Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Manager of Marketing at T1D Exchange.
I think it was 6.4. The one before was 5.8. I’ve seen several people in the past say they were in the 5’s. My doctor seems to think that’s too low. She thinks it must mean I’m having a lot of lows. I didn’t, but she seems happier when it’s in the 6’s. Anyone else have a doctor like that?
@SherolynNewell — yes, my endo felt the same way, but when I showed her my Dexcom trend graphs, she could see that I spend >80% of my time “in range” (between 70 and 150), and have very few lows. Research shows that “TIR” is a better predictor of A1c than average blood sugar.
@ Sherolyn Newell — that’s such an old-school, pre-CGM mindset, but yeah, it still persists. Back in the day I used to get yelled at if I was below 6.5, because A1C is an *average*, and that means you had to have a lot of lows–or a few severe ones–to get there. Which was actually true. Back on the old R/NPH, “exchange diet” regimen, severe lows were much harder to avoid. NPH was especially bad because the peak time was so far out, and could sometimes intersect with the R still being active, and wham! You really had to organize your life around your insulin and not the other way around. I used to call it the END regimen, for “Eat Now or Die.” But there’s really no excuse for docs/endos maintaining those outdated attitudes, at least for patients using CGMs, where it’s easy to check how many lows you’ve had. That’s why the community is much more centered on Time In Range, than the A1C “average.”
I’ve always been in the high 5’s and low 6’s my last two A1C were 6.4. For some reason both my endocrinologist as well educator want this number to rise closer to 7. They feel that if I’m getting A1C’s high 5’s to low 6’s I’m having to many reactions. Admittedly this is somewhat true but not in a severe sense.
Thanks for all the replies. I have Dexcom, so I know if I’m going low. I think the doctor worries too much. Sometimes I just do great. The times that I don’t, it’s usually a period of too high. That will happen, I don’t know why. For a week or two, seems like I can’t get it right and go too high all the time. After a time, I go back to normal. The opposite never seems to happen. The lows are usually a result of bad carb estimating.
I am grateful for sensors to see how to adjust my basal, bolus and insulin sensitivity. My A1c of 5.7 shows my average with lots of hypoglycemia in it, even if they are short. I don’t want the long term consequences on my brain from the lack of fuel it needs.
I live in the UK where we have, for a number of years now used the IFCC (International Federation of Clinical Chemistry and Laboratory Medicine) measurements of mmol/mol (millimols per mole) rather than the older DCCT (Diabetes Control and Complications Trial) measurements of a % value. My last HbA1c level was 63 mmol/mol, which is equivalent to 7.9%.
In an emergency I will order pump supplies or go buy older style insulin and syringes OTC to get me by in an emergency. Just ordered pump supplies with cash this week because there was an incorrect shipment and I was complete out.
A lot of you are in for a nasty surprise down the road with the results I’m seeing here – tryst me, I’ve been there and know. :'(
Not sure. My endodid one and it was 7 plus. Another Doc do it and it was over 8. I see my endo again in early February
I think it was 6.4. The one before was 5.8. I’ve seen several people in the past say they were in the 5’s. My doctor seems to think that’s too low. She thinks it must mean I’m having a lot of lows. I didn’t, but she seems happier when it’s in the 6’s. Anyone else have a doctor like that?
@SherolynNewell — yes, my endo felt the same way, but when I showed her my Dexcom trend graphs, she could see that I spend >80% of my time “in range” (between 70 and 150), and have very few lows. Research shows that “TIR” is a better predictor of A1c than average blood sugar.
@ Sherolyn Newell — that’s such an old-school, pre-CGM mindset, but yeah, it still persists. Back in the day I used to get yelled at if I was below 6.5, because A1C is an *average*, and that means you had to have a lot of lows–or a few severe ones–to get there. Which was actually true. Back on the old R/NPH, “exchange diet” regimen, severe lows were much harder to avoid. NPH was especially bad because the peak time was so far out, and could sometimes intersect with the R still being active, and wham! You really had to organize your life around your insulin and not the other way around. I used to call it the END regimen, for “Eat Now or Die.” But there’s really no excuse for docs/endos maintaining those outdated attitudes, at least for patients using CGMs, where it’s easy to check how many lows you’ve had. That’s why the community is much more centered on Time In Range, than the A1C “average.”
My 15 year old’s A1C was 5.8 in December.
I’ve always been in the high 5’s and low 6’s my last two A1C were 6.4. For some reason both my endocrinologist as well educator want this number to rise closer to 7. They feel that if I’m getting A1C’s high 5’s to low 6’s I’m having to many reactions. Admittedly this is somewhat true but not in a severe sense.
Thanks for all the replies. I have Dexcom, so I know if I’m going low. I think the doctor worries too much. Sometimes I just do great. The times that I don’t, it’s usually a period of too high. That will happen, I don’t know why. For a week or two, seems like I can’t get it right and go too high all the time. After a time, I go back to normal. The opposite never seems to happen. The lows are usually a result of bad carb estimating.
I want to know how the 2% of respondents with A1Cs lower than 5 are living.
Austin, I’d like to know how I’m living, too! Almost always my A1c has been in the mid to low fives. I must not be diabetic any longer, eh?
I am grateful for sensors to see how to adjust my basal, bolus and insulin sensitivity. My A1c of 5.7 shows my average with lots of hypoglycemia in it, even if they are short. I don’t want the long term consequences on my brain from the lack of fuel it needs.
I live in the UK where we have, for a number of years now used the IFCC (International Federation of Clinical Chemistry and Laboratory Medicine) measurements of mmol/mol (millimols per mole) rather than the older DCCT (Diabetes Control and Complications Trial) measurements of a % value. My last HbA1c level was 63 mmol/mol, which is equivalent to 7.9%.
In an emergency I will order pump supplies or go buy older style insulin and syringes OTC to get me by in an emergency. Just ordered pump supplies with cash this week because there was an incorrect shipment and I was complete out.
Just got my results today and it was 6.5 even though Dexcom report said 6.3.