Low A1C poll

A little background, I have been achieving A1C’s in the 5.2-5.5 range for about 15 years now. Thanks to my pump and CGM and a ton of fingersticks, I micro-manage things (it suits my anal retentive personality). Anyway, the Endo practice I have to use (due to insurance) insists that it is only possible by having very high bg’s offset by way too low bg’s. Even showing my CGM printouts doesn’t seem to convince them. They have even changed who I see to an old-school endo who took it upon himself to change my pup settings and make things in the 140-250 range! Anyway, I would love to have a number to tell them - i.e. this many people in the DOC have achieved the same A1C’s and do so by staying in range (most of the time - we all have ups and downs, but catching them early works wonders). Hopefully, people will chime in so I can say there are e.g. 45 people in this community with the same results I have. I’d welcome any post where a person’s A1C is consistently below 6.

I’ll admit, the only reason I go see them every three months is to keep coverage of my pump (I pay out of pocket for my Dexcom) and to get the Rx’s I need. I’m too experienced and too smart to require hand-holding and scolding just cuz I dfon’t fit their perception of a PWD1.

Thanks in advance.


Count me in. I share your sentiment 100%.

There is a feature that allows polling.

  • Yes I am consistently below 6
  • No I am not consistently below 6
  • I won’t answer

0 voters

When I get a chance after some time I will show the results.

ps. The polling feature isn’t really a secret it is just part of the advanced features that we haven’t documented extensively.


It’s just over three years that I’ve been on insulin. My A1c the first month on insulin was 6.0 (sliding scale). Since then, I have been 5.6 or under (mostly as low as 4.9) without an unreasonable number of hypo episodes - and none severe enough to require assistance from anyone.

My a1c is typically 5 - 5.2. My latest was 5.
My dr used to be very worried about my low a1c, but he now sees that I have such good control because of how I manage things (low carb, frequent testing, aggressive corrections for highs), and no longer worries and though he monitors other things he leaves my diabetes management up to me (as long as I report to him every 3 months or so).

I have been diabetic on insulin for about 7 years now. I am on MDI and use about 50 units of insulin on a normal day, mostly basal. My highest a1c has been 5.6, and my lowest 4.8. I only ever had 1 low requiring assistance and that was in the first year when I was on mixed insulin with next to no training on how to use it. After that I changed to basal bolus. Since I have been on basal bolus I have never had a low requiring assistance. As I get better over time with managing, I think my lowest in the past 3 years has been 55. Typically I can stay between 70 and 140 (mostly 70 - 120) nearly all the time.

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Just5Lookin - ou are very lucky to have an MD who respects you. I’ve had T1 for 33+ years now, and after moving to a new city, I have never dealt with anyone as dismissive as this Endo practice. Thanks for showing me there are “good ones” out there. and thanks to the people who have responded to the poll and I hope many more do.

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@JustLookin sounds like we are diabetes twins

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I tend to run a little higher than you do - mostly in the high 5s. The one time my A1c hit 5.3 I was having too many lows and wasn’t real happy. I’m sure you’re too nice a person to slap the endo’s hand when he reaches to change your pump settings but he really should learn to keep his hands to himself.


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Art woman - I hope you changed your pump settings back as soon as you walked out. That endo practice must be treating a lot of diabetic complications if that is how they manage their patients.


My A1c floats in the middle to high 5s. I started on MDI and am now on a pump. No CGM, so lots of finger sticks. I eat low carb and so my excursions are almost always a mistake in estimating carbs or quantity. I’ve never needed any assistance handling a low (almost 10 years since dx). So far, the endo is willing to adopt a ‘watch it and see’ attitude even though he’d prefer to be more ‘command and control’. I do get ‘the talk’ when he sees lows below 65 or so.

I think that my endo has sort of the same problem that I do: he wants to be accepted as part of the team, that his advice is important to me and that he has something positive to add to my treatment. Where we disagree, I make sure to let him know that I do value his advice and that I’ll definitely keep it in mind in the coming weeks. He particularly likes it when I take notes… So far he and I haven’t had anything like what you’re going through. Good luck!

I’ve been in the low 5s for a while. 5.8 since I started pumping in 2008, 5.2-4 2010-2013 on the SofSensor/ Harpoon and 4.9 (ok, only once!)-5.1 since 2013, when I switched to Enlites. My endo is fine with it, full of praise. She doesn’t do much as I sort of do my own thing and she says “looks, great keep it up…” I dislike using A1C as a metric that needs to be raised or lowered, it’s more like a measure of strategic success. I think that having more normal BG targets has, perhaps unsurprisingly, helped me hit more normal BG targets. It’s not always there but, if I drift away, I figure out how to get it back, usually pretty quickly.

The big issue should be avoiding catastrophic lows, whether your A1C is 5.0 or 10.0. The key to that is having enough test strips and figuring out a way to have quick-acting carbs readily avilable. You don’t have lows because your A1C is too low.

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Unless you are having problems @artwoman, I’d fire the endo immediately. 140-250 is not a reasonable target for a person of your considerable talent, unless you are having tons of hypos. Even then, I think I had more catastrophic hypos when my BG was higher, because it was flying all over the place.


Yes, @acidrock23. 140-250 is too high a range even according to ADA guidelines (just read their latest report yesterday, i fact!) – such a range is recommended only for patients with considerable cardiovascular risk, dementia, or other serious risk factors (as you said a history of severe hypos requiring assistance or hospitalization). And yes, when my BG was going all over the place, both high and low, I had (and occasionally have) a lot more frequent and serious lows.
Yesterday was just a mild version of such a “roller coaster” day for me - though the peak was just 147, low 50. My BG was rather rapidly and inexplicably swinging back and when the low end hit, I felt bowled over. Fortunately, days like that are infrequent now. I’m not planning on much if any further thought on yesterday’s wild ride.

Your endo is wrong. Just plain, flat, wrong. Full stop.


I did wait a vfew days before I changed back. I wanted to show how wrong he was, so I did a well- documented basal test. Then I changed back. And, if most of their patietns don’t or can’t do what they need to, well celebrate the ones that do. If I were an Endo I would love patients that were doing well, recognizing that it takes a lot of effort - and brains - to do D well. Standard apt practice would include a hug or handshake, or high five - not scolding. By the way, as I left the last apt, I was handed a sheet outlining the things necessary to be eligible for coverage of a pump - included was uncontrolled diabetes. Excuuuuse me! Did it not occur to them that the pump was one of the read=sons for my success? And, the fact that I pay out of pocket for my Dexcom - they don’t cover CGM.

I’m usually around 5.7


My A1c has been around 5.5 for the last 7 years, my lowest ever tested was last month 4.7…FYI…this has not stopped me from having diabetes related issues such as neuropathy and stage 2 kidney issues. I do agree that well controlled BG is going to help but clinically speaking I am not sure our low A1c’s is actually having a big impact on the statistical data used.

I agree with everything your saying but the DOC is only a tinny tinny segment of the PDW world that’s seen by our Doctors and the insurance community…The DOC views the Diabetes world through rose colored glasses…JMHO…again not saying we are wrong…just a minority.

My doctor has told me many times that I’m odd, different, he said your a square peg in a world of round holes. He said I agree that what your doing works but I cannot tell my patents to do what you do, but I’m willing supply you with whatever help I can and I’m not going to tell you to change what you do.

[quote=“artwoman, post:15, topic:48815, full:true”] By the way, as I left the last apt, I was handed a sheet outlining the things necessary to be eligible for coverage of a pump - included was uncontrolled diabetes. Excuuuuse me! Did it not occur to them that the pump was one of the read=sons for my success? And, the fact that I pay out of pocket for my Dexcom - they don’t cover CGM.

When I was first turned down for a pump, despite my endo doing a live “peer review” with the insurance company’s so-called “doctor,” the reason they gave was that my control was “too good.” They said they only authorize pumps for people with an A1c over 9 or repeated incidents of BG over 500. My endo said he wanted me on a pump because I was having regular hypo episodes that he was unable to fix by adjusting my basal insulin shots. Their response to that was that for lows they authorize CGMs, not pumps. Pumps are only authorized for problems with highs…

… One week later, they turned down the authorization for Dexcom!

I understand that the DOC is populated by a minority of PWD’s. But…those of us who do a good job, are engaged in our health shouldn’t be scolded, doubted, and threatened. (one threat was telling me I had to see the Endo, that the CDE was too “soft” with me.) They also admitted that thye were afraid if I had a major low they would get sued. Come on…

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I remember when I was trying to get my first pump - abonut 10 years ago - I had to prove that I knew about basal rates - how to determine them, know that they can be dfifferent on different days or time of day, that I had master carb counting and how to use it, and that I tested many times a day. At least as a PWD1, it is easier for me.