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    • 14 hours, 44 minutes ago
      Greg Felton likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 15 hours, 15 minutes ago
      ConnieT1D62 likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      One time I was explaining that a new pump would be too expensive at the time because my deductible had just started over.. and she asked if I had insurance and I said yes….. then she said “then it should be free with insurance.” 🤦‍♀️ She may know a little about the challenges of living with diabetes, but she knows nothing about how insurance works or how costly T1D supplies are.
    • 15 hours, 34 minutes ago
      Steve Rumble likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 16 hours, 5 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I am an RN. Been going to same doctor for about ten years. Took me six years to train him. I am very well read when it comes to my LADA. He trusts my judgement and gives me excellent parameters to make decisions. Recently had a bad case of Covid. Insulin needs changed dramatically. Getting back to normal but he made sure I had scripts to cover my ups and downs with insulin needs.
    • 16 hours, 5 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Mine acknowledges the struggles and challenges that go along with managing T1D in my daily life. She gives suggestions as to what may or may not help and has often asked me I how I handle situations so she can give suggestions to other T1D patient's.
    • 16 hours, 6 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      None of my endocrinologists or NPs have had T1D but I always discuss my challenges and they are incredibly helpful. What I always find astonishing is they are constantly amazed at how well I’m doing even when i don’t think I’m doing that well because most of their patients have nowhere near the A1c’s I’m able to achieve. And just hovers in the 6’s!
    • 16 hours, 31 minutes ago
      Jubin Veera likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      The hard spots are fairly frequent with the pump infusion sets. Especially if I go past 3 days which I try to avoid! I don’t think I ever got one from injections. I try heat and massaging to treat them and they normally go away after a day or so. Once I had a large area that I had to treat with antibiotics.
    • 16 hours, 33 minutes ago
      Magnus Hiis likes your comment at
      Have you experienced any symptoms of physical sexual dysfunction as a result of having diabetes, or having diabetes-related complications?
      I’m 79. My last orgasm was springtime about 3 or 4 years ago. When I complained of ED, my PCP Rxd 3 to 5 (60-100 mg) sildenafil tablets by mouth about one hour prior to sexual activity. This alone hasn’t worked to bring me up to former sexual capacity that I had 10 years years ago. I’m still considering consulting finding a doctor who’ll prescribe a safe but effective way of administering testosterone or an anabolic steroid in a dose low enough to avoid causing cardiovascular problems but high enough to restore normal ability that I had up to my sixties. My present doctors say it can’t be done, but there are doctors who advertise otherwise. Analogs of the hormone insulin can be delivered in small safe doses, why not testosterone?
    • 1 day, 8 hours ago
      Becky Hertz likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      We are all so very different, and trying to say that all of us with T1 understand what it's like for another who has the same hill to climb is unproductive. Having a health care provider with T1 may often be helpful just because there's apt to be more knowledge about the specifics. How we respond to the disease is such a personal matter, that I really don't think there are any guaranteed benefits beyond the grasp of the factual. Finding a doc with the same general attitude about the disease does feel good, and sometimes that's all I hope for after working hard to make peace with the disease for 70 years. Asking my doc to "get it" used to be almost my mantra, but I've come to realize that the ones who don't just see us as unruly childrenchildren
    • 1 day, 8 hours ago
      Becky Hertz likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Both my endocrinologist and my nurse practitioner are great. They compliment me on the way I take care of my life and health and make aure I get all the supplies I need managing all the paperwork Medicare and insurance requires. My nurse practitioner who works with me on managing the pump has her own opinion about the pump settings based on her technical knowledge which is different than what I do with my settings based on living with them. She has thru the years learned to respect what I do and is surprised with how my settings work. So we are now at peace. Both very supportive.
    • 1 day, 11 hours ago
      pru barry likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 11 hours ago
      mojoseje likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I said yes but that refers to my nurse practitioner who sees me every other visit, if not more often. The doctor may know how hard I try but perhaps takes my efforts for granted.
    • 1 day, 14 hours ago
      Anneyun likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      How can someone without the disease really understand what it is to live with it? I have never had a doctor with T1D in 60 years.
    • 1 day, 14 hours ago
      Bruce Schnitzler likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 14 hours ago
      Kristine Warmecke likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My endo is young, very empathetic, thorough, always asks for my input, and does research. I am blessed too. have him, and the one before for over 25 yrs.
    • 1 day, 14 hours ago
      Kristine Warmecke likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 14 hours ago
      lis be likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      None of my endocrinologists or NPs have had T1D but I always discuss my challenges and they are incredibly helpful. What I always find astonishing is they are constantly amazed at how well I’m doing even when i don’t think I’m doing that well because most of their patients have nowhere near the A1c’s I’m able to achieve. And just hovers in the 6’s!
    • 1 day, 15 hours ago
      Daniel Bestvater likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 15 hours ago
      TEH likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 16 hours ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I have no clue what my T1D health care provider understands about my daily challenges and I don’t know about his daily challenges either. Not sure why I should care as long as I have access to information how to best take care of myself.
    • 1 day, 16 hours ago
      Jeff Marvel likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 16 hours ago
      Richard Wiener likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Hi Connie, I still have my glass syringe and show it off occasionally. We boiled the needle and syringe every morning and sharpened the needle with a file. I was diagnosed at age 6 in 1963. Life is so different now! Then, my diet was extremely limited as was my exercise. Now, I am very active and eat pretty much as I please. I maintain an A1C in the low 6s (6.2 was my last).
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Connie and Beth, I was diagnosed in Nov 1962, age 10. During the early years I developed lumps and indentations on my upper thighs from my injections. In fact, I was able t o spot other t1 kids in my junior high school based upon the lumps in their upper arms.. (I eventually met up with them and learned that I was correct.) By the time I reached my twenties, these indentations had more or less disappeared, but I still have remnants of the lumps. I wish I could say that the layers of tissue now deposited on my legs disguises them, but they don't. I think the changes in insulin have been responsible for this improvement: the isolation and purification of animal insulins were refined, and then the various human clones were game changers in many ways.
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Yes in my upper arms when I was a petite and skinny child in the 1960s with T1D. In those days we used glass syringes with stainless steel 1/2 inch long heavy gauge needles. My mother would jab me in the upper arms, it hurt like the dickens, and I developed several hard nodules. I was diagnosed at age 8 in December 1962 and after the initial two months of her jabbing me in the upper arms, I took over giving my own "shots" and started self injecting via site rotation in my thighs for several years. Eventually the lipohypertrophy in my upper arms resolved and I never injected there again until many years later as an adult on MDI using disposable syringes with very short and fine gauge needle tips. Periodically I would give my tired pin cushion thighs a rest and take a break for a few months or a couple of years and rotate injections in my abdomen or upper arms. Have been using a pump for over 20 years now and rarely use MDI unless I am taking a pump break for a short period of time. Happily, I no longer have lumpy sites.
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    How important is the A1c measurement to you?

    Home > LC Polls > How important is the A1c measurement to you?
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    Which of the following T1D organizations do you support financially? Select all that apply.

    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    30 Comments

    1. Molly Jones

      It is very important to keep my A1c normal, but I wish hypoglycemia did not help to lower it!

      2 years ago Log in to Reply
    2. Kathy Hanavan

      TIR is much more important to me.

      2 years ago Log in to Reply
    3. Bob Durstenfeld

      It is still a comprehensive measurement that gives feedback on glycemic control. I agree that Time in Range is useful too. But both are recent developments within my life time.

      2 years ago Log in to Reply
    4. Ahh Life

      Time in range and the standard deviation have become much more important to me. But especially important is the percentage of the time I am in the hypoglycemic range, That’s a little like the time you are exposed to covid–you want to keep it as small as possible. Zero is ideal. How to do it? That’s another very, very long story.

      2 years ago Log in to Reply
    5. Larry Martin

      A1C used to be the standard. Mine was at 5.1 but you know what that means? I am WAY low too much. Time in Range is now the gold standards.

      2 years ago Log in to Reply
    6. Nevin Bowman

      Along with time in range and SD, these are about equal. I aim for less than 6.0 with 95%+ time in range with no lows.

      2 years ago Log in to Reply
    7. brian bloch

      Time in range is as important if not more so

      2 years ago Log in to Reply
    8. Jodi Greenfield

      It is important because it is important to my doctors. I like the time in range information my flash CGM gives me the best because I have very high and very low swings most of the time.

      2 years ago Log in to Reply
    9. Jana Foley

      I put somewhat important. It used to be very important, but now I am more contentious of my time in range as it is more accurate.

      2 years ago Log in to Reply
    10. Gene Maggard

      To me, both A1C and TIR are equally most important. They accomplish different things but added together provide a great benefit both for me and for my doctor.

      2 years ago Log in to Reply
    11. Daniel Bestvater

      Both time in range and A1c are important indicators. If your TIR is good generally your A1c is good. TIR can help reduce the wild hypo-hyper swings.

      2 years ago Log in to Reply
    12. Anthony Harder

      It’s important to me to reach my goal, but changing my A1C day to day is impossible. I work on individual tests on some aspects of diabetes care and long-term aspects. Affect long-term by repeating short term.

      2 years ago Log in to Reply
    13. connie ker

      My Abbott Freestyle Libre gives me time in range and averages by the day, week. 2 weeks and month. It also tells you how many highs and lows or in range numbers you have had. My Dr. still wants lab A1Cs along with all of the other tests that require fasting. I hate fasting labs!!!!

      2 years ago Log in to Reply
    14. Clare Fishman

      Since I have a Dexcom G6, I have found an actual A1C number to be fairly unimportant. I think TIR is a better indicator of blood glucose management. I can manipulate my A1C just by donating blood a couple of weeks before, but I can’t manipulate my TIR as easily.

      2 years ago Log in to Reply
    15. Adrienne Hitch

      I tend to run a bit higher in my A1c than my blood sugar average would suggest so I pay more attention to Time in Range.

      2 years ago Log in to Reply
    16. William Bennett

      Glad to see TIR as weighing as, or more heavily for a good many of us. A1C is an *average* not a *mean,* which means that you can get a splendid A1C by crashing low every few days. That’s why they used to yell at us for having one that’s too LOW, back in the day, as well as too high. “You can only get that number by going hypo–stop doing that!” With CGMs it’s much easier to avoid that, focus on TIR instead. I still find it somewhat useful just as a kind of way marker–as when I broke through the < 6 AIC barrier a year ago, yippee! But only did that (safely) by maintaining an >80% TIR.

      2 years ago Log in to Reply
    17. Sasha Wooldridge

      I agree with the majority of those leaving comments – A1C is important, but TIR is a much more informative and actionable metric.

      2 years ago Log in to Reply
    18. George Lovelace

      A1c will simply be a reflection of what your TIR and SD numbers are.

      2 years ago Log in to Reply
    19. ConnieT1D62

      TIR is the more important indicator to me than A1C.

      2 years ago Log in to Reply
    20. MARIE PEELER

      I agree that TIR is much more important but care about A1C because one can have a 100% TIR running on the high side of the range and still not maximize the A1C. (But one can have a fabulous A1C while having too many lows.)

      2 years ago Log in to Reply
    21. Tim Lors

      Most important to me is TBR (Time BELOW Range). After that, A1C. This combo analysis addresses A1C’s that are deceptive due to excessive lows, and TIR’s that are deceptive due to hovering around 160.

      2 years ago Log in to Reply
    22. Steven Gill

      When l initially got the MEDTRONIC system my a1C rose a bit but it stopped the extremely lower levels I experienced from work/life. Since I stopped utilizing the CGM I’ve had a few lower than “safe” levels so while I expect an improved a1C there are those risks, and yes I’ll tend to snack for specific tasks to prevent those drops. With a CGM I’d vote for the “time in range,” but l now have to use the a1C.

      2 years ago Log in to Reply
    23. NancyT

      Now with CGM availability, A1c is far less important. My doctor doesn’t always order A1cS any more.

      2 years ago Log in to Reply
    24. Janis Senungetuk

      I find TIR far more significant. A1c is an average that doesn’t accurately reflect my daily life.

      2 years ago Log in to Reply
    25. Janice B

      I believe that time in range is much more important.

      2 years ago Log in to Reply
    26. Julian Reeves

      The comments from others are very informative. Time in range does appear to be more important than A1C. I thought it was important because my doctor performs the test and asks the questions.

      2 years ago Log in to Reply
    27. Mary Ann Sayers

      The A1C gives the long view of what I did on a daily basis. I like the accountability. I have a CGM not connected with my pump. I’m waiting to get one that can be connected, so I’ll have a “Closed Loop” system (better known as an artificial PANCREAS!!!)

      2 years ago Log in to Reply
    28. Nicholas Argento

      I said unimportant but that is only part of the answer. I look at my GMI (A1c estimate from CGM data) every week. I look at the average glucose, not the population average for correlation of mean glucose with percent of hemoglobin with a glucose molecule stuck to it in a particular position of that molecule, which is what the A1c actually is. It is the population average applied to the individual. The GMI (glucose management indicator , that is, an A1c generated from CGM data) is your actual average BG level compared to the measured A1c of a population of people using CGM. GMI with a modern system where you use it nearly all the time is more accurate for you. 30% of people have a measured A1c that is 0.4% or more different than the GMI. Many endorsed time in range. I use this daily, set a goal that is tough and try to meet it. It requires me to avoid post meal hyperglycemia, and hypoglycemia, to meet it (90% or better between 70-180). TIR is a better indicator for day to day, allows time below range (hypoglycemia) which is a critical safety indicator. I want both- the A1c-GMI is what has been correlated to risk of complications over time in studies, countless times. It turns out that applying TIR retrospectively to the Diabetes Control and Complications trial showed TIR with fingersticks predicted as well as A1c. Actually, these are highly correlated with each other, but the TIR is more complete. GMI discussed more here: Glucose Management Indicator (GMI): A New Term for Estimating A1C From Continuous Glucose Monitoring Richard M. Bergenstal, Roy W. Beck, Kelly L. Close, George Grunberger, David B. Sacks, Aaron Kowalski, Adam S. Brown, Lutz Heinemann, Grazia Aleppo, Donna B. Ryan, Tonya D. Riddlesworth and William T. Cefalu Diabetes Care 2018 Nov; 41 (11): 2275-2280. https://doi.org/10.2337/dc18-1581 BTW- I am sorry this new format does not allow posting images. A picture (often for me a graph or table) can be worth a thousand words…

      2 years ago Log in to Reply
    29. Cheryl Seibert

      Somewhat important. The A1C is just an average over several weeks so if BGs widely swing very high and very low and trend towards more lows, your A1C looks great, but your control and time in range is horrible. Time-in-Range and Standard Deviation of TIR is much more important.

      2 years ago Log in to Reply
    30. Angela Langway

      I said A1c is very important because it’s one of the tools used to help manage diabetes and anything that helps is very important in my opinion. However A1c alone can be misleading, you can have a high A1c and be having serious lows, but if your highs are high enough and often enough they can cancel out those lows. To really understand you need to go below the surface. I would say time in range would be more helpful and therefor more important, but without a CGM there won’t be enough data to get reliable time in range info. Personally, I feel that the graphs from my CGM & pump data are the MOST important to me, this is where I see the trends, the real numbers behind my A1c and time in range, this is the data that informs my decisions on treatment changes.

      2 years ago Log in to Reply

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