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I’m Chris, 19 years old, and I have diabetes since I was 13 years old. I must confess that the first 4-5 years of diabetes I couldn’t care less about my results, blood glucose test, hyperglycemias…It was just too much for a teenager. My mother did almost everything. The last year and a half I started taking care of myself more. My HbA1c was getting lower , and I’m very happy with that, I can managed my pump very well. What I don’t understand is what has happened last week: I got a phone call from my nurse and she left a message in the answering machine and  I was told off like a naughty boy for low HbA1c. She asked me to come by this week. My last HbA1c result that she has is 5,5%. I don’t get it. Is 5,5% too low?? I’m just keeping my BG good, I’m feeling good why does she wants to see me???

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Hi Chris! Don’t get angry with her, be glad that there is a nurse who cares about you, you don’t have this everywhere. I’ll tell you why she did it. When you have a HbA1c from 5,5%, this means that your estimated average glucose level was around 110mg/dl, of which you may think that it’s great. But the fact is, because this is an average, it can also mean that you have gone from 30mg/dl to 190mg/dl and she wants to be absolutely certain  that you don’t get seriously dangerous low values. She is afraid that you can get a serious hypoglycemia. But as you say that you are keeping your BG good and feeling good, this can mean that maybe your variation was from 80mg/dl to 140mg/dl, or something like that, which actually is not easy to get and certainly she is not used to see it a lot in her practice. Not because she doesn’t have enough experience but because it is really difficult to have  a patient of your age who really manages to have such a good control. The best thing you can do is showing her your BG meter so she will see that your BG values are very good. But if she’s right and you are pushing too much to the low side,  listen carefully to her advice. 

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I had a similar experience as well when I was diagnosed with lower hemoglobin A1C levels and I was so scared. I remember that a nurse told me that I really should not be scared and that I am very immature because I haven't come to see her earlier. I was like - OK, but why I would do that since I never felt any sign of it, I never was bad until that day when I came to see her in the first place. Anyway, I went to seek another opinion and then I felt good about it. I don't know what to tell you, it can be really nasty, but you should deal with it or find another opinion. 

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Maybe that nurse isn't very well educated in the manner of diabetes and the lab values of an A1c. I would complain about her misconduct of her leaving a private message on an answering machine. This violates the Health Information Portability and Accountability Act (HIPAA) that health care professionals are to adhere by. You are right about your A1c being at a good level. You do not need to speak to this nurse if you do not wish to. If you wish to, you may go in for an appointment but hopefully the doctor will set her straight beforehand. I wish you the best and it is great that you are compliant with your diabetes management!
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