my doctor and the results, I try to prepare myself for the chance that it may be higher than I would like. I think of how I will react if the doctor comes back with a number that shows I am "out of control". For example if its over a certain number, will I consider giving up carbs completely to try to get it down? Will I break down in tears and lose it completely right there in the office? Will I be ashamed to tell my mom the results? Will I consider going back on the pump?
I have been very blessed with what I consider pretty good a1c's for the past four years of my diabetic life. In fact they have been so consistent when I was sure they wouldn't be, that I somehow feel like I am destined for higher a1cs eventually as I spend more and more years with the disease. And I feel as though if my "bad" a1c level is going to come at some point, it may be with this next test considering this test will include all of my holiday splurging and the cold/infection I have been fighting on and off since the new year. My sugars have been less than great over the past few weeks with the combination of fevers, sore throats and less trips to the gym. I know this is an enviable part of dealing with the disease and I will try to keep this in mind as I hear my a1c reading next week. As much as getting my a1c results can cause me stress, I also rely on it to "keep me going" in a way. A good result gives me the praise of a job well done for the hours of effort and energy I put into managing my diabetes. Whether the result is good or bad I know I will left with the same disease to deal with and with the same unknown of whether I will develop complications or not. A great a1c is not a guarantee of a complication free life just like less than ideal a1cs do not destine you for bad kidneys, but the results still make me nervous. The result has a crazy combination of feeling like your "diabetes grade" and is very personal like your weight or salary. And for me I think it makes me nervous the most because it represents both my hopes and fears for the future.