Feeling like a bit of a failure following blood/eye results

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pawprint91

pawprint91

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So last week I had a blood test for something unrelated, but the dr said he would check my HBA1C whilst he was at it, so to speak. I've just read the results on the online system, and found that my HBA1c is 6.7 (Dr called it 'satisfactory'). Whilst back in June when I was first diagnosed (and what led to me being diagnosed in the first place) it was 16.6, so I have in fact dropped it by over half, I am annoyed it's referred to as 'satisfactory' not 'normal' or 'good' as it would be were it 6.5 or below. All the information I was given by the hospital and DSN nurses has been to eat normally and enjoy a normal diet, which I most definitely do, and if anything am more likely to go for meals out etc as I experiment to try and manage my diabetes, but now I'm kicking myself wondering if I'd been a bit safer would I have been a solid 6.5? My libre graph can look like a bit like a rollercoaster 50% of the time (especially days when I'm working) but my average time in target is 93%, which I didn't think was too bad.

I also had my first diabetic eye screen last week and accidentally came across the results on the same online system. It told me I had background diabetic retinopathy in my right eye. I'm actually a bit shocked by this (probably naively) as I genuinely didn't think I would have had diabetes long enough for it to do any damage to my eyes, and again I'm beating myself up by this, wondering if it's to do with my management.

Sorry for the woe is me post, but I just needed a rant to those who would understand!
 
I think what would be considered 'normal' is different for people who are Type 1 because of the greater risk of hypos.
Many people sometimes find that their eye screening can show background retinopathy but then the next test it is normal.
Nonetheless you have done really well to get your HbA1C down to where it is. People are Type 1 are advised they should be able to have a normal healthy diet and the challenge is getting the insulin regime to match.
 
My HBa1c always says 'Abnormal' next to it on my online notes, even when it’s 48, (or 6.5 in the old system, which some doctors still use) which I find galling, because it’s what I've been told to aim at. Increasingly, though, I’m finding the hospital are happy if I'm a touch above that, and look more at my hypo percentage and time in range, on the Libre.
 
The Libre in range is more useful, I think @pawprint91 and it sounds like you’re doing really well 🙂 Ignore the daft, po-faced “Satisfactory”. You’ve made a vast improvement and have really got to grips with Type 1 in the very short time you’ve had it. I reckon that’s an “Excellent”!
 
I think some surgeries’ systems don’t record anything above the diagnosis level of 48 as “normal”. My latest was 53 and recorded as “Satisfactory- no further action”.

I’d been getting “slight background retinopathy” from my annual eye check for years, but last year’s test found there was none! And my own optician, who has more sophisticated equipment and takes the time to discuss all the graphs and pictures with me, has concluded that I have no problems at all!

Please don’t beat yourself up - you are doing fine!
 
I'm not sure if the satisfactory marker even comes from your GP, rather than the lab analysing the results - who are not remotely familiar with your history. On mine I sometimes see a comment with the initials of my GP.
 
You should be very proud of your excellent result, ignore the doctors comment and keep doing what you are doing as its working x
 
Well done an amazing result!!! Glad you're feeling more positive, you should be proud of all your hard work. 🙂
 
pawprint91 said:
I've had a bit more time to consider this and process it this afternoon, and am feeling a bit more positive now - thank you so much everyone for your kind words. 🙂
Click to expand...

Glad to hear you are feeling a little more upbeat @pawprint91 - and so you should be! That A1c and your time in range are fantastic. Well done!

I think it is still the case that with your A1c you’ll be managing your diabetes more effectively than 90% of people with T1 (I think only about 6-7% reach 48mmol/mol or less). Before 2015 the suggested target for T1s was 7.5%, which you have smashed.

These lab test labels seem to be more automatically generated than anything - probably using a reference range of a theoretical person who isn’t having to pretend to be their own pancreas!
 
pawprint91 said:
So last week I had a blood test for something unrelated, but the dr said he would check my HBA1C whilst he was at it, so to speak. I've just read the results on the online system, and found that my HBA1c is 6.7 (Dr called it 'satisfactory'). Whilst back in June when I was first diagnosed (and what led to me being diagnosed in the first place) it was 16.6, so I have in fact dropped it by over half, I am annoyed it's referred to as 'satisfactory' not 'normal' or 'good' as it would be were it 6.5 or below. All the information I was given by the hospital and DSN nurses has been to eat normally and enjoy a normal diet, which I most definitely do, and if anything am more likely to go for meals out etc as I experiment to try and manage my diabetes, but now I'm kicking myself wondering if I'd been a bit safer would I have been a solid 6.5? My libre graph can look like a bit like a rollercoaster 50% of the time (especially days when I'm working) but my average time in target is 93%, which I didn't think was too bad.

I also had my first diabetic eye screen last week and accidentally came across the results on the same online system. It told me I had background diabetic retinopathy in my right eye. I'm actually a bit shocked by this (probably naively) as I genuinely didn't think I would have had diabetes long enough for it to do any damage to my eyes, and again I'm beating myself up by this, wondering if it's to do with my management.

Sorry for the woe is me post, but I just needed a rant to those who would understand!
Click to expand...
Satisfactory in health record parlance generally means "good". We used to write "satisfactory weight gain" for babies on clinic notes - partly because there was wariness about whether writing "good weight gain" would mean that parents got in the trap of "all weight gain is good" - satisfactory meant enough but not too much. It's less used now because feedback was that parents didn't like the phrasing or really understand what we meant by it, so now I tend to write "appropriate weight gain" or "weight following centile curve". I'm not sure whether that's really better... but with my health professional hat on I would be pleased if GP said satisfactory, if that helps.
 
42istheanswer said:
Satisfactory in health record parlance generally means "good". We used to write "satisfactory weight gain" for babies on clinic notes - partly because there was wariness about whether writing "good weight gain" would mean that parents got in the trap of "all weight gain is good" - satisfactory meant enough but not too much. It's less used now because feedback was that parents didn't like the phrasing or really understand what we meant by it, so now I tend to write "appropriate weight gain" or "weight following centile curve". I'm not sure whether that's really better... but with my health professional hat on I would be pleased if GP said satisfactory, if that helps.
Click to expand...
When they introduced a performance review system where I worked, the categories were, needs improvement, satisfactory, excellent and outstanding. People were always discouraged by the satisfactory, but you had to jump through hoops to get excellent and hoops of fire to be outstanding.
 
Same with OFSTED. Satisfactory seemed so grudging and seemed to imply "Not Good"!
 
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