True!
I assume you’re using the DCCT range… it has been quite confusing since the new IFCC system came out :-/ I never know which one is being referred to…
Thanks, this explains why my Dr. wants me in the 5 range but I would be chugging o.j. all the time if i tried!
My very non-diabetic wifes last a1c was 5.4. While I’m sure doable by some, seems pretty extreme and risky for most t1’s. If i era t1, I would be shooting fr high 5’s myself but doubt I would try ti push myself too much lower.
Yes there is a difference between the 2. When my a1c falls into the 5% because I’m T1 it means I’m having lows that I don’t feel. Since we all have to walk that tightrope for T1s it’s even finer because our D is different from T2s. After what my Endo said I temporarily wore a CGM from my educator and found I was having hypos I knew nothing about.
There isn’t a single number that is correct for a standard deviation since it is an estimate of the variation around a given mean, and dependent on how many readings you take.
I’ve read that, generally speaking, non diabetics have SDs that are within 3x their mean. So, from what I understand, if they have an average BG of 90, they’d expect the SD to be 30. Please correct me if I’m wrong.
Keep in mind that SD is only an estimate of your variation, as well, and is based on a normal, bell shaped distribution. The more readings you take, the more you’d expect the distribution to be “normal”, meaning they’d fall along a bell shaped curve around the mean.
Honestly, I’m not sure if BGs are normally distributed along a bell shaped curve. If your mean is 90 with an SD of 30, for example, you’d expect 68 percent of all readings to fall within 120 and 60, or one standard deviation, and 95 percent of all readings to fall within 150 and 30, or two standard deviations. Virtually all readings (99.7%) would fall between 180 and 0, or 3 standard deviations.
Umm, yeah.
How many normal people are going to spend any amount of time at a BG of 30, or 60 for that matter? Nobody is ever going to see a BG of 0. Where the heck is the other 0.3% supposed to fall if between 180 and 0 only account for 99.7% and it’s a bell shaped curve? Does hat mean that some should be above 180 and some should be below 0???
I suspect that BGs are not normally distributed along a bell shaped curve and that BGs, especially for diabetics, would be skewed away from low, hypoglycemic readings. So, even standard deviation should be taken with a grain of salt.
Somebody better with the population statstics of blood glucose readings has to have an explanation.
Actually pre-diabetic goes up to 6.4 as diabetes isn’t diagnosed until 6.5.
Cool, and I agree.
I suspect that there has to be a time element (reftected in the Poisson distrubution? Been a long while.) since A1c readings are dependent on the exposure of hemoglobin to glucose. It’s not just the snapshot of the BG reading, but also the amount of time you spend at each BG, which may not reflected in BGs logs and stats from those logs unless you test A LOT.
So, even if your BGs were distributed normally, magically in your logs, you don’t have highs and lows exerting an equal and opposite affect on your BG. I know, even looking at slightly larger BG range than normal, like between 130 and 60, I would spend a lot more time at 130 than I do at 60 since I would notice and correct a low immediately and might not even notice a 130 until the next time I tested.
Anyway, good stuff.
There’s been a study done with healthy nondiabetics wearing CGMS, and it found:
Sensor glucose concentrations were 71-120 mg/dl for 91% of the day. Sensor values were ≤60 or >140 mg/dl for only 0.2% and 0.4% of the day, respectively. Sensor glucose concentrations were slightly higher in children than adults (P = 0.009) and were slightly lower during the night than day (95 vs. 99 mg/dl, P < 0.001).
If you read the entire study, the average glucose for all age groups was 98 with an SD throughout the day of 13.7. It also notes that no subject’s glucose stayed between 70 and 120 all the time, although clearly as the summary above indicates, they didn’t go too far outside those ranges. The average A1c for the group was 5.3.
Nice study. I wish I could trust the readings from my Dexcom to accurately reflect how much time I’m spending in the normal range.
Hear hear!!
…or is it here here??
Whatever it is, agreed!
5.7 We are TTC and my endo wanted it under 6. No significant lows for me at all.
My A1C stays between 5.8 and 6.2 and both my endo and i are happy with it i keep with in range with the help of my cgm and have few lows so it works for me it really comes down to what works for you and your d team
Went to Endo July 16, A1c was 6.9, dr was pleased.
My last A1c was 5.4 on MDI, no CGMS at hand, no very low carbing, T1 since 1987. I recommend to aim below 6.3 at least but would not accept that for myself I must admit.
lol, they through the dexcom data into supplement:p apparently it had ‘too many’ points out of range. but if the dexcom data is believed, then the non-d were actually only in range (70-120) 65% of the time (vs 90ish in the MM and Nav). i find that interesting bc from what i’ve heard the dexcom is supposed to be tops on accuracy (I use MM and am very cautious about it’s accuracy, especially on lows <60). it would have been useful if they had used something like the glucoscout for comparison, we’d know which data to believe.
Do you think a 5% A1c is obtainable for T1s who don’t have CGMs, without having too many lows?
Jennifer,
Mine has been holding at 5.2 without a CGMS or pump. I have some lows, but not many. My lows are due to gastroparesis since this makes insulin timing hit or miss. Not to open up the whole carb debate, but eating low carb was the single best thing I did to control BG & prevent wild swings.
Non diabetics are between 4 and 5.9.
I found this information: The International Diabetes Federation and American College of Endocrinology recommend HbA1c values below 6.5%, while American Diabetes Association recommends that the HbA1c be below 7.0% for most patients.[18] Recent results from large trials suggest that a target below 7% may be excessive: Below 7% the health benefits of reduced A1C become smaller, and the intensive glycemic control required to reach this level leads to an increased rate of dangerous hypoglycemic episodes.[19] (wikipedia).
Last and first A1c on a pump was a 5.8, I’m happy as can be with that as prior to this my A1c ranged between 5.8–6.2 but I was on a very low carb diet using MDI. Now I am able to eat more normal and with trial an error the pump has helped me control my A1c and live life a little more free again. I think I could get it lower but I’m not sure I’d want to limit my life to go down that little…my goal is to stay just at 6 or under for myself.