My PCP went ape**** over my 5.4 A1c

I think if you have both values together it’s really a good indicator. I had a 5.9% on my last test and my dexcom tells me I had 89%in range and fewer than 2% low.
Surprised me because usually I’m 95% day to day, but one or 2 bad days will kill your data. In 3 months of data, I always have a few bad days for what ever reason.

That TIR data kind of tells the A1c story and that it isn’t being suppressed by hypos.

But also look at the opposite side, if I run 165 every day, thst would put me at 100% in range but my a1c would be higher.

So I guess what I’m saying here is that more data is generally better at completing the picture. Either one alone can be deceiving


@Tesie I concur with most of the other comments you’ve received here. Both A1c and TIR are good indicators based on different measurements, both have good and bad points. I lean toward TIR (along with StdDev of it and Co-ef of Variability). I am not a doctor, but I recommend next time you see your doc that you ask him/her the exact question being discussed here, i.e. “Why do you [the doc] trust A1c more the TIR? When did you [the doc] last look at both, how they are derived, the comparability, strong and weak points? Please, give me [you] a reason to trust one more than the other and understand why.” If the doc answers to your satisfaction, then go with it; if not, then ask him to research both based on current studies (not 10-20+ year old medical school training) and come back to you with the “why.” Don’t do this from a point of contention, as if you’re stubborn or angry, but out of a desire to understand “why,” for the current facts, and interest in your own life. The doc sees you for 15-20 minutes a couple of times a year, you live with T1 24/7/365 and with the consequences of your doc’s advice for the rest of your life. Any doc worth his salt will respond positively to your question and request; any doc not responding positively is cause for you to pause, consider why, and possibly seek medical advice elsewhere. Remember, you, your PCP, your endo, possibly a CDCES and you form a team effort, but your the team captain, reliant on the expertise of others, but in the end you make the decisions of what to do and what to believe.


just catching up after many months away…but, with that disclaimer, your doctor needs a T1D refresher from JDRF/ADA.
I keep a spreadsheet of my A1c levels and they have been consistently lower than 6 going back to 2016, most recently 5.4 and the uniform response from PCP and Endo was, “great job!” TIR most recently was 93% and is usually more than 85% based on the weekly emails I get from Dexcom.
Background: my T1D diagnosis was in 1966 and I credit insulin pump (Tandem X2) and CGM (Dexcom) for making A1c/TIR easier to achieve. Yes, there is hypoglycemia, but I’ve learned to manage it and ALWAYS carry glucose gel/tablets.

My a1c before my last one was 5.4.

This doctor is out of touch. If you’re wearing a CGM; you’re in range most of the time, 80% or more; and don’t have a ton of lows what this means is you’re managing it really well. Congratulations to you.

He freaked out probably because there is a heightened risk of other things going wrong after a low. An endo that I know told me this. I can’t remember the specifics, which is why I’m being general about it. He’s not my treating endo, but that was interesting to learn.

I would try really hard to never go low at your age. How I do it is I have my CGM alert me at 70 mg/dl. This way I can catch a low before it becomes a dangerous low.