Discouraged with A1C

Five weeks ago I started a low carb lifestyle and I have been so encouraged…until I got my A1C, which was 6.9, exactly like my last one 3 months ago!!! According to my meter download, my average for the past 12 weeks is 130, or a 6.2 A1C. Can my meter be that far off??? How could my A1C say my average is 150?

Now I am questioning all the changes I have made. My meter for the past 30 days says my average is 121. Wondering if I can trust it at all. Bummed!!!

PS: I have the OneTouch Link—links with Minimed Revel.

Don’t be discouraged…low carb will pay off soon. 6.9 is an accomplishment! There must be higher BS numbers when you aren’t testing. Even if you are testing 10 times a day there’s still a lot of time you aren’t testing, does that make sense? You could be running high in the night for example. It could also be a meter accuracy problem. Can you use the testing solution to see if it is in the correct range?

A1C has a very wide reference range you will note, and readings can vary widely (at least +/- 1.0 and maybe more) from lab to lab.

Often when I feel best about my control, my A1C actually kicks up a notch instead of down. And when I feel bad about my control my A1C goes down. It’s useful for some big-picture things sure, but looking at ups and downs of 0.2 or 0.4 of A1C is probably in the noise.


That’s great that you test in the night too, you sound very dedicated. If you rule out everything else you might consider looking at a cgms. It is very enlightening to see 24 hours of data vs a snapshot of 8-10 readings throughout the day. Most people don’t test until 2 hours after a meal but those post meal elevated blood sugar numbers still roll into your A1C. That could be a 6 hours a day that is left out of your meter average. If you continue with low carb this will be less of an issue. The post meal numbers on the cgms are a real eye opener to be honest. I hope when my daughter is on her own someday she chooses low carb. She’s 14 and doesn’t want to hear it right now, ha ha.

If you started LC 5 weeks ago, then the A1C also includes the 7 weeks before that, so great job on getting it down! Can’t wait to hear what it is next time. If you had another A1C tomorrow, it wouldn’t be exactly the same. Someone (I think it was BMD) posted a scatter plot showing how much variation there can be. Please don’t be discouraged :wink:

Don’t give up. Hang in there!

I am always higher A1c than my meter. 2 things usually account for my A1c vs meter and that is my post prandial and also the difference between whole blood and capillary blood. Check and see what your post prandial BG is doing

If you have changed to low carb only in the last 5 weeks then it is unsuprising that you would still have an unchanged A1c - and that one is pretty good - my latest was 9.9! A1c tells you how you have been over 16 weeks, so expect an even better result after that one unless you are ill during that time with infections, have hormonal changes or are under a great deal of stress when sugar levels do go up.

I am one of those people who have their A1c come back very different than their meter readings. Back when I used to test 3-4 times a day I had myself convinced that I was actually high at the times I wasn’t testing. But now, I am on MDI, I test like 8 times a day, that is not true. My A1c is consistently 0.5 to 1% higher than my meter averages. That is a lot. I’ve since learned that there is a lot of variation. There are people that are high and low glycators, people that consistently have a biased A1c. I am apparently a high glycator. It may be because my red blood cells live longer than usual. It may be because I have thick blood, my hematocrit is usually over 50%. And most recently I’ve become concerned that I might be hypothyroid and was shocked to learn that hypothyroid can also make you A1c artificially high.

In the end, I calibrate my meter when I go to my doctors office and I check it against other meters I have and it is pretty darn close. I trust my meter, and I suggest you do as well.

ps. I think you are doing great.
pps. If you actually became healthier and your red blood cells started living longer that would increase your A1c.

That is really awesome to have done! Regardless of the A1C, there are benefits to eating more reasonable amounts that are beyond diabetes. I find A1C useful to know but I don’t beat myself up about it, except a few years ago when I had some issues that led me to decide to try a pump, not just for the A1C but to facilitate some workiout / life goals. I got it back to ok results but they were always the same, every time, for about two years!! It was an ok result but it bothered me to change stuff and have the “test” come up with the same number anyway? I also think that getting good data is very important to managing diabetes. It sounds as if you are doing everything you need to do and will see the results in the longer run.

The A1C is an average over the past 90 days (right?)

You won’t see the accurate results of your new lifestyle until you’ve been going for three months solid.

the A1c had 2/3 of its history pre-change. Only 1/4 of the 120 days it supposedly covers were post changes. That is, if your red cells last 120 days.

It’ll pay off next time. I don’t worry about pay offs. I only think of here and now. Today. Next meal. Which protein shall I incorporate? How shall I do it with the place I have to go to?

Your are doing awsome, wish I had a 6.9 A1C, actually thats my goal for my next one in July. The diet though, if you have only been on it for 5 weeks maybe your body needs more time to adjust. Any stress on the body can affect your readings and ultimately your A1C. For example two hours of excerscise will put my readings up to 11-13 mmols or I think if I converted right around 225 or so, after a day it will then drop into the normal range. With an A1C like yours I would definetly give it a bit more time. Good luck :slight_smile:

I agree with the group! Keep up the low car diet it helps in the long run. Not only with the D but, I have lost over 35 lbs. Your A1C was not bad my last one was 7.6 but, my data said it was 6.2. Doctor said I had just taken a snapshot of selected blood sugar levels but, it was not seeing the big picture of all of the highs and lows. Just keep moving forward!!!

The thing to really keep in mind is that those charts used to determine A1c from average BG, and vice versa, have a huge range around them. I’m more suprised when people report their A1c and average BG match up from looking at those charts than when they don’t. Mine certainly do not. It’s more important to have a personal reference point. As others have said, highs will tend to have a bigger impact on A1c than lows, or even averages IMHO. We are just not as good at detecting highs, how long we have been high, and under what circumstances our BG goes high, than we are our lows.

Stick with it, you are doing great!

Not sure if low carb will or will not pay off, but an A1c in the low to mid sixes is good; high sixes not bad, either. A1c is skewed toward the last month prior to taking the test. I would just get the Bayer A1c now test and test every month. You will get a more accurate average.

Don’t feel bad
my last a1c was 9

Shoot I wish my numbers were that good…