A week or so ago I participated in an online diabetes survey in which one of the questions was, 'do you have an A1C goal?  If so, please provide a number below.' The question made me pause for a moment, but my answer was 'no.'

The real answer was only sort-of no. Our A1C goal is not quantifiable.  It's to do our very best at managing this unmanageable disease.  It's to get the lowest number we're capable of getting every three or four months.

One would think that not having a numerical goal would lead to less glee or disappointment when the all-important number is unveiled at every appointment.  But the truth is that I always have a guess, optimistic or pessimistic depending on my sense of how the past couple of months have gone.  Sometimes my guess is high and I'm pleasantly surprised. Sometimes I come away feeling unpleasantly discouraged.  Sometimes I'm so close to the actual number I consider a side trip to the race track on the way home.  But no matter what the result, I can't say this test plays a huge part in our daily diabetes decision making.

Do I think about the A1C as the months go by?  Sometimes.  When we're having a few days of high numbers, I file the week in my memory to explain a higher A1C.  A few days in range will give me hope it won't be so high after all.

But it's more of an afterthought.  My goal for my daughter is not a good A1C.  It's for her to feel well every day.  We strive to avoid the kinds of major highs and major lows which would impact her functioning and fun on a daily basis.  We strive to keep her pump humming and her blood sugar monitored with the understanding that this steady flow of insulin and awareness lessens the likelihood of complications down the road.  Then we work to incorporate these arduous tasks into a full, happy life at school, activities, home and wherever else the road may lead her.

These more immediate goals should, and usually do, lead to an acceptable A1C.  But that's not our goal.

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