Aim for an A1c of…What?!

All my life, I’ve been told that I should do what I can to keep my A1c levels between 6 and 6.5. This is the “ideal” range, the sort of long-term goal I should bear in mind on a daily basis.

So when my primary care doctor suggested that an A1c of 7 to 8 might be a more realistic, sustainable, and healthy zone, my jaw dropped to the floor.

He explained his reasoning for saying such a thing: Since people with diabetes obviously have different needs when compared to people without diabetes, it’s not entirely logical to expect a person with diabetes to maintain an A1c that they might have with a functioning pancreas. He said that as time goes on, it could affect cognitive abilities.

And then he said that this was the range that would be recommended to a person with type 2 diabetes – there’s no new research that indicates any difference in desirable A1c levels for a person with type 1 diabetes, so, as my doctor said, I should continue to aim for 6 to 6.5.

This was such a WTF moment for me, for a couple of reasons.

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Does anyone else feel super awkward taking selfies in exam rooms? Does anyone else even take selfies in exam rooms?!

One being that I had NO IDEA why he was saying this to me. He built up this whole explanation as to what the “new recommended A1c” is, only to inform me at the very end that it was only safely applicable to people with T2D at this time. Was he confused? Did he forget that I have type one for a minute there?

The other reason I was flabbergasted by this little discussion was that we hardly ever go into detail when it comes into my diabetes. In fact, he didn’t even ask me when my last A1c test was, or any questions regarding my insulin pump/CGM. He just asked the standard “how is your diabetes” question, to which I replied with a super-lengthy, not-at-all vague response: “good”. He did put orders in for the standard array of tests that I take for each annual physical, which would inform him of my blood sugar at that moment in time, as well as my current A1c. But it was nothing that I’d be talking to him about during that appointment because the results wouldn’t be available until late in the day. So yeah, I found the whole thing to be pretty bizarre and mildly misleading.

Coincidentally, I’ll be seeing my endocrinologist in a few weeks, and let’s be real here: She’s the one doctor who can best advise me when it comes to diabetes treatments and protocols. So I’ll be sticking with her recommended A1c range for me, which I have a feeling won’t be any different from what I’ve been told all these years with diabetes.

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2 thoughts on “Aim for an A1c of…What?!

  1. I am also flabbergasted at his comments! I don’t understand why doctors recommend such high A1Cs. There’s no reason that we aren’t entitled to normal blood sugars just like everyone else! Best of luck with your new endo.

    Liked by 1 person

  2. I read an article about this almost a year ago where they were suggesting A1Cs of 7 to 8 for people with less control. Me Mine is currently up to 10 so I’m not one to talk but I will anyway. lol I had it down to 6.9 many years ago but found it too hard to not go low. I seem to be much more active than a normal person (not just diabetics) so I burn through sugar faster it seems. A while ago I had a twitter argument with a man who said A1C are wrong and need to be done away with in favor of CGM results. I argued that CGM doesn’t even read blood sugar directly and A1Cs were accepted by doctors world wide as a gauge to average blood sugars. My point is that A1C is still good gauge as to whether your diabetes in under control. That said what defines control is still a subjective answer since everyone has different needs and wants. A normal person’s A1C is actually 4.9. Another issue in deciding the right A1C is that diabetics are at a natural disadvantage with it. We take insulin either right before we eat or right after and that creates a lag in function. I can only speak for how I react to insulin. My sugar sky rockets after I eat even when taking it before I eat. That act will raise my A1C despite it coming back into range later after the insulin has time to work. I also run into issue where My sugar will drop 130 points in just 1 hour. To me that just scares the crap out of me. If it drops that far that fast then if my sugar is at 130 it will be at 0 by the end of the hour. I just think it should be based on what works for that person not a set you need to be in this range regardless of if it meaning you can’t drive yourself (too low). lol Plus I have to say, never heard of taking a selfie in an exam room.

    Liked by 1 person

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