What is a 'good' A1C?

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What is a 'good' A1C?


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Old 03-14-2012, 19:57   #1
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Default What is a 'good' A1C?

At a recent visit with the Cardiologist, he told me that my current A1C of 6.3% needs to be lower, but he didn't say what it should be nor did he suggest how I can get it lower. I'm confused as the Endocrinologist said that anything under 6.5% would be good for me. I don't understand the difference in advice between the two "professionals".

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Old 03-14-2012, 20:14   #2
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The ADA says 6.5 is what diabetics should shoot for, while others aim for less than 6.0.

There's the diff between the two and your goal all in one. Lol

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Old 03-14-2012, 20:23   #3
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Cardio doc is going by a recent study done on A1Cs and CVD but I can't remember the figures they quoted.

This is the chart I like to refer to. It is quite extreme though.

Hb-A1c to Average Blood Glucose Conversion Table, in mg/dl and mmol/l

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Old 03-14-2012, 20:49   #4
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That chart always bothered me because of their lone-wolf correlation values between A1C and our average bg readings.

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Old 03-14-2012, 21:01   #5
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Quote:
Originally Posted by Strawberry View Post
At a recent visit with the Cardiologist, he told me that my current A1C of 6.3% needs to be lower, but he didn't say what it should be nor did he suggest how I can get it lower. I'm confused as the Endocrinologist said that anything under 6.5% would be good for me. I don't understand the difference in advice between the two "professionals".
I'm with David here.

The French standard follows the ADA like a good little puppy. They define "acceptable" when not on insulin as below 6.5%

My personal target is firmly in the "5% club" range and I wouldn't have a problem getting out of the club on the low side. I quite like the idea of 4.8% rather than my current 5.1%

The telling statement on the link page MCS has given is "Keep Your Glucose Levels Tightly Controlled Between 70 and 100 mg/dl all day long, everyday... or else you will pay the consequences."

Whilst I don't think the formula the table uses (DCCT) is the best one for blood glucose figures in the range 70 - 100 (I prefer the Norton formula) that minor difference of opinion doesn't detract from the message.

John

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Old 03-14-2012, 21:05   #6
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Quote:
Originally Posted by John.in.France

I'm with David here.

The French standard follows the ADA like a good little puppy. They define "acceptable" when not on insulin as below 6.5%

My personal target is firmly in the "5% club" range and I wouldn't have a problem getting out of the club on the low side. I quite like the idea of 4.8% rather than my current 5.1%

The telling statement on the link page MCS has given is "Keep Your Glucose Levels Tightly Controlled Between 70 and 100 mg/dl all day long, everyday... or else you will pay the consequences."

Whilst I don't think the formula the table uses (DCCT) is the best one for blood glucose figures in the range 70 - 100 (I prefer the Norton formula) that minor difference of opinion doesn't detract from the message.

John
I didn't know of a difference for those of use using insulin. I was just told to go with 6.5%. Is there a different value for T1/insulin dependent?

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Old 03-14-2012, 21:47   #7
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Quote:
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I didn't know of a difference for those of use using insulin. I was just told to go with 6.5%. Is there a different value for T1/insulin dependent?

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Reading the "Recommandations HAS Juillet 2007" through properly, no, they don't actually have a different target as such.

What they say is if you can't make 6.5% without drugs, they'll prescribe medication. If despite that, you go over 7%, they'll add insulin to the mix and settle for getting under 7%.

In other words, they wait until your A1c is too high for long term health before doing anything too positive!

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Old 03-14-2012, 21:50   #8
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I think it is good to follow the advice of your doctor(s) and ask them to explain the different goals. Who knows what "chart' they use and if it is the same one, even. What is your own goal - that is the one that matters if you ask me.

Quote:
Originally Posted by Strawberry View Post
At a recent visit with the Cardiologist, he told me that my current A1C of 6.3% needs to be lower, but he didn't say what it should be nor did he suggest how I can get it lower. I'm confused as the Endocrinologist said that anything under 6.5% would be good for me. I don't understand the difference in advice between the two "professionals".

 
Old 03-15-2012, 01:23   #9
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Quote:
Originally Posted by Strawberry View Post
At a recent visit with the Cardiologist, he told me that my current A1C of 6.3% needs to be lower, but he didn't say what it should be nor did he suggest how I can get it lower. I'm confused as the Endocrinologist said that anything under 6.5% would be good for me. I don't understand the difference in advice between the two "professionals".
At a recent doctor's visit, my doctor told me that for 'recent' diabetics, an HbA1c of below 6.2 was desirable, but that the Americans had recently revised it up to 6.5, so he expected Australia to follow shortly. The reason for wanting a lower value for 'recent' diabetics was that 'all complications are established in the first 10 years'. What he didn't say, and what I have read here and elsewhere, and had confirmed (without being asked) by a doctor I had lunch with yesterday, is that insulin resistance starts 10-12 years before diagnosis of T2 diabetes.

 
Old 03-15-2012, 01:48   #10
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Wow, I think
the chart
Hb-A1c to Average Blood Glucose Conversion Table, in mg/dl and mmol/l

is pretty irresponsible, especially since the person who posted it is not a diabetic or a doctor. I understand what he is saying about glucose levels, but apparently he does not understand the immediate and severe risk of an insulin dependent diabetic trying to maintain a BG below 85 all the time. He does not understand what causes fluctuations in BG levels and to indicate A1C's between 5.3 - 5.9 are bad/terrible is not really responsible. But I guess everyone is entitled to their own opinion...

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