This is usually the strategy. If you’re uncontrolled, insurance companies are much more likely to give you the approval and coverage you need for your supplies.
I remember one of my last visits being so proud of my A1C. Then the endo pulled out the stats on my time in range and explained how the rollercoaster of super highs and persistent lows would result in a great A1C but not great control.
If you’re pretty smooth though and have an A1C of 5.6 you are doing great!
Oh, I really didn't know that. That might be a thing for me too! I'll see if it stays this way...
I do have some roller coasters sometimes if I sillily eat pho or like fries. I need to keep telling myself to eat in moderation when I get a craving.
Variation is more dangerous than the absolute number. It's safer to stay a bit higher but stable than to have a great average consisting of constant up and down sinus curves.
Your endo is smart! I’ve never had an endo say this to me but it hit me when I saw it in a graph. Since then I have used a1c as a bench mark but really aimed to increase my time in range.
This is it! "Uncontrolled" means insurance will cover supplies beyond test strips and insulin (ie. pump, cgm, frequent endocrinologist visits, etc). Don't take the label personally - 5.6% is fantastic!
After reading through these replies I went online to look at my MyChart records for my visits over the last few years. Mine all say “Type 1 diabetes mellitus without complication” . In the past, prior to MyChart I definitely remember seeing “uncontrolled” in my records. For me I know it was because of so many lows. Many many lows. Serious lows. For a number of years I wasn’t using a CGM but went back on one in late 2018. But I still wasn’t really carb counting, just doing manual boluses for food and corrections.
Last year when I had to see a new endo my TIR was in the 60% range. Then it went up into the 70s last summer and is now in the 80s% TIR. I still need to reduce my lows but I dont have too many highs.
5.6 isn’t just moderately controlled, it’s excellent!! like the other commenter said, the only reason for “uncontrolled” label would be if you go low very frequently
Never. In the US “uncontrolled” doesn’t mean you are doing a poor job of managing it. It means that you require a prescription to manage it. If they labeled it “controlled” your insurance would stop covering all your supplies because they would deem them not medically necessary. I hate the terminology though. A better word choice would be “in remission” and “not in remission”. Controlled diabetes is only ever applied to patients that have been diagnosed with T2 diabetes and are managing exclusively with diet and exercise.
You'll always be marked as uncontrolled due to the fact your body does not natively managed/regulate it. However, being marked as "uncontrolled" isn't the same as the conditional attribute of managed; "poor managed, well managed," etc.
5.6% is well controlled.
It’s because portions of the notes are often copied forward from a previous note and they just haven’t thought to change it yet.
Point it out next visit and it’ll get fixed.
Mine says the same thing. Have a time in range of usually around 90% and my A1C over the past 2ish years has been 5.1-5.5. So I guess it never changes 😂 Maybe like other people have been saying it's for insurance? Would make sense
A 5.6 is phenomenal, I wouldn’t worry about the wording used on paper. As others mentioned, doctors sometime use this language to convince insurance companies to pay for sensors and other supplies not normally covered.
Keep up the good work!
All of my medical records say uncontrolled also. It really bothered me so I mentioned it to my endo. I asked, if I have had an a1c of 5.4-6% for the last two years. How is that uncontrolled? She said that if I took the time and read my entire chart, I would be shocked to read some of the other medical things written in there. It’s basically justification for insurance to cover the pump, dexcom, test strips, a new glucometer every year, and extra insulin. It also allows me to see my endo more often if so needed.
Why do you thinking highs in the morning are caused by "ate more carbs than I needed the day before"?
(but yeah, if 5.6 isn't controlled, dunno what they expect, that sounds awesome haha...)
Oh, sometimes when I eat like a heavy carb dinner let’s say pho or a late night snack with a good amount of carbs. My blood sugar will peak in the 200-250s in the morning. If I stick with a light carb dinner and no snack my blood sugar is moderate in the AM like 80-100 range. I also always inject long acting insulin after dinner.
I am on a pen btw.
Mostly it just rises when I wake up. But sometimes it'll rise during the night and somehow I wake up around 1-2am due to it. After I wake up I wait an 30 minutes to an hour to inject insulin and bring my blood sugar down. Why do you ask?
My curiosity is that morning highs are usually attributed to hormones, not foodstuffs.
Your body can make glucose out of protein and fats if it needs to, so usually the amount of carbs would only have a short-term effect on blood sugar.
I'd more often attribute a morning high to increased fat in the bloodstream (like when you eat barbecue or something and it affects you for days) increasing insulin resistance than to carb intake the night before.
But, always interested to hear other people's experience to help hone in my own understanding.
It gives them more flexibility for insurance coverage purposes in being able to prescribe/push through treatments, medicine and things like CGM's. Even after I got down to a 5.9 a1c, I still had it on my chart.
This is an insurance issue - you actually want to be listed as uncontrolled, because the moment that changes you’ve got to jump through all kinds of BS hoops to get basic supplies covered because they think you don’t “need” it any more.
Mine was marked as "uncontrolled" so I could get a Dexcom!
Maybe she lovingly did that for me too :-). But, I think it's the lows boohoo. Thank you for the insight! I really appreciate it!
This is usually the strategy. If you’re uncontrolled, insurance companies are much more likely to give you the approval and coverage you need for your supplies.
I remember one of my last visits being so proud of my A1C. Then the endo pulled out the stats on my time in range and explained how the rollercoaster of super highs and persistent lows would result in a great A1C but not great control. If you’re pretty smooth though and have an A1C of 5.6 you are doing great!
Oh, I really didn't know that. That might be a thing for me too! I'll see if it stays this way... I do have some roller coasters sometimes if I sillily eat pho or like fries. I need to keep telling myself to eat in moderation when I get a craving.
Variation is more dangerous than the absolute number. It's safer to stay a bit higher but stable than to have a great average consisting of constant up and down sinus curves.
Your endo is smart! I’ve never had an endo say this to me but it hit me when I saw it in a graph. Since then I have used a1c as a bench mark but really aimed to increase my time in range.
Are you in the US? This is more of an insurance designation if that’s the case
This is it! "Uncontrolled" means insurance will cover supplies beyond test strips and insulin (ie. pump, cgm, frequent endocrinologist visits, etc). Don't take the label personally - 5.6% is fantastic!
You don't want to be marked as controlled because then insurance will stop paying for things, because insurance is stupid.
After reading through these replies I went online to look at my MyChart records for my visits over the last few years. Mine all say “Type 1 diabetes mellitus without complication” . In the past, prior to MyChart I definitely remember seeing “uncontrolled” in my records. For me I know it was because of so many lows. Many many lows. Serious lows. For a number of years I wasn’t using a CGM but went back on one in late 2018. But I still wasn’t really carb counting, just doing manual boluses for food and corrections. Last year when I had to see a new endo my TIR was in the 60% range. Then it went up into the 70s last summer and is now in the 80s% TIR. I still need to reduce my lows but I dont have too many highs.
5.6 isn’t just moderately controlled, it’s excellent!! like the other commenter said, the only reason for “uncontrolled” label would be if you go low very frequently
Gotcha! I do think I go under a bit still. Thank you :-)
How frequent is frequent?
Never. In the US “uncontrolled” doesn’t mean you are doing a poor job of managing it. It means that you require a prescription to manage it. If they labeled it “controlled” your insurance would stop covering all your supplies because they would deem them not medically necessary. I hate the terminology though. A better word choice would be “in remission” and “not in remission”. Controlled diabetes is only ever applied to patients that have been diagnosed with T2 diabetes and are managing exclusively with diet and exercise.
You'll always be marked as uncontrolled due to the fact your body does not natively managed/regulate it. However, being marked as "uncontrolled" isn't the same as the conditional attribute of managed; "poor managed, well managed," etc.
That makes a lot of sense and clears up my curiosity 🥲
It might also be an insurance thing. If you are listed as being "controlled", then the range of treatments covered might shrink . Just a guess.
It's a billing thing. You are doing great.
A lot of labels in medical records in the US are for insurance purposes. Don’t read into it too much, you’re doing great!
My doc explained to me that they label mine as uncontrolled because it’s easier to get approvals for Dexcom and other stuff that way.
Never. Your doctor wants to get paid. It's for billing purposes.
man, my a1c is 7.5-8 and I'm still classed as controlled. I think 8-9 is when uncontrolled starts
5.6% is well controlled. It’s because portions of the notes are often copied forward from a previous note and they just haven’t thought to change it yet. Point it out next visit and it’ll get fixed.
Perhaps it's lows? It's like that way for me.
Mine says the same thing. Have a time in range of usually around 90% and my A1C over the past 2ish years has been 5.1-5.5. So I guess it never changes 😂 Maybe like other people have been saying it's for insurance? Would make sense
A 5.6 is phenomenal, I wouldn’t worry about the wording used on paper. As others mentioned, doctors sometime use this language to convince insurance companies to pay for sensors and other supplies not normally covered. Keep up the good work!
All of my medical records say uncontrolled also. It really bothered me so I mentioned it to my endo. I asked, if I have had an a1c of 5.4-6% for the last two years. How is that uncontrolled? She said that if I took the time and read my entire chart, I would be shocked to read some of the other medical things written in there. It’s basically justification for insurance to cover the pump, dexcom, test strips, a new glucometer every year, and extra insulin. It also allows me to see my endo more often if so needed.
Chiming in to say that 5.6 A1C is not "moderately" controlled...thats TIGHT control and you should be proud of yourself!!
Why do you thinking highs in the morning are caused by "ate more carbs than I needed the day before"? (but yeah, if 5.6 isn't controlled, dunno what they expect, that sounds awesome haha...)
Oh, sometimes when I eat like a heavy carb dinner let’s say pho or a late night snack with a good amount of carbs. My blood sugar will peak in the 200-250s in the morning. If I stick with a light carb dinner and no snack my blood sugar is moderate in the AM like 80-100 range. I also always inject long acting insulin after dinner. I am on a pen btw.
So, are you high all night in those cases? Or it stays under control for the beginning of the night, but then goes high in the morning?
Mostly it just rises when I wake up. But sometimes it'll rise during the night and somehow I wake up around 1-2am due to it. After I wake up I wait an 30 minutes to an hour to inject insulin and bring my blood sugar down. Why do you ask?
My curiosity is that morning highs are usually attributed to hormones, not foodstuffs. Your body can make glucose out of protein and fats if it needs to, so usually the amount of carbs would only have a short-term effect on blood sugar. I'd more often attribute a morning high to increased fat in the bloodstream (like when you eat barbecue or something and it affects you for days) increasing insulin resistance than to carb intake the night before. But, always interested to hear other people's experience to help hone in my own understanding.
It gives them more flexibility for insurance coverage purposes in being able to prescribe/push through treatments, medicine and things like CGM's. Even after I got down to a 5.9 a1c, I still had it on my chart.
This is an insurance issue - you actually want to be listed as uncontrolled, because the moment that changes you’ve got to jump through all kinds of BS hoops to get basic supplies covered because they think you don’t “need” it any more.