Had my quarterly A1C done last week; and then monthly visit with my CDE this week. We were talking about my A1C being up a little, but since I am now 61 that I could expect that even with the control that I have, a higher A1C could be expected...in other words don't panic and quit eating. He gave me a copy of an article from Joplin Diabetes Center that suggested that older diabetics, those over 50 could anticipate seeing higher A1C numbers; and that even though we have always thought that 7.0 was the highest to go with bg's that perhaps the new number should be 8.0 Okay, I I panic'd . I think the higher the numbers we raise the limit to people, will go for the higher numbers. Has any one else heard this information, and what are your feelings as to where you want to keep your A1C and /or daily numbers at? Just wonderin'
I think the "over 50" thing is a crock. My mother-in-law (a T2 who has struggled to accept it,) laid that one on me yesterday, and I think it is an easy fix for endos--higher A1Cs, less attention to patients.
I also struggle with the concept of me being non-compliant. I have regularly had A1Cs between 5.1 an 5.4, and been happy, even though I did have lows.... Basically, my endo wants me higher--quote "I would not even correct for a meter reading of 270." ARE YOU KIDDING? If he deems me non-compliant, I can lose access to supplies for pump and CGM. What a mess.
I am also 61, have had T1 for 51 years, and still struggle for 5.5 A1C.
I am a type 2 , 20 years,61. I want to keep a below 7, mid 6 if possible. So I will continue to strive for my goals !thank you. Nancy
Spock spoke for me when she called it a crock. I have no intention of letting my management slack due to my age (I'm going on 65). Why would I? If nothing else people in my age group have more time to manage as they're partly or wholly retired, some have lots of experience, often good insurance, and the maturity to make changes and adapt. If I'd been diagnosed as a teen I might have had A1C's of 8.0 (or worse) - now, hell no! To me that's just part of the ageism that says, "don't stress the poor dears,by expecting too much of them". Yuck!
But like my MIL, who totally knows nothing about D---The doctor says 8 is OK and she is thrilled. But it sends a VERY weird message to all diabetics about control.
But my recent endo experiences have shown they want us all to go for higher BG levels. Does it make their lives easier?
I think, Spock, your mother-in-law is of a generation that believed that anything the doctor told them must be true. I think people our age or younger are much more willing to question and to use the internet to learn on their own and empower themselves to make better decisions. But I continually remember that there are huge parts of the world where people of any age just don't have the access to that kind of information or the money or insurance to cover state of the art tech or even purchase books like Diabetes Solution or Using Insulin. I also think dietary choices and options are culture bound.
But it does show how much of an influence we can each be in mentoring someone or just sharing what we know.
I have read that the average non-diabetic fasting BG and A1c increase as one ages. Here's a diagram taken from a paper by Yashin who got the data from the Framingham Heart Study. Look at the line with square boxes on the bottom for the BG of non-diabetic men and women as they age.
The average BG does increase over time, though the curves don't change much until about age 75. Plus just because your non-diabetic peers have an increasing BG doesn't mean you would need to do the same. What does the Joslin paper say? Is it saying BG goes up simply because management gets harder, or that it's OK to increase to match non-diabetics? Could you put in the name of the paper so we can search for it online?
Stipulating for sake of argument the age-related increase, who's to say that doesn't contribute to many of the various problems people have in their twilight years?
The elderly have all sorts of eye, kidney, circulation, etc. problems. Sound familiar?
Perhaps diabetics who maintain tight control for decades, on into 70s, 80s, 90s, wind up with fewer of these problems.
I'm certainly not suggesting there's any proof of this... Just, given the graphs above, it's does open the question.
Well, friends, it appears I am in agreement on this one. I don't think my age should have a big concern over my A1C numbers or daily numbers. If 6.7, 6.2,5.9 have been good enough for 59 0 60 then I am going to keep striving for those kind of numbers if not lower into the 6's and high 5's. To me this is like saying "oh, 180lbs is okay, you've lost 70 that's good, no, 150 is better and attainable if not stayable. To I continue to work on weight and keeping my numbers where they have been. My mil also was told 8.0 was fine, and she should keep it there, then she had a medical emergency (broken pelvis and fractured back) her numbers went to 7.1 and 6.9 and she felt and mended a lot better. hmmmm makes me think.
Seems pretty plausible...as we age cells are going to die off and reproduce at different rates. Overall metabolism decrease. Just as A1C isn't iron clad between individuals, it might not work the same when we are 70 compared to when we are 20. So one really needs to look at the research.
Someone who does good data collection would be able to tell if it is a false increase (in average BG) compared to a real one.