A1C Shock! I REALLY could use your input!

Hi all. Happy WDD a day late. I bought an A1C kit back in August and my results on August 6th were 6.3. My management since then has been about the same (I thought). I have had some basal instability for which I have just tried switching to Levemir. But the basal fluctuations were in both directions - giving me some highs or some lows every few weeks, so I would think that would even out.

I just did my second test and it was 7.6!! Yikes! I had planned on doing it on WDD but yesterday was hit with crazy high numbers and was occupied with that. The numbers, I assumed were because my Levemir dose isn't high enough yet. I switched from Lantus to Levemir 5 days ago and started with the same dose, knowing I might have to move it up a bit. I've now moved it up two units and am waiting to see how that works. I've had several highs into the 200s (very abnormal for me!) for 3 days.

So my question is, would that greatly effect the A1C? The insert says that 50% of the results are from the last 30 days,( 25% from 30-60 and 25% from 60-90). Of that 50% is it evenly distributed over the 30 day period or is there a relatively higher influence of the most recent numbers? In other words would the last few days have a disproportionate impact contributing to that huge increase in my A1C?

I am not a happy camper!

Does anyone know the comparative influence of the most recent numbers on your A1C?

I don’t know if I can give the best answer. But many on here have speculated that the A1C test can vary depending on what time of the month you use it etc etc. so it is just an average and not truly accurate of how well you have been doing hte past three months. But here is how I understand it: The thing is because all your red blood cells don’t die off all at once, you can have varying amounts of “sugar” on one cell compared to another. Mr. Super Sugary blood cell (that was born of a “bad” day of numbers) might die off tomorrow and be replace by Mr. Squeeky Clean No Sugary blood cell and thus your A1C could be different (ok. so maybe not just ONE cell but maybe a cluster of several super sugary coated one die off and replace by new clean ones).

So, it is sort of weird in a way because you could have a bad week (and us women with our hormones all crazy can have some weeks where we have higher numbers because of that) and those higher sugar cells might still be alive when you do your test and than they could die off tomorrow. Not saying there might be a huge number difference but I think you get the picture. Now, if ALL your blood cells died off and replaced exactly every 3 months it might be an easier estimation because you could start with a clean new slate of cells and THAT would be an exact average of how you are really doing.

Someone on here said it best to test that A1C when you have nice low week. I know we had a couple threads on here based on this subject. That said, although I want to keep my A1C low - I am not going to freak on it. There is only so much I can control so cie la vie.

For example, my DX A1C was 9.2 (and I know why). Three months later (and many paniac attacks and hardly no food and all salads) I am at 4.9! Three months after that I am at 5.6. I am going to get mine tested again this week for free at CVS plus I have an appointment at the clinic so I might get it done there too - just to see. Even though I am a few weeks early for my test - I want to take advantage of free so whats a few weeks. I expect it to be higher (unfortunatley) because I have been trying to eat more to make sure I get all my calories so I don’t lose any more weight (and hopefully gain some). I have a feeling I will have a 6 something. (ugh but hey, I got to eat right!)

Duck on here tests every month. He is the A1C master! He might have more insight for you if he chimes in. :slight_smile:

Now, the REAL test of the A1C would be to do it every week and really see how it varies. I bet you could have .decimals of differences based on your weeks.

Go back and do want you were doing when you had an A1c of 6.3 that was much better.

I found in my case that levemir is no as effective as lantus.

FWIW, I used one of those home A1c kits on the same day I had a lab A1c done. The home kit result was 7.5%, and the lab result was 6.9%. That’s a pretty big difference.

I just started the Levemir 5 days ago, Anthony, and it takes awhile to get on the right dose. So many people have said their experience on it is better that I want to give it a fair trial. I probably just should have waited to do the A1C until my dose and numbers stabilized but I was planning it for WDD and since I went ahead and did it, I’m trying to see if anyone knows how the highs of the last 3 days would be weighted in the results. Thanks for your input, though!

No hormone flucuations to worry about, KimKat, I’m happily past all that!

Yeah, maybe Duck will know how the times are weighted!

The last few days would have more impact than those from weeks ago, but not enough for the difference you’ve seen from the previous test. I’d have a lab test done.

I was wondering how accurate the home tests are. Does anyone know. It seems as if Shannon had quite different results. What is the statistical accuracy of those things and does it vary by brands - if there is more than one brand out there? Just curious.

My son has was 13% at diagnosis… then 8.9…7.0 7.0 and now 7.9… that increase upset me some…the doc said it was expected since he is just now leaving the Honeymoon period. How much more "unhealthy is every .01 of an A1C? What do you all feel is a reasonable A1C for a 16 yr. old male? I am hoping…as he grows up… and matures and realizes more how this will all impact his future…he will eat less carbs and correct and check better… he does well now…for one year in…but I see him “slipping” into “this isn’t so cool anymore mode and I am tired of it mode” He has been so possitive and compliant w/what he needs to do…but I am afraid that will also “rollercoaster” for him. What should I start “worring” at?? Cuz right now…I am worried at the 7.9.

I’ve heard they are 90-95% accurate, Nancy.

Wow, I thought I was good in math, Alan! Ok, I tried using your figures and assuming I could just divide that 29.7 evenly for my 4 days of high numbers, and making a guess at average bg’s for those time periods including raising my previous A1C from 6.3 to 6.5 as I might have not been doing as well for the rest of the period, I came out with a 6.7 which is a far cry from the 7.6 I got! Does that all work out correctly for the weighting as you know it, Alan? (I don’t know what an RBC half-life of 30 days means and probably wouldn’t follow the explanation if you gave it!). Hmmm…so all I can conclude is the 4 days weighs more than we think, I was doing worse than I thought the rest of the time (I was having trouble with having to wiggle my basal, but I thought the lows would balance the highs) or the home test wasn’t that accurate due to some other factor. Like being high when I took it?

Bottom line I think, is I need to not freak out, but work on stabilizing my basal dose and blood sugars, wait at least a month and then take at least another home test or preferably a lab test. If that is still that high, then I have to go “back to the drawing board.”

Thank you all for your input.

An A1c of 7.9 is an average of 180 BG. An A1c of 7.0 is an average of 155. Commonly believed that BG over 140 is where damages occurs. Yea, I’d be concerned with a 7.9. Hard for teenagers to maintain good control because of hormones & the rebellion all teenagers feel. Many people have written about their teenage years, which weren’t stellar.

Hope your son would consider joining. Members his age to relate to.

Using Insulin & Think Like a Pancreas are great books that perhaps your son might want to read.


I would recommend trying to use an CGM if possible, at least as a trial, or the one iPro (I think it is that doctor’s offices can lend ou)t. SInce using mine, I have discovered spikes at weid times that I never would have known about. It can give you more information to go on in terms of making adjustments.

Thanks, Hope, that’s a good thing for me to look into as soon as I get this current glitch settled and see where I’m at. I had been hoping to get my 6.3 August down a tad, and now I’d just like to get back there!

I don’t remember where I saw it, but I have seen it somewhere that the last 7 days account for 17% of your A1c value!

Thanks so much for posting this, Alan! Now can you tell me how I interpret it!! This is why they don’t let me teach General Psyc - too much science, graphs and stats for my right brained mind! Ok, so I’m looking at the influence of the last 4 days before the test, and I can certainly see it is much higher, but how do I get a percentage out of that? Visually it looks like 97% of the whole. That can’t be right!

Thanks Kari! This is why some of us are saying to plan to do your A1C after a week of lower numbers. :slight_smile:

I am thinking that many diabetic have higher A1Cs after the holidays and such. I know my next one will be higher because I had my b-day and Halloween and I remember some higher number around those times because of special treats or dinner out. I would have to wait several months for those sugar coated cells to die off - unfortunatley Thanksgiving and Christamas are coming up so I don’t think this is going to work. :slight_smile:

I am so waiting for pill to be invented that scrubs that excess sugar off your cells. :slight_smile:

Thanks, Kari, I tried the formula with those numbers and still only came out with 6.9, not 7.6. So I’m going to just put it aside for now, and like everyone is suggested do it again after a month. I’m going to pretend I never heard that 7.6 which is the highest I’ve ever measured (though I was probably higher at my first diagnosis and before I started on insulin when I got rediagnosed).

Thanks, Duck, I somehow missed your post till just now. I spiked over 200 4 times in the last few days and each time got it back down within 2-3 hours. I appreciate your input and I think that is exactly my plan: deep breaths, get a bit more aggressive management of the highs (I tend to be a bit over-cautious), work on finding the right basal dose and test a month after that. I’ll settle on a Christmas present of getting back where I was and then go from there at pulling it down a bit. I’m going to look at this as a temporary disheartening detour!