#A1C chart

[diabetesknow]

Learn some great tips on managing diabetes efficiently with a Hemoglobin A1c Chart.

[appalachiananarchist]

Work-related rant here…

I have noticed that a lot of the colleagues in my area let so many "minor" abnormalities slide despite being signals of a larger problem. I have had patients walk in with really obvious abnormalities ongoing for years without any further investigation done. Example: I had a guy come in with a complaint of weight loss and joint pain. His skin looked weird. Did some basic labs - AST was 40, platelets were ~130. Obviously alarm bells started going off, so I checked his ferritin. It was 3500. Did genetic testing to confirm- hereditary hemochromatosis. It took me quite literally one visit to diagnose this man. Here's the annoying part: afterwards, he got me copies of labs from his previous providers. He had mild LFT elevations and mildly low platelets for years. He has been dealing with this, having damage done to his liver, for years because no one thought an AST 40 + PLT 130 was a combination worth investigating, despite his "unexplained" family history of death by liver cancer.

I would love for this to be a one-off event, but it isn't. I inherit "diet controlled" diabetics with double-digit A1Cs, patients with positive HCV ab testing and no follow up, people with a GFR <60 and no mention of kidney disease in their chart or renal dosing performed, HFrEF patients with no ACE-I/SGLT-2/BB etc, and just… ugh! I am so upset about this HH patient that now I all of my frustrations about shoddy local care are coming out. I just want people to pay attention. I feel like I am always cleaning up messes and I am tired of it.

[g-kat423]

Oh my bloodwork finally came in. All is good, but they didn’t run an iron panel. I swear, my Dr has me mixed up with someone else or doesn’t know how to read her own notes. My chart said I was vitamin d deficient, I’ve never been vitamin d deficient so that panel was run and of course, not vitamin d deficient. The last time my iron was run it was super low so I think she somehow mixed up vitamin d and iron??? That was probably the most important testing that I needed done and it wasn’t so that’s cool. At least I got an a1c, lipids panel, and the typical cbc and metabolic panel that were all normal though since it would not be good if any of those were out of wack.

[sillimancer]

highlights from today's doctor appointment:

doctor didn't know my name (I've been seeing him for nearly a year)

doctor introduced himself to me like we've never met before and then looks at my chart and goes "oh we've seen each other a couple times now huh" (yes I've been seeing you for nearly a year)

looked at my most recent blood work and said I was prediabetic (my glucose was 90, which is normal, and the labs didn't test for my A1C)

said my high heart rate was probably prediabetes/weight-related despite 1) my weight has changed significantly in the past 5 years and my heart rate has been over 100 the whole time, suggesting my weight has nothing to do with it and 2) I'm not prediabetic according to my own bloodwork

shrugged it off when I said none of my other symptoms have changed since the last time we talked

anyway when I finally snap there will be signs

[lafseanchai]

I went to the doctor the other day to catch up on some maintenance care that I haven't really done since COVID started, and the oh so joyful pap smear. I got updated on all my jabs, and did several blood tests for various levels of things.

Everything came back good, except my A1C levels were just high enough to knock me into prediabetes. Which... I am not surprised by, and one of the reasons I got that test done. My diet isn't great with having a massive sweet tooth and being a comfort eater, my physical activity outside of work isn't consistent, and I am fat.

The doctor recommended seeing a nutritionist to help me out, and sent a referral for me. I just have to make the appointment.

Considering how good this doctor has been to me in general (not bringing up my weight, using gender neutral terms as much as possible when discussing things (people with uteruses, etc) being respectful and asking if she or they was preferred and putting my answer in my chart when she saw my pronoun pins,) I am hopeful the nutritionist visit will follow in a similar vein.

I am a bit nervous about the new food lifestyle, as I have had bad brain nonsense with diets in the past. And I haven't had a lot of time to try and work with my therapist about my emotional eating, which I want to do. We finally got to a good spot with the Catholic trauma and guilt and queerness and family issues where the next thing I wanted to address was the food.

Not sure when I will be able to get into see the nutritionist between their schedule and me going out of the country, but I can at least be aware and try to make as good of choices as I can with the stress of the trip and all the challenges there.

[lunazuniga-smith]

What to Expect When You're Expecting Who: Luna Smith & Dr. Leonard When: Saturday, June 10th, 2023 What: Luna gets some unexpected news Tagging: @detkhamani

Luna kicked her feet back and forth as she sat up waiting for her doctor to come in. The nurse's had taken care of her dip-stick and her vitals. For the last couple of weeks, the high-risk reproductive doctor had been monitoring Luna every couple of days, taking her bloods, checking her A1C, and checking her hormones. The last two cycles didn't go too well and the doctor had reassured her they usually wait for four more before considering fertility treatments. This cycle, she decided not to think about it too much. Luna had a few things going on with the court hearing for Cannon and prepping for other family matters. Between that and work and raising a toddler, she had fallen into a comfortable ryhthm. As always, the dip-stick was performed as a precautionary measure. At this appointment, she'd have her pap since her annual was due anyway. It wouldn't be a big appointment and hopefully she'd be back home to surprise the boys with lunch in no time. When she heard the knock on the door, Luna smiled and let the doctor know he could come in.

"Luna. Always a pleasure." Dr. Leonard smiled at his patient and then sat by his mobile computer to log into the hospital database. "Your sugars are great by the way and your last labs were phenomenal. How are you feeling?"

"Fine! I've cut out sugar from my coffee and I've taking sugar free creamer instead. It's helped a lot."

"Excellent. That does come a long way sometimes." He began typing away. "And nurse Elena tells me your cycles have been a bit wonky?"

She nodded. "Mm hmm. I'm assuming from the ovulation medication?"

"mmm I'm not too sure. It shouldn't be messing with it too much. Did we run a dip stick last month?"

"No. My annual is today so you said it wasn't actually necessary until today's appointment and since nothing was really changing. Pregnancy tests have been negative at home so..."

"Luna, when was the first day of your last cycle?" He looked up from his typing with concern written all over his face.

"What? Uh...Sorry, Dr. Leonard I haven't been keeping track. The hearing and finding a summer camp but I spotted pink last month around ...the first week of May?"

"And how long did that last?"

"I don't know. three days maybe?"

"I see. When did you do an HPT last?"

Luna pulled out her phone and pulled up her woman's cycle log. "Last month? I promise I'll get better at tracking but there's no way I'm pregnant because the ones I have done have been negative and I got my period so..."

There was another knock on the door and Elena came in, waving at Luna with a smile from ear to ear. She sat beside the doctor and asked him to pull up the labs tab on Luna's chart. "Oh your dip stick is back." the doctor reassured her once more that her A1C looked fantastic at a steady 5.1 and then he got quiet."

"What is it?" Luna perked up as if she could look over the monitor somehow.

"Luna...you're pregnant." He smiled widely at his patient and nurse Elena cheered. "Of course on the appointment Khamani isn't here for!"

Luna's eyes widened and she stated blankly at the doctor and nurse. "That's impossible. My hpts have been negative and I got my period. I don't understand. "

"Well, mostly likely you're very early and with your cycles being out of wack, it's very possible that you're easily four weeks or so. Elena ordered a sonogram so we're just waiting for the machine and we'll get to it!" Dr. Leonard asked his nurse to bring in what he needed and then asked Luna to lie down. "It's early yet so we won't be able to pick up a heart beat most likely so just bear with us. I want to make sure we see what we need to see and then I'll want you to come back when you're able 8 weeks or so. Okay?"

"This is...this is a lot. I want Khamani here for this. I--I'm not ready. I haven't done anything and I was supposed get on more insulin. What if the baby is not okay?" She felt the tears fill up her eyes and Dr. Leonard planced his hands on her shoulders.

"Luna. One thing at a time. Remember? Just like we spoke about when Khamani was here. He'll be here for the heartbeat, ok? I just want to make sure you're doing alright and we'll go from there. This is a happy time." He pulled a tissue from the tissuebox beside him and handed her one.

After wiping her tears and nodding at the doctor's words, Luna lied down, glancing from her position toward the sonogram machine being rolled in. She wanted her family here with her. This wasn't how she expected any of this to go down.

"You're going to feel some cold jelly over your belly. We'll start with a transabdominal before we use the probe, okay?"

"Okay." Luna sniffled and looked over to the screen. As much as she wanted to be happy, she was scared and that only heightened when she caught the change of expression on the doctor's face. "What's wrong? Something's wrong?" She couldn't decide if that was a question or a statement. In that moment, Luna was glad for Elena who came to hold her hand.

"Eveything's okay." Elena whispered, eyes on the screen and a smiled pulling at her lips. "Luna...there's your baby."

Dr. Leonard smiled at his nurse and pointed to the little spot don't he screen. "Gestational sac and pole..." He measured the screen and then stopped. "And that right there is your baby, Luna."

Luna was full on crying, squeezing her nurse's hand tight. "My baby. Our baby. How is that possible? I thought it was too early."

The doctor didn't respond at first and asked Luna to move forward on the stirrups so he can perform the second part of the ultrasound. "Actually..." He looked back at the screen and pointed with his free hand. "Looks like you're about ten weeks today. Are we doing okay?"

He looked up at his patient that had completely passed out and Dr. Leonard quickly ended the ultrasound and asked his nurse to bring her water and a few compresses.

"And please call Khamani at the emergency number!"

Ten whole weeks.

[atomic-two-sheds]

Listen, to look at me, I'm way bigger than is healthy. I've got some (mostly joint-related) issues that stem from my weight, but this is the kind of thing that has historically baffled my doctors. I currently live in a university town with a med school, so my PCP rotates out to a new fresh face every few years. My opening line is usually, "I look like my blood is made of maple syrup and sausage gravy, and that my heart probably contains a whole hard-boiled egg somehow, but please check my charts before you make an assumption." Like, my dad did have diabetes, yes, but he also had endocrine damage specifically linked to Agent Orange exposure, so I may not have the same developments, y'know?

My blood tests are down the middle for someone my age. My A1C is closer to too low than too high. My last echocardiogram was so clean that my current doc (who is excellent) isn't even slightly concerned about blockages. Those aren't my problems, and over the years I've had to gently steer numerous physicians toward other things when I go in. That's getting better, but there's a ways to go before they establishment fully embraces that fat doesn't have a lot of the connotations once assumed.

I saw a comment on your blog that says 'the way you eat does not cause diabetes'...are you able to expand on that or provide a source I could read? I've been told by doctors that my pre-diabetes was due to weight gain because I get more hungry on my anti psychotics and I'd like to fact check what they've told me! Thank you so much!

Pre-diabetes was rejected as a diagnosis by the World Health Organization (although it is used by the US and UK) - the correct term for the condition is impaired glucose tolerance. Approximately 2% of people with "pre-diabetes" go on to develop diabetes per year. You heard that right - TWO PERCENT. Most diabetics actually skip the pre-diabetic phase.

There are currently no treatments for pre-diabetes besides intentional weight loss. (Hmm, that's convenient, right?) There has yet to be evidence that losing weight prevents progression from pre-diabetes to T2DM beyond a year. Interestingly, drug companies are trying to persuade the medical world to start treating patients earlier and earlier. They are using the term “pre-diabetes” to sell their drugs (including Wegovy, a weight-loss drug). Surgeons are using it to sell weight loss surgery. Everyone’s a winner, right? Not patients. Especially fat patients.

Check out these articles:

Prediabetes: The epidemic that never was, and shouldn’t be

The war on ‘prediabetes' could be a boon for pharma—but is it good medicine?

Also - I love what Dr. Asher Larmie @fatdoctorUK has to say about T2DM and insulin resistance, so here's one of their threads I pulled from Twitter:

1️⃣ You can't prevent insulin resistance. It's coded in your DNA. It may be impacted by your environment. Studies have shown it has nothing to do with your BMI.

2️⃣ The term "pre-diabetes" is a PR stunt. The correct term is impaired glucose tolerance (or impaired fasting glucose) which is sometimes referred to as intermittent hyperglycemia. It does not predict T2DM. It is best ignored and tested for every 3-5yrs.

3️⃣ there is no evidence that losing weight prevents diabetes. That's because you can't reverse insulin resistance. You can possibly postpone it by 2yrs? Furthermore there is evidence that those who are fat at the time of diagnosis fair much better than those who are thin.

4️⃣ Weight loss does not reverse diabetes in the VAST majority of people. Those that do reverse it are usually thinner with recent onset T2DM and a low A1c. Only a tiny minority can sustain that over 2yrs. Weight loss does not improve A1c levels beyond 2 yrs either.

5️⃣ Weight loss in T2DM does not improve macrovascular or microvascular health outcomes beyond 2 years. In fact, weight loss in diabetics is associated with increased mortality and morbidity (although it is not clear why). Weight cycling is known to impacts A1c levels.

6️⃣ Weight GAIN does NOT increase the risk of cardiovascular OR all causes mortality in diabetics. In fact, one might even go so far as to say that it's better to be fat and diabetic than to be thin and diabetic.

Dr. Larmie cites 18 peer reviewed journal articles (most from the last decade) that are included in their webinar on the subject, linked below.

[death-rebirth-senshi]

😬 cholesterol and a1cs are all really really bad after previously being pretty good

Like. Steep spikes and drops all over this chart. I'm in danger.

[spaciousreasoning]

Jumping Back Up

My blood sugar was back up to 144 this morning, higher than it had been since Saturday. Was it just because I did not take the metformin at dinner last night? Was it something I ate yesterday? Or the fact that I did not walk as much?

I requested more help via the PeaceHealth portal and later heard back from the PCP. She prescribed a lower metformin dose (850mg as opposed to 1000mg) and wants me to continue taking it twice a day, since my A1C is still so high.

I was also able to link the Arizona chart to the new one for PeaceHealth, so my COVID info and more is now available to my new medical team.

After coffee and brain games we started doing laundry, both clothes and sheets, then Nancy whipped up a protein drink to hold us until lunch time. Then we took Grace to the vet for another blood check. She has been whining a lot, which usually indicates her thyroid levels are off. We should get the results early next week.

Nancy’s granddaughter passed on joining us for lunch, so Nancy and I went to Cornucopia in downtown Springfield. It was busier than the last several times we ate there, but their burgers and tater tots are definitely worth the wait.

After lunch, we went to Target for jeans for Nancy, but she couldn’t find any she liked. We did find a new quilt for the bed, and when we got home we changed sheets and put the new quilt on. The bed is a queen but the quilt is for a king bed, so there’s plenty of extra coverage.

We went for a walk about 3:30 p.m., passing once again by the Springfield UpStream Art project at E St. & 67th St., then proceeding to the magnolia garden, for a short 1.5 miles. Since 2016, the Springfield’s Stormwater Team has commissioned artists to paint murals at select storm drains. This project supports artists and beautifies the city while increasing awareness of the connection between City streets and local waterways. The goal is to inspire community members to change everyday behaviors to prevent pollutants from entering neighborhood storm drains.

The new metformin prescription was supposed to get filled around noon, but when it was still listed “in process” at 5 p.m. I drove to the drugstore to check on it. The pharmacy closes at 6 p.m. on Friday and doesn’t open again until Monday morning. It was finally filled about 5:45 p.m.

With lunch still weighing us down, we opted for just a salad for dinner, followed by splitting a chocolate bar for dessert, and then a few grapes and peanuts later. I took the new metformin pill after dinner.

We watched Colbert’s Thursday night show with Anderson Cooper and Sting, the final episode of the third series of “Under the Vines”—no news yet on a fourth series��and the last episode of the eleventh series of “Midsomer Murders” featuring multiple murders.

Sister Deborah and Beth finally made it to Tucson and went out for Mexican food. Deborah flies back to Virginia on Saturday.

[t1dlikeme]

Sheridan’s Story

When I was 12 years old, my life changed forever when my pancreas decided to stop working. Weeks of losing weight without reason, trying to manage an unquenchable thirst, having to use the bathroom every 5 minutes, and being constantly fatigued were finally explained with just a tiny finger prick. When I first got my A1c tested, it was off the charts (literally). The doctors slid the paper towards me to show me where my numbers should be, and pointed to the end of the table past the chart and said: “and that’s where YOU are.” After that day in August of 2016, I decided that Type 1 Diabetes was not going to control my life. I wasn’t going to let it define me, and I certainly wasn’t going to let it keep me from achieving my dreams.

As part of an avid soccer family, my first question to doctors was, “Will I still be able to play soccer?” Looking back, I was asking that question already knowing that I wasn’t going to accept any answer but yes. Through almost 8 years of finger pricks, pump changes, chugging gatorades, and highs and lows, Type 1 Diabetes has shown me that I am so much stronger than I realize. I never considered that this disease would hold me back—not from competing in the highest collegiate level of soccer, attending an academically-rigorous university, or from serving as a role model to other young soccer players who have been diagnosed with this disease. When I look back to that day in August of 2016, back to the face of a young girl who had just received a life-changing diagnosis, I am filled with neither sadness nor pity. Rather, I feel a sense of gratitude that the universe decided to throw something so incredibly difficult at me, because it knew that I could handle it with strength and grace.

Sheridan Brummett

[onecalldoctor123]

Convenient Blood Tests at Home Can Help Expecting Mothers Prevent Pregnancy Diabetes | One call Doctor, Dubai

Pregnancy diabetes, or gestational diabetes, is a condition that affects some women during pregnancy when their blood sugar levels become higher than normal. This can happen because of hormonal changes or insulin resistance in the body. Convenient blood tests at home services can help expecting parents to closely monitor sugar levels by fixing the sample collection dates as charted by the doctor. Gestational diabetes can lead to serious problems for both the mother and the baby, such as high blood pressure, pre-eclampsia, premature delivery, heavy birth weight, respiratory distress, and an increased risk of developing diabetes later in life.

These risks to mother and baby can be greatly reduced with a healthy lifestyle, body weight, and routine blood tests to monitor sugar levels. With many hospitals and clinics offering convenient blood tests at home in Dubai, routine monitoring of blood sugar levels has never been easy. The expecting parents should also take care to maintain a healthy diet, do recreational activities, exercise, and sleep for a minimum of 8 hours to keep the risk of pregnancy diabetes at bay.

The blood tests for gestational diabetes are usually done at 24 to 28 weeks of pregnancy, or earlier if the woman has risk factors such as obesity, family history of diabetes, or previous gestational diabetes. The tests involve measuring the blood sugar levels before and after drinking a glucose solution. If the blood sugar levels are higher than the normal range, the woman is diagnosed with gestational diabetes and needs to follow the doctor’s advice on how to manage it. There are home healthcare services providers in Dubai who offer routine blood tests at home for expecting mothers.

One of the main causes of prediabetes, a condition where blood sugar levels are higher than normal, but not high enough to be classified as diabetes, or type 2 diabetes, is insulin resistance. If the body suffers from insulin resistance, the cells do not respond properly to insulin and require more of it to take up glucose from the blood. Insulin resistance can be tested indirectly by performing blood sugar and lipid tests at home and by evaluating the signs and symptoms that may indicate a reduced insulin sensitivity. However, the most accurate test for insulin resistance is still not commercially available and is still only used in research and studies.

Doctors use blood tests that measure the amount of glucose or hemoglobin A1C (a form of hemoglobin that reflects the average blood sugar level over the past 2 to 3 months) in the blood. These tests can also detect prediabetes. Type 2 diabetes risks are high in those with prediabetes levels of blood glucose.

By regular blood tests at home in Dubai, which are convenient, reliable, and affordable pregnancy diabetes can be diagnosed early to limit its associated complications. They can also help track the progress and effectiveness of the treatment plan. These tests can help detect gestational diabetes early and allow the doctor to prescribe the appropriate treatment, such as diet, exercise, or medication.

Regular blood tests at home can help expecting mothers prevent pregnancy diabetes from becoming a lifelong condition, by allowing them to take timely action and avoid potential complications. By keeping the blood sugar levels under control, the mother can ensure a healthy pregnancy and a healthy baby. Moreover, by adopting a healthy lifestyle, the mother can also reduce the risk of developing type 2 diabetes later in life. For more details visit our website : https://theonecalldoctor.com/

[shatteredmommy]

564

Diet went to shit today but that’s ok tomorrow is a new day. Had my endocrinologist appointment today…he was happy my a1c came down but is really concerned about my cholesterol and triglycerides. His words were” you’re off the charts and I don’t want you to have a heart attack.” Guess I’m gonna have to restart my atorvastatin. Tomorrow, I have my cardiologist appointment for blood…

[jenroses]

Victory/Victoza

So, I've been fighting my insurance company since January to allow me to renew a prescription for Victoza (Liraglutide, a diabetes drug for type 2 diabetes).

Usually the way these things go, my doc argues with them for a while and then they cover whatever it is they don't want to pay for. This time they denied it twice, and so I had to appeal to the state. In preparing for that hearing, I ran into a bunch of roadblocks, first of all that the hearing packet with all of my insurance company's exhibits was supposedly served March 8, but did not get to me until mid-April, postmarked... mid April.

So it was not until I got that packet, 2 weeks before the hearing date, that I got a look at what they were basing their decision on.

Y'all, it was gobbledegook. Someone had apparently transcribed a phone message while high, or possibly helped by a cat, but it was not intelligible. Or it might have been someone who didn't type well trying to take dictation while I was speaking.

You know I pride myself on clear communication. It was embarrassing, and I'm not sure who it was more embarrassing for. Like I had firsthand embarrassment at those "words" being attributed to me, and secondhand embarrassment for whoever wrote it up.

And my doctor had not sent enough medical records, and the records that were sent were... also badly transcribed. And some were upsetting, such as the comments on the usual stuff that gets rudely commented on in type two diabetics' charts. (I have steroid induced diabetes, not typical type 2, but that's another story.)

It took me more than a week to overcome the mental inertia of knowing I had to do a deep dive into my own medical history, which is inherently traumatic, beating two not entirely merged digital charts into something coherent.

When I finally tackled it, my first draft had 1200 words and there was a spreadsheet with multiple sheets.

Here's what I did:

Went back through the chart to note things like dates of care, messages with the doctor about meds, and correlated the vitals stuff to my blood test dates. This all went in a spreadsheet.

Wrote a narrative countering their assessments (such as my diagnosis being "type two diabetes without complications." Excuse you. I'm very complicated) and making it clear what meds were being taken when and how my A1C responded and what my weight was doing and what my RA situation was and how my body responded to treatments.

Read the instructions for submitting exhibits.

Printed (in light mode!) to PDF both supporting doctors' letters that I had, all of my A1C data for 11 years, my vitals for 3 years, my own narrative, and a digital version of the exhibit list.

Emailed all of that to the hearings assistant, the hearings representative and the insurance company.

What happened:

A few hours after I sent the email (6:30 am was when it went out) I got a call from my hearings representative. She told me she was going to make sure the insurance company read the exhibits.

A couple hours after that, she called me to tell me the insurance company itself had reversed its own decision and was entering the approval for the medication into the system immediately.

A few hours after that, I submitted the refill request to my pharmacy, they were out, so we transferred it to a pharmacy that had it in stock.

And tonight? I got my meds.

Zero copay.

So now i get to ease my blood sugar back down from the 160-180 range over the next couple days, and hopefully stabilize back at the 90-120 range I was at before when I was able to take both Victoza and topical metformin (avoids digestive problems! No side effects!)

I know better than to drop it too quickly, that way lies a confused body acting like 110 is the new 50.

It was maddening knowing how hard I've worked to keep it under control and knowing that we had figured out things that worked and not being allowed to DO those things. Like, I cannot afford to pay $1000 OOP every month for one single medication.

(And before you talk about patient assistance, I am in a category where I absolutely positively do not qualify, end of. That was the first place I looked.)

[highwaydiamonds]

Exercising stuff 'n' nonsense

I wanted to post that I did my exercise stuff this week - and that it was hard on thursday! I have no idea why it was so hard but it was... Ok maybe a little idea why it was hard... I increased the resistance on the machine for pretty much the whole 40 minutes and managed to get in over 2.25 miles so yeah I mean I guess that's why... But i also just felt sweatier and like I had to physically push more than I had on wednesday... And I think I pretty much did the same on wednesday - or close to it. I definitely was glad it was the last day of this week to be in there. It was the first time I wanted to take a break, but I didn't. I'm proud of myself or that.I also got a compliment from a couple of the staff. One looked at my chart they keep of my data and stats and told me that I am doing really well. Another saw my weight data and complimented me on that - That's nice and all, and I'm glad to see it because of my health issues but that's not why I am in there really. (I mean it is something I am working on but that's not necessarily what I am doing the rehab stuff for - if that makes any sense... If not and you want to know more - dm me - there are some things I'm not ready to spit out in public juuuuuust yet. I will in time I'm sure. It's nothing bad :) Just not ready yet to declare it all out here.) However, it was very nice to get the positive feedback, especially on days that feel hard and frustrate me.

Also I'm annoyed with myself. I've eaten too many oreos the last couple of nights - like several too many and it always happens at night. and it's been making my blood sugar out of whack. Of course I'm ndoing this right before I see the doctor and my blood sugar he last day or so has been higher than it has for weeks so that's annoying. I haven't always been good about taking the lantus but I have been trying otherwise (well ok for the most part) but it is really frustrating to see my blood sugar like this right now. I don't want to have to go on another med... and it is making me worried about what my A1c is going to be. smh I need to turn this around, and I know it's down to my own choices and figuring out better habits- at least I know the pattern maybe I just need to figure out something about how to rectify this night time thing :/ and maybe forgive myself for it for the past since i can't undo it - better to move on.

Lastly, I felt cute earlier this evening. I actually managed to make a baby wing in liquid eyeliner! You do not understand - this is a big deal. I wasn't going anywhere but I actually made them small and cute (usually i mess it up and they get CHONKY and not cute v quickly and with my hooded eyes it looks awwwwwful) But tonight they stayed thin and cute and baby sized which works even on my hooded eyes. so i did some other make up and played on snapchat for mahself. but i'mma hide a few pics in here because I want to :P well and maybe also the stats off the nu stepper from thursday because i worked for those numbers dang it.

hair down

hair half up

lip gloss worn off and hair more ala Usagi Tsukino minus the long pony tails 'cause y'know short hair... And yes i know the baby wings are p much invisible on all of them but i know they're there and that is enough for moi.

[spicysoftsweet]

A Very Important Episode starring Hisoka

Or the one where Hisoka learns Bungee Gum is not a food group.

A/N: We all know that Hisoka likes candy and Bungee Gum but we would like to encourage Hisoka to make healthier choices and prevent diabetes complications. There will possibly be a part 2. I hope this is educational.

---

This time Hisoka had actually done it. He’d actually managed to fuck up his entire body beyond what he could repair with Bungee Gum or Machi’s services - which she was charging higher and higher for - and now he was somewhere almost unthinkable - an emergency room.

“Illumi~~~~” he half-sang, half-whined now that he was finally lucid, after undergoing an exploratory laparotomy to stabilize his profuse internal bleeding - the surgeons had been in awe of just how much of his body had been purely synthetic due to Texture Surprise exclaiming that he’d be an incredible case to write up - and being amped up full of pain meds. He probably didn’t need the pain meds, but it was fun to go in and out of consciousness; he couldn’t remember the last time he had an actual night of sleep.

His unwilling friend sat at the side of his hospital bed, legs crossed and focusing his jarringly large, black eyes at the fluid and blood that was being transfused into him by IV drip. A small part of him was surprised that Hisoka could be transfused with regular looking blood and regular looking fluid. He was almost sure that he was made up purely of nonsense and Bungee Gum.

“Illumi~” Hisoka moaned dramatically a second time. His gaze slid now to him, with lips pressed into a flat line of distaste.

“Don’t ever use my name as your emergency contact again.”

Illumi had to hide the fact that he was impressed Hisoka could spell clearly enough to make out the letters of his name and had actually retained his phone number. He had been surprised to get a call, but made his way over as soon as he had finished gutting an enemy and stringing them up for display as requested in his latest contract. The idea of Hisoka being dead was incredibly alarming, for he did enjoy his health and company, but also sparked a morbid curiosity in him. Could Hisoka actually die?

“But you came, didn’t you?” Hisoka teased, with a shit-eating grin.

He had him there.

There was a soft knocking on the door, and a young woman in a white coat, followed by a taller man wearing a pair of scrubs came in. The young woman glanced at Hisoka and then Illumi, visibly wincing at the hard stare of the latter in the semi-dark room, then raised her badge to introduce herself. 

“H-hello, I’m Dr. Rhgyl, I-” her eyes flickered to Illumi briefly, unsettled by the fact that he hadn’t yet blinked in the past two minutes, then shifted back to Hisoka, whose devilish smile was almost more unsettling. “I was one of your surgeons and am here to answer any questions you have.”

She turned to Illumi, and gave a nervous nod of the head. “And who is in the room with you, Mr. Morow?”

“My husband,” he said, in a sickly-sweet voice. Illumi gave him a glare, then crossed his arms.

“Sure,” was all he said.

Sure, what? What is sure? Just answer the damn question... The poor young doctor’s face fell as she already knew this was something she’d have to spend unnecessary minutes during her already excessively long call night clarifying in her documentation. She turned to her nurse behind her, who gave her a small shrug. 

“So uh, Mr. Morow, how is your pain?”

“It’s wonderful!”

The doctor again tried to conceal her internal screaming, and continued to keep her professional smile plastered on her face. “In that case, please let us know if you have any more pain, and your nurse will take care of it.”

“We do have one other issue, however, “ she added, making sure to communicate this next part as clearly and effectively as possible. Hisoka perked up in surprise, and Illumi continued to sit perfectly still, as still as a statue. “Your blood sugar. Your blood sugar was extremely elevated, and we were concerned about a diagnosis of prediabetes or diabetes.”

“Diabetes?”

“We expect you to make a fast recovery… surprisingly fast in fact, but we would still like you to follow up with a primary care doctor about your blood sugar. We’ll draw a lab test to check how your sugars were for the past 3 months, called a Hemoglobin A1c test, and then we’ll have your primary care doctor follow up the results and help you with strategies to have better control.”

Illumi turned to Hisoka, who he could tell that whatever the medical team was telling him was going in one ear and out the other, and he was now only thinking about either his next fight or Bungee Gum based on the elated smile on his face.

Bungee Gum.

Bungee Gum was the fucking problem. 

As the doctor and the nurse finally exited out of the room and Hisoka went back to telling Illumi battle stories, Illumi started to clear his schedule in his head, to figure out when he could best drag Hisoka to his follow-up appointments, which he would have to make for him. Someone had to be the adult in this relationship. 

---

Hisoka’s new primary care doctor, another similarly young woman, but less easily intimidated as the tired one from the hospital sat at a computer, pulling up his chart to review his lab results from his hospitalization.

Illumi and Hisoka noticed how she visibly paled as she scrolled, then turned to Hisoka and gave him a reassuring smile, that looked to reassure her more than them. 

“What is it? Am I dead?” Hisoka asked. Illumi gave him a look to quiet down.

“Well, you’re diabetic, all right... Your A1c is 14%.”

“Is that bad?”

She swiveled in her chair to face him, hands in her lap. 

“Well, diabetes is diagnosed at an A1c of 7%. So... unfortunately,  yes.”

Hisoka started counting on his fingers and Illumi forcefully put his hand down.

“Hisoka, listen to the doctor. Diabetes is serious. My great-grandaunt was diabetic.” Illumi said in an even, impassive voice.

“Oh, how old was she when she was diagnosed?” The doctor asked, attempting to build rapport with the patient and the patient’s loved ones.

Without skipping a beat, he replied, “206, exactly. She loved nothing more than to unwind with Mountain Dew after her assassination missions. She ended up on dialysis.” 

The doctor seemed to be at a loss of words briefly, so she turned back to Hisoka, pulling out a pen and a notepad to focus on rather than lose her cool. 

“So, uh… let’s start by talking a little about what you usually eat,” she began. “What do you eat in a typical day?”

“Hm... “ Hisoka didn’t usually keep track of what he ate, so it took him some time to come up with an account. “Ah! Okay, so in the morning, I usually skip breakfast, but sometimes I’ll have some Bungee Gum.”

Odd choice, the physician thought, but she nodded and wrote that down, allowing the floor to Hisoka to speak.

“For lunch, I try not to eat too much, but I also have a couple pieces or ten of Bungee Gum.”

Hm…

“Oh and for dinner, I have a bowl of gummy candy if I’m feeling particularly peckish and also Bungee Gum.”

She looked up from her pad and paper to see Hisoka looking blissfully unaware that he had just revealed that he subsists solely on sweets. She suddenly felt an overwhelming urge to pull at her hair repeatedly. This would be a ton of education, and she still wasn’t exactly sure what exactly Bungee Gum was.

---

Illumi parked his custom Ferrari minivan, purchased entirely for this shopping trip, outside the Costco Wholesale, and gave Hisoka, a long, hard look. 

“Do you have the list?” Illumi asked, hand outstretched as Hisoka handed over a partially crumpled sheet of paper, outlining the basics of a balanced, carbohydrate-controlled diet for people with diabetes.

Hisoka looked outside to the large building, then looked back at Illumi. “Isn’t this for families? I thought we were shopping for me only, and sometimes you when you come over.”

“I don’t know, the butlers told me that they come here to stock the kitchens. It seems from the website that this store provides high quality bulk goods for very competitive prices so this will be an appropriate next stop.”

This was just one out of countless stops today - Hisoka had spent the earlier part of the day searching frantically for sugar-free Bungee Gum in every supermarket in a 25-mile radius unsuccessfully, and demanding to see the manager every time, only to kill them when they told him they didn’t have his particular brand. Illumi warned him that there would be no such shenanigans any longer.

They stepped out of the car and walked right past the door greeter who was waiting eagerly for them to present their membership card only to recoil once they both turned to look at him in unison with intent to kill. 

The first things Hisoka noticed as he walked in were the multiple little free sample kiosks at the aisles every so often and curiously wandered over to them. 

“Make sure to avoid anything glazed or with a sauce,” Illumi called after him, poring through the list as he wandered over to the produce aisle. He didn’t understand the draw of free samples; if he wanted to try something, he would simply buy it.

Hisoka made his way to Illumi and Illumi’s overfilled grocery cart about a half-hour later after wandering the entire store, arms filled with small paper cups and tasting spoons. It was clear that he had sampled literally everything, possibly twice or thrice. Illumi let out a sigh and moved to the front of the store to check out. 

Keeping Hisoka’s blood sugar low would be a daunting task, but he was determined that by the next visit to his PCP, he’d have some improvement in his A1c. Texture Surprise can only replace so many amputated limbs at once. He’d just have to buy every supermarket’s supply of Bungee Gum and possibly halt every single production chain devoted to it or something similar. A pain, but it was worth it. Hisoka was annoying as all hell, but still, he was worth it.