Whats the key to getting glyco hemoglobin A1C's in the 6's?

When I work really hard at it, it seems like the best I ever get is in the low 7’s. What does it take to get to the next level?

I average about 80 carbs a day - if that can be called low to moderate carb. Stay away from junk foods. Stick to meat, vegetables, fruit and Atkins bars (available online or in Target, among other places) for a treat. Also helps a lot to have a CGM. My A1c’s have been in the 6’s. Last was 6.2. Hope this helps.

Joshua, any chance you could send me the data file for your CGM. I’d love to see what the daily ups and downs look like for someone with 6.2 a1c. I also have to say. 80 carbs per day is pretty disciplined. In six months I need to be there. Hopefully you can hold me to it.
Nice Job!

Robert, thanks for the kudos. I’ve attached the modal day report for the past two weeks. Also, Netrition is a great website from which to order low-carb foods. My wife started on it and it gives much more enjoyment to eating. Hope this helps.
6811-leesevigGlucoseModalDayReportJan192010.pdf (666 KB)

Hi! 36 years here. My A1c has been good but I can’t remember very far back. Last one was 6.3 but I’m pretty sure I’ve had them under 6! Have absolutely no idea how I do it. Not a clue. Sorry. No CGM, no pump. I eat a fairly low carb diet but not a freak about it. It’s about the averages, though. If you have 20 readings at 30 and 20 readings at 200 you’ll average out to 115 which would give you a decent A1c but that’s not good. While a good A1c is something to strive for I think it’s almost just as important to keep a good level of readings, not a lot of ups and downs, I’ve heard that’s what really hurts. I’ve heard a lot about CGM’s, do you have one? Thought about getting one because I have hypo unawareness.

I am in the air over 400k a year & am still in the 6s.The key for me is no food for 3-4 hrs B4 bed & go to bed with a stable # in the 90s & burn 400 cal at the gym 3 days a week.
(Your milage may very) I’m in the air now !
Be Well

. I know what your talking about. I have the same problem Trying to get 6’s gives me many low blood sugars. Right now I’m having problems getting mine down to target. I’ve been a diabetic for 53 years. I’m tired of insurance companys. i have Helth First Medicare and they won’t let me get my strips for my pump unless I’m blind. So stupid because I use my readings to get highs and lows corrected. We already have a hard time living with disease why won’t they pay for items that help keep complications away. Insurance also won’t cover CGM.

I started having A1c’s in the 5.5-5.9 range several years ago. If I push extra hard to go below 5.5 I have too many hypos. my doctor ptefers the range I am in. I eat 130-150 carbs per day, that is much less than it used to be. I walk one hour at a fast pace every day, on roads with a lot of hills. It comes to be about 2.5 miles for the hour. I am 70 years old now, so that is getting to be hard to do. I could walk 3 miles in an hour a couple of years ago. I am slowing down, but I am very healthy.

My pump and CGMS also help very much in keeping my A1c low. I am rarely above 150 or below 60. I feel low in the high 70’s.

low carb, low carb, low carb. i have fallen off the wagon recently and have been eating a lot of carbs and so my a1c is 8.5, but when i was disciplined with 45 carbs a day or less i got my a1c to a 6. the great thing about the low carb is that i didn’t have the lows either. it was all very stable and my total insulin intake was around 26-30 units per day.

Robert my experience and advice of prof of endocrinology is try for between 7-8 as if you are in the 6s then, allowing for usual >8 readings I guess we all get, then at 6s you are close to hypos just as many times. Latest studies in Australia suggest long term complications at 7-8 are not statistically more than 6-7. Hope this helps. David

Kristen-when you say low carb, low carb, low carb…can you give an example of what you eat during a typical day? Do you exercise? I am interested in your daily life pattern to support a low carb diet. I got into a very low carb diet when I first started following the TuDiabetes web site and my AIC dropped from 9 to 8 and I lost a few pounds. I find I have to stay very close to reading the TuDiabetes comments daily to stay on this regime. Obviously I feel better when I dropped a few pounds although it took some adjustments to my pump to allow for the diet change.

Hi, I’m not sure if it’s possible or even desirable to get an A1c in the 6s. For people with insulin on the outside not the inside, can we really expect our bodies to achieve the same as those who do not have Type 1? I think it makes for too hard a life, full of ‘failing’ to get the right results when in fact we’re doing an amazing job with the tools (and the condition) that we have. Sue

Sue: I think I love you! After a grueling visit with my endo today I needed your words of wisdom…
Thanks! Annie

HI Barb, I just got a CGM (Dexcom) exactly bc of the lows. Totally unaware. :frowning: I can feel great at 35, and low sometimes at 80, oddly?

JUST learned about the benefits of the pump, no one EVER having told me why they are good. So I figured they didn’t do anything I couldn’t do myself. Wrong! No one ever told me that fat and protein slow the absorbtion of carbs, nor of the differing rates of absorbtion of carbs, say bread versus rice. Never knew!

So now I’m working to get a pump, and, like the cgm, am totally exasperated at the trouble it is to get one. Seems you need to totally go through whole education again, as if you’ve not been managing it for 35 years! So exhasperating. Took me over a year to get a cgm, and I’m going on month three in pump preparation. sigh

*Low carb is the way to go, for better control in my experience.

Using someone else's blood comes to mind.... -only half kidding-

Look there are little tweaks, habits we can identify. Some we will not....

Do remember an A1C reading is only an average. You can crunch any two numbers and come up with something very pretty in between the two. That does NOT mean my bg is where we want be, by any means.

A low A1C can be extremely dangerous... be very careful pushing yourself too low. It can kill us...

Hi Robert, if your bg is in range (and not low) before eating, you could, if you dont do so already, bolus for your meal and allow 15 mins for the insulin to start working before starting to eat. Or, for example, if my bg is slightly elevated, I will take the correction dose and whatever bolus is required to cover the meal, but I would do the bolus and wait 30 mins before eating. This allows the insulin (in my case humalog) to start working, and therefore reducing the post prandial readings, which in turn can help reduce your overall A1C. This is not always possible, say if you’re in a restaurant. and you’re not certain how long the food will take to arrive, but then you could take half of your bolus prior, and the remainder when the food arrives? sorry it’s a bit wordy, but hope it helps! jason

I don’t have a pump or a CGM and my A1cs have been in the high 5’s the last few years. Answer: low refined carb diet. I eat pretty similarly every day. Breakfast: slow cooked oatmeal w/flax seed, peanut butter, greek yogurt and touch of fruit. Lunch: veggies and hummus, little feta cheese, some beans. Dinner: protein, low carb veggies, beans. In between snacks: nuts, 85% dark chocolate. It seems pretty simple to me, when I eat this way I don’t need a lot of insulin and my sugar is much easier to control. I started this when I read Dr. Bernstein’s book, “The diabetes solution.” If you can do it, you’re lucky, if you can’t, I don’t know another answer.

The key for me has been the medtronic pump and cgm. I started using them about 5yrs ago on the advice of my endow and have been in the 6’s ever since. I pretty much eat whatever I want just adust my insulin to what I eat. I average about 50 units of novolog per day. I’ve had type 1 for 31 yrs and fortunately I have no complications. These two tools are invaluable in managing my diabetes.

I to have to keep my carb intake low, under 150 carbs, try to keep my blood glucose readings at or below 100, endure a lot of low blood sugars, test 7 or more times a day, its a very disciplined deal to get to a 6 A1C, low fat creamed cheese on celery and not much of that type of thing, you just have to work at it and realize you are not going to get that magic number every time and just keep trying it will come and don’t knock yourself no bodys perfect or even expected to be. †