had my A1C done last month and it came back at 5.8, which I know sounds fine to most people. my endocrinologist basically said “yeah, that’s normal” and moved on. but here’s the thing: two years ago when I started dealing with the thyroid stuff, my A1C was 5.1. I get that 5.8 isn’t diabetes.
I know that. but when you track your own numbers like I do, you notice the creep, and it kinda worries me. what’s weird is everything else is supposedly fine now. TSH cooperating, free T3/T4 in range, but my fasting blood sugars are getting harder.
some mornings I’m waking at 115-120 when I used to sit at 95. I’ve put on maybe 8 pounds and I’m not eating differently. more tired than the thyroid stuff alone explains. I asked my endocrinologist if we should be watching for insulin resistance and she said “not yet,” which basically means check back later.
the carpenter work keeps me moving, so it’s not sedentary, but I’m wondering if the thyroid meds shift your metabolism or if I’m just older now, or if I’m seeing ghosts in the data. has anyone else watched their A1C drift up slowly while everything else tests normal? does it actually matter at 5.8?
The “not yet” from your endocrinologist is a classic case of two different questions getting bundled together. She’s answering the billing question, “Does this A1C warrant a new diagnosis code today?” You’re asking the more useful question, “Is the trajectory from 5.1 to 5.8 a meaningful metabolic signal?” The creep you’re tracking is the signal. Those morning numbers, 95 creeping up to 115-12
that creep is the entire story, not the single 5.8 number. i know that “we’ll watch it” feeling, my own doc handed me a 6.1 a1c with the same instructions. your fasting glucose numbers are telling you what’s happening right now, while the a1c is just a three month look in the rearview mirror. the question “does it actually matter at 5.8?” is the one to push on.
it matters because of the direction of travel. the next question i’d be asking, if it were me, is what your fasting insulin is. my fasting glucose was sitting right where yours is now, around 104-108, when my a1c hit 6.1. but my fasting insulin was already 14.
that was the number that showed the problem wasn’t coming, it was already there. you’re not seeing ghosts in the data. you’re seeing the data before it gets averaged into a single number your endo is willing to act on.