When my son is with me we test with a meter before meals and don’t go by Dexcom. But when he is at school (6th grade) or out with friends he only goes by Dexcom. Overall with an A1C of 6.4 and his hormones raging we comfortable with this method.
My A1c has been right at 6.1, give or take a tenth, for years, CGM or no CGM. I like CGM because it keeps me from poking my fingers 17 times a day and gives me early warnings of ups and downs. But it hasn’t changed my A1c yet. Its my diet and will power that affect that the most.
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+1 for diet and will power. I’d add “motivation” as the other key
I’m at 5.0 with no cgm
i think i would be passed out on a hospital gurney with BGs that low. what is your average BG? are you on the pump? are you on a low carb diet? do you even eat food? 
People have a tendency to toss around an A1C result as though it has more significance than it may deserve. I suppose that’s understandable. But I think it’s more important to try to view it in context especially when one talks about trying to lower it towards the 5% level.
Consider the chart in this Mayo short blurb about the A1C test. My understanding of the chart is that an A1C of 5% is roughly equivalent to having a 24/7 BG of 97 mg/dL (5.4 mmol/L), 6% corresponds to 126 mg/dL (7 mmol/L), and 7% to154 mg/dL (8.5 mmol/L).
Now look back at your CGM graphs for periods when you trust its accuracy. How “easy” is it to keep your BG under 126 mg/dl for most of the time without also going hypo? For me, it is next to impossible at this time. But looking beyond feasibility, I currently don’t want to attempt to do this. I think trying to do that would just drive me crazy.
Sure, if a flatter BG could “just happen” for me, great. But my body doesn’t work that way. My BG tends to oscillate in a wider range than that. I am not going to try to thread the needle of a narrow range just for the bragging rights of a lower A1C because I don’t want the added stress that would entail.
So I try instead to mostly attempt to avoid extreme peaks in my BG and gradually … very gradually … improve on spending more “time in range”.
Chasing someone else’s A1C numbers makes about as much sense to me as trying to get rid of my eyeglasses because someone else can do it. Different person, different physiology. You have to try to do the best you can in your own context.
Someone else being able to easily do something does not mean diddly to me. It can be hard to remember that, but that doesn’t make it any less true.
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I eat like a king. I do eat what most people would consider pretty extreme low-carb, but I eat foods that satisfy me— I see no example in human evolution (or religion, if you prefer) of any reason why I need to eat breads or other processed grains on any kind on a regular basis. I use Lantus and novolog, and as of lately, primarily afrezza for bolus-- though I still find novolog to work better for fattier meals… Afrezza sure makes it easy though
My average BGs are probably in the 80s. I don’t have any noteworthy hypoglycemia if I’m careful, which I am. I try not to let my BG rise above 120, though of course it does sometimes. I don’t pump. I also find that exercising a lot seems to help me quite a bit…
Thank you. i do my best one day at a time and i try to avoid foolish decisions. but when my birthday comes, i will never pass up a large slice of key lime pie. i admit to having OCD, which plays itself out by over-checking my cgm, but i doubt that ever hurt anyone.
I completely agree @irrational_John. In fact, in my mind, as beneficial as the diabetes online community is, comparing A1c results is one of its downfalls. Some people find diabetes control relatively “easy” and some find it extremely hard. All of us are in different life circumstances (children, adults, different degrees of insulin production, some living with other health conditions, different jobs, and so on). As someone who has driven myself to burnout in the past trying and failing for years to reach an A1c level, comparison is most definitely not a good thing.
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there’s a wise old saying: “compare and despair.”
My A1c before the CGM was 5.1. After the CGM, 5.0… Been 4.9 to 5.6 since.
CGM did not make my A1c what it is. It just helps me feel more secure doing what I’m doing, anyway.
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I don’t see it as a downfall. These are discussions about diabetes and AIC is one of the primary benchmarks of measuring how effective our treatment plans are and are being implemented. I think its a valuable thing. It isn’t a contest, and nobody should ever feel put-down by someone else remarking on something they’re proud of. I can assure you, it hasn’t been “easy” for me either, but what I am doing seems to be working quite well, and I’m here and willing to share those things with others… not trying to one-up anybody… but it can also be disheartening to see people just assume I’ve had it so easy because I’ve achieved tight control…that’s not my reality either.
Nice. I was 11.1 when first diagnosed, fasting levels at 400— have been 4.9 - 5.5 since…
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was also in the 400s when first dx. now my A1c is 6.4% don’t have any desire to go much lower. the hypos are not worth it. i feel healthy and i take very good care of myself. i am very proud of that.
I was at A1c of 11.8 at diagnosis, fasting at 309. Got it down -
with a bit of OCD. Made my share of mistakes - CGM helps keep me
safer; pump helped me minimize hypos.
I don’t see the A1c number as a method to compare blood glucose control. My red blood cells may live a shorter life than yours do. So given the exact same CGM traces, I would have a lower A1c than you. That is not a relevant comparison.
Plus, I much prefer to compare myself to myself over various periods of time. I want to do better in this 14-day period than I did in my last 14-day period. Comparing myself to others is analogous to comparing apples to oranges. It’s neither valid nor informative. But, we’re all humans and that’s what we tend do, but we should keep it sensible and in context.
As I’ve said before, I rate time in range as the superior statistic to monitor. Next is time spent low. Then BG variability as measured by standard deviation. And lastly I look at average BG. The A1c is not even on my list.
The A1c suffers because it is merely an average that can hide wide variability. It’s the reason doctors will reflexively warn about lows just on the basis of an A1c at less than 6%. This totally discounts the idea that some people with A1c’s at less than 6% can experience absolutely safe BG levels. I wish the A1c did not have the level of recognition as a good representative of blood glucose control. Because it’s not.
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The reason it has the recognition it does is because it is the only meaningful, measurable, single data point available. It’s certainly not perfect, far from actually-- but it’s the gold standard in the medical world for good reason, IMO. You’re absolutely right that comparing weeks, months and years of CGM and glucometer tests against past results might actually be more meaningful to an individual person with diabetes (particularly if they’re using a cgm, and it works well and is accurate for them)-- it just becomes impractical and unrealistic in the medical field.
i couldn’t agree more. the A1c doesn’t take into account the highs and the lows that we can travel to during a 3 month period. it might look like a healthy number, but it can be extremely deceiving. but, i have to admit, that if i know that my trends are in order, i like to see it reflected in a nice, healthy A1c.
Finger stick before meals… what is that? 
Nope. A1c 6.3
well how do you know how much insulin to give yourself? do you take insulin? do you use a cgm?