Samantha Walsh
Samantha Walsh has lived with type 1 diabetes for over five years since 2017. After her T1D diagnosis, she was eager to give back to the diabetes community. She is the Community and Partner Manager for T1D Exchange and helps to manage the Online Community and recruit for the T1D Exchange Registry. Prior to T1D Exchange, Samantha fundraised at Joslin Diabetes Center. She graduated from the University of Massachusetts with a Bachelors degree in sociology and early childhood education.
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How important is the A1c measurement to you? Cancel reply
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I answered somewhat unimportant. Time in range is much more important and more precise
With CGM data and a hgba1c between 5 to 5.4 for over 5 years now I don’t check it more than every 6-12 months. However this my choice and would check more often if blood sugars were not normal.
I answered moderately important even though I view TIR as much more valuable because the medical world, other than in diabetes providers is focused on A1c still. One day soon, I hope that changes.
I answered “very important”, but felt perhaps somewhere between very important and somewhat important. I view all of my T1D numbers as important. My A1c is just one important part of the the puzzle. Time in Range is important, as are trends, actual CGM readings, and a myriad of other important blood test and urine test results.
The older you get the more important it becomes just like kidney health.
TIR most important.
I answered “neutral” as this measurement is treated by me as a guidepost on my journey through diabetes.
Yes, what we now call HgA1c/HbA1c is certainly an important measurement guide, I do not use this reading as a goal. I say that even though, in 1974, my body and blood was used in the development of this test.
I try to keep eye on A1c, TIR standard deviation. Keeps me honest
I answered ‘Very Important’ because my A1C shows to my Endo and Medical Insurance that I am compliant and well controlled T1D.
I care about A1c’s only to the extent that it affects some health care providers’ (not my endo’s) impression of my blood sugar control. Particularly because I have irregularities with hemoglobin metabolism, A1c’s don’t mean much for me and actual blood sugar measurements are far more informative.
This is exactly how I feel. My Dexcom predicted A1C is always much lower than the actual test result comes back. And all other doctors besides my endo, look at A1c and don’t think that my control is as good as it actually is.
It used to be more important in the days before CGMs. I am suspicious of it for me now because it is always significantly lower than the average blood sugar values my Dexcom gives for 30, 60, and 90 days. For example, my Dexcom will say the average would result in an A1C of 6.1 while my A1C result is a 5.4. It’s been consistently like this ever since I got my first Dexcom eight years ago and my endo can’t explain it.
Same trends for me. My endocrinologist thinks it may be due to (1) my severe anemia or (2) the cancer medications I take.
Thanks for your reply, Bruce! I am neither anemic nor take cancer meds so I’m not sure what my issue is but that is interesting to know. My endo originally thought that perhaps the meter I was using for finger stick calibrations (back when I used a Dexcom that required calibration) was inaccurate so I got a new meter that is supposed to the most accurate on the market but nothing changed. (Shrugs)
I am much more concerned with time in range. Which gives a better measure of blood sugar measurement
My TIR (time in range) is more import to me and my endocrinologist.
My A1C results have never been accurate. My Endo says I probably have a protein in my blood that negates the results. I always get a Fructosamine test and that result correlates with my TIR.
It was all important in the past, but just moderately important since I have had a CGM.
A1c is important- just understand that it is an average. Also very important is time in range. An acceptable average doesn’t tell the whole story especially if an individual is experiencing many lows and highs.
A1c is not as important now that 6 are CGM’S with TIR.
As the mother of a teen with T1 it is very important to me, but not important enough for my son to change his habits to have better blood sugar management.
The 3 major pieces of data I use to assess how well I am doing:
A1c, Time in range, and Standard deviation. Occasionally, I will delve deeper if numbers are getting out of whack.
A1c somewhat important yet TIR tell a better story of diabetic control
1. Time in range
2. Standard deviation
3. CGM hourly one month report.
These are the most useful for my management. A1c is very useful for me to educate non-endocrinologist physicians who erroneously believe:
1. Everyone should have lower A1c’s,
2. The A1c is the be-all and end-all of diabetic management, and
3. A1c is the gold standard for diabetic management. 🤕🤠
I consider TIR far more important, because the A1c is an average and after 68 years living with T1D “average” is an illusion. A1c results from the same time period have varied from one certified lab to another. My endo agrees with me, unlike the other physicians I see who treat the A1c number as the decisive judgement on my glucose management skills.
Time in range is the more important measurement for me. A1c is important for insurance reasons but TIR gives a better indication of how steady I am.
I use GMI, SD, and CoV more, A1c is only because my Endo still uses due to Medicare and medical community reliance on it.
Since using a cgm, the A1c measurement is no longer important to me. The cgm gives me real information on my bg levels whereas A1c is, and always has been, an estimate with high individual variation.
one doesn’t get a complete picture unless multiple statistics are used. I like to see a1c, TIR and SD.
Hi, what’s SD?
Given that the A1C testing technology is decades old and directly impacted by ethnicity, health, recent big, lab variabilities, food, drugs, and more, it is not a valuable daily management assessment tool, CGM data is far more effective at assessing daily management.
I didn’t realize how important A1C was in relation to things besides T1D. I had a sholder injury and needed rotator cuff repair. Two surgeons said oh you are diabetic so it is just Normal age related wear and tear. When I finally found a surgeon that agreed I had an actual injury he said he would only do surgery if my A1C was under 7. So I am glad I keep it at 6.3- 6.6
Zero importance. I understand how the information is used. Most white coats utilize it in the manner of as “moral” scythe (e.g. entirely negative) at every possible opportunity. I understand it well, I reject any import
A1C is important because it is the only current measure of T1D control that reflects actual physical lab-obtained BG. However, it alone is not a good measure of control. TIR and SD are dependent on BG meters (point in time) or CGMs (continuous measuring). Both meters and CGMs can vary from lab-drawn BG values.