The A1C test, in my opinion does not really say what is going on and only adds stress to an already stressful situation.
I had a lot of trouble with synthetic insulin the 80s and I measured “LO”, below 1, many times a day and 40 at other times and yet my A1C was around 7-8. My doctor at the time told me it had to be lower but I knew if I tried that I would die so I ignored that educated opinion.
I am in a much better place now with 5.5 - 6.0 and don’t use synthetics, but just the same I am retired and am at home most of the time, so in a safe place which allows me to safely run close to the wire.I get an A1C once a year just for fun just because I like looking at my own blood, OK, bad joke ha ha!!!
I believe kids and teens should always be higher than adults. I believe people who work or are physically very active should be higher too. As well, diabetics who live alone should be a lot higher for safety. There is a reason most people who succumb to dead in bed are kids, teens, and people who live alone. We are far from equal as the medical system seems to think we are.
Just my humble opinion and I hope to hear your opinions and take care of yourselves.
Don
PS: I never meant to infer that the test is bad, in fact it is very helpful. The problem is that some people can’t seem to get the number low enough for their doctors. I have one friend who has never been below 9 but is brittle and every day is a total surprise and is always so frustrated with the A1C. At one time I was hypo-unaware and tested 15 times a day and my number was never below 7.
I completely disagree. A lot of people dwell on the shortcomings of A1c; most of which are actually relatively minor. But one area where there is no dispute, is that an A1c is a very good measure of your personal relative control. So if your average BG are lower than they were from another test, then your A1c will be lower. And visa versa.
It is therefore a very good reminder of how well you are doing with your control. This will be especially useful for those who do not test very often, since it can point to undetected excursions during times of the day that are not being tested. How can that be bad?
Stress can be under our control. We can allow it to ferment in our bodies or we can seek those events and ways to live that make it useful to us.
I would have given anything to have an A1c possibility in the 1970s when I was helping a 13 year old daughter with diabetes. Also a testing meter, a CGM, a pump, etc. etc. They can each add stress or they can be greeted each day with gratitude and joy that they can tell us/help us in our responses to eating and exercise.
I think we need reality every so often because we are human. I can take my averages in the computer and come out with what my A1c will be, but the fact that someone else knows my A1c and validates what I am doing is another evaluation point to help me stick with it. I need lots of those evaluation points. We don’t make some decisions, or grow, without stress
I think A1c can be too stressful when you compare yours to others. I find it stressful to read that I am doing badly and am going to get horrible complications if I am not in “the 5% club” even though I have never been able to get anywhere close despite really, really trying. On the flip side, for me an 8.5% is definitely higher than it could/should be.
So I think an A1c is good to get and a good measurement of how YOU are doing when compared to YOU. I think where it gets stressful is when you start comparing it to others.
I heartily concur, Jennifer! I wish my former endo had understood that the 10.7 A1c was totally, unacceptably, life-threateningly high for ME, regardless of what anyone else shows.
I use the A1c to track myself – it’s another datum in my kit. I pretty much know how I’m doing by my meter, but it’s nice to have the A1c confirm it. And it’s nice to have a doc who treats you as an individual, not a statistic!
And what diabetes doesn’t do to you, you’ll do to yourself on your bike??? LOL!!!
I’m waiting to hear from you when you’re 80, still waiting for the complications! (Did I say I’m an optimist?)
Her A1cs have been in the same basic range over five years. If we are having problems with control, they skew toward the higher end of the 6s, normal control mid sixes and good control, very low 6s. We have often gotten an A1c test more than once every three months (if we go to see CDE or eyedoctor, nutritionist, I will pay for another test). So I do think the A1c is accurate. Does that mean she does not spike postprandially sometimes or even 40 percent of the time or that she does not have highs due to hormones or unknown reasons? No. As well as occasional lows. Key for us is keeping the overnight numbers good as much as possible. No reason to stress about A1c, as it is just one of the guides to help. Charting your daily numbers and adjusting is another. When A1c is higher, we aim to immediately reign things in, tighten control as much as possible and do better.
That assumption has always driven me to invest less in myself and more in the people / things around me. Fortunately, I found a light at the end of hte tunnel with Dr. Bernstein’s treatment methods. I’m hoping to put an end to whats been set in motion after 25 years of crap control. We shall see, but none the less I’m working towards that now as opposed to just throwing the dice and seeing what happens.
I figure some type of management goal is needed. I have to feel like there is something I can do every hour, every day, etc, to try to control this monster. The A1c may be just one number, but there are so many factors that affect it. I don’t have to compare myself to others. I can look at my own number from month to month, or even from week to week with a home kit, to see how things that I do affect my control.
Can it be stressful? Sure, but it can also be informative, even motivational, as long as I maintain my perspective and have reasonable assumptions for what my A1c means to me.
When I’m not in good control, I feel added stress. The A1C number per se isnt the issue, but the BGs that I know have caused that number. My best results under my old control method were a 7.0 and that was with large swinging highs and lows. I got pats on the back that I brought it down, but the stress was there because I knew it wasnt a good representation of my control. My control sucked.
Now, Im able to achieve the numbers I want with a new control management system (Low Catb) and this has alleviated a ton of stress.
As for the required high for kids and teens, if your talking 120 as high, then ok, otherwise, no. I’m a good example of higher BGs causing compications. I didnt fluctuate a ton, but averaged 180-210 all the time. I thought that minor fluctuations was the ticket, no matter where your BGs were. A few eye surgeries due to diabetic retinopathy proved me wrong. Besides that, I wouild venture to say some kids/teens are in much better control than some adults.
The A1c doesn’t bug me one way or the other. I can be good and get a 6.? or be 300+ and 60+/- everyday and still have a 6.?. They both say I’ve been good.
It’s just an average and I’m not sure about it being totally useful, I think it is a general “trender”. I had my first A1c test 20 years ago, the next one was 5 years ago when I wanted to get on the pump. It was 8.9 and now I’m consistently at 6.1-6.7. The pump did help the averages.
I’ve been Type 1 for 52 years and still have all my toes…that is my measuring scale. B-}
As I’ve said elsewhere in more detail, my A1cs say NOTHING about my BG numbers. I do A1cs to keep my doctor happy. But then my old doc was OK with an A1c (10.7) that landed me in the hospital in a coma. I now have a new doc, and I’m going to make him write LOW GLYCATOR in caps on the front of the chart!
I’m pissed as hell that they want to use the A1c as a diagnostic tool, because there are surely other little Natalies out there who will be missed for years.
I understand your situation Natalie, but apart from every chart ot there that tries to present an A1c in terms of average BG level, does a change in A1c for you indicate a change in average BG, or is it just a crapshoot for a low glycator?
I pretty much agree that, given the range of average BG levels around a specific A1c for Humans, it’s really difficult to say that our A1c = X average BG level.
It’s more or less a crapshoot. For many years, I was consistently in the 6’s whether I was in good control or not. (But never in really horrible control, either). It was when I was 500+ and never much lower for a couple of months that I got the 10.7.
There is a movement to translate the A1c into an average BG for ease of communication with patients – it might work for most people, I don’t know, but I don’t approve of that either, because people aren’t statistics.
Yeah, getting back to your thread about glycation, I wonder if there is a way to look at an individual’s average blood glucose and correlation with A1c. I know that my A1c will flucutate up and down according to my level of control. ItIt takes an extended period of good control to recover a couple of tenths on my A1c while a few bad days in a row will raise it a couple of tenths.
When I look at my meter and CGM stats, however, they don’t correlate at all to what charts say my A1c should be. According to my A1c, my average BG is 10 to 20 points higher than what my meter and CGM say it is. I test 10 - 20 times a day and at 30 minutes, 1 hour, and 2 hours after each meal religeously. Not sure where the discrepency is coming from.
Interestingly enough, my Endo (shes new to the scene) actually said,
well we’ve recently started to think the A1c isnt the magic number we thought it was." I found this amusing as I’ve always thought of it as an average, but averages are easily influenced.
MissKitka, my old Endo used to tell me to go to bed at 170mg/dl, I would overshoot that quite often (into the 200s) and need to eat or stay awake late to try and hit that target. Then When I would come up with an A1c of 7.6 (172ish) she would tell me it needs to be lower.
