What's Luck Got To Do With It?

Towards the beginning of July 2011, a miracle happened. My blood sugar went below 200... and it stayed below 200 for FIVE DAYS. It was the first time since 2008 that I had stayed below 200 for more than one day. I had previously stayed under 200 on less than five days in 2011. I had averaged less than one day per month in which I'd stayed under 200 for all of my months I'd been monitoring my blood sugar.
And the thing was, I wasn't doing anything any differently than I'd been doing it for months.
I had an endo visit with an A1c in June 2011. My A1c then was 7.0%. About a week later, my blood sugar mysteriously got much more stable and easy to control. Although I certainly see highs and lows (some of them very high and very low), and especially at night, often my blood sugar has been stable. It is amazing. I have no idea why it is happening. It takes days off (the last three have been bouncy) but has been back to stability enough that when the line seems straight, I trust it to stay straight while I (for instance) change my sensor. And my A1c last week was 6.1%. If this keeps up, my next A1c might easily be under 6%.

When I talked to my endo and told him that my blood sugar was much more stable- that I now often see straight lines on my Dexcom, some for as long as TWELVE HOURS!, he asked me if it was because I had figured stuff out, if my long experience has been paying off. The answer is no, or at least, not really- because my blood sugar is still, without a doubt, willing to go very high if I eat out of proportion to the insulin I take, an it sometimes plunges for no reason and would do worse if I didn't react promptly- but overall, the answer is no.

So I've been thinking about the variation in my blood sugar control over the past five years. My A1c hasn't actually varied by a lot- from 6.1 at its lowest to 7.2 at its highest- but it has varied. The question in my mind is: how much of that variability has been due to the variability in the intensity of my diabetes management?

It very clearly has mattered whether I do something v nothing- a missed meal shot means a blood sugar of over 400 usually, and my A1c at diagnosis was over 16%. And there was one A1c rise that happened when I was guessing at all of my carb counts (that's the 7.0 in March 2008). And my A1c did fall right when I went on the Dexcom.
But my A1c rose when I went on the Guardian, and the recent drop in my A1c had nothing to do with my efforts, and the facts of my diabetes itself have nothing to do with my efforts.

Without my efforts, the A1c of 6.1 would be impossible. And the fact that my A1c has not been back up to my pre-dx levels, I take credit for. If I was lax about taking shots, I would have regain an A1c of 16% if I didn't die first. But the difference between my A1c of 6.1 and 7.2 does not reflect any difference in my effort, and I don't think it reflects a difference in the insulins I've used or my blood sugar monitoring. It just is.

And that is why I am more motivated by reading about diabetes in the abstract than my own meter. Diabetes facts to honor diabetes month to start on Tuesday.