As much as I have said that we shouldn’t put too much weight on the A1c result, it’s hard to avoid that. You were smart to be skeptical about the 5.4% outlier.
I realize the hazard of letting the A1c take on the role of serving as a judgment of our glucose control efforts. But it is an independent measure of our average control and can be helpful in motivating us with the long game.
For years I observed that my A1c rode about 0.5% above my Clarity CGM average. I knew there had to be a reason for this and recently discovered that my undiagnosed iron deficiency anemia was the cause. It irritated me that a series of doctors failed to be curious about this and missed the opportunity to detect and treat my anemia much earlier.
When I added daily iron supplements my A1c aligned with my Clarity average glucose within 0.1%. That confirmed my sense of this misalignment was justified.
I agree with others that insisting on a repeat lab test when faced with an outlier result that prompts a significant treatment change is prudent. It also confirms to me that the patient has a distinct and important perspective. We should never allow the doctor to unilaterally take action without persuading us, based on tangible facts, to take significant clinical action. Simply deferring to the professional credential absent strong supporting evidence is a mistake.