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HbA1c
- Thread starter JoeJOns
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Would that be a doable score to reach? According to my average this month it is 5.8mmol so if I keep it going maybe It will go well!
Martin9
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Yes I did it and you can too...
TheClockworkDodo
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Type 1s tend to have slightly higher HbA1cs than well-controlled type 2s (and much lower HbA1cs than badly controlled type 2s!). So a lot of the HbA1cs you'll see on this forum would be difficult for a type 1 to achieve.
If you have a look at this chart, it shows you how your daily averages (in mmol/L at the bottom) compare with your HbA1c (in blue, at the top), and what numbers are good, fair, and bad. Anything in the green - HbA1c under about 50 - and you are doing well for a type 1. If it's under about 42 your diabetes team are likely to tell you that you're having too many hypos (whether or not you are actually having any hypos!) and it should be higher!
If you have a look at this chart, it shows you how your daily averages (in mmol/L at the bottom) compare with your HbA1c (in blue, at the top), and what numbers are good, fair, and bad. Anything in the green - HbA1c under about 50 - and you are doing well for a type 1. If it's under about 42 your diabetes team are likely to tell you that you're having too many hypos (whether or not you are actually having any hypos!) and it should be higher!
Kaylz
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it is achievable but I certainly wouldn't advise it, in my case I was hypoing during the night and not waking up but it could also mean that you are spending too long in the 4's which isn't the best as a Type 1 as it can lead to losing hypo awareness which I have suffered from on more than one occasion xx
Bruce Stephens
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For most people with T1 that would be extraordinarily low (I'd be startled if my test were 35: I'm expecting somewhere around 50, with any luck one or two lower than that). Your doctors would suspect (probably correctly) that you're going too low sometimes. (Having said that, I think even for a typical person with T1 (so without any active beta cells) if one ate low carb, and especially with a pump, 35 might be doable. I don't think I could handle the diet, though. And I suspect you'd need to be rather obsessive about it.)
Presumably you're mostly measuring just before eating? In which case 5.8 is a good average, but isn't an average of your blood glucose levels: we go higher after eating.
NICE recommends 48 as a default target level (with the strong caveat that the target has to be an individual thing agreed with each patient; there may be good reasons why a different target is suitable).
I would definitely check my blood glucose levels around 12-15 times a day including once or twice during the night depending on my levels. I am on 1 long acting insulin injection a day and 3 fast acting insulin injections before each meal every day. I went into hospital about a month back with DKA and blood sugars of 28 so they were quite adamant on getting my bloods sugars lower and stabilizing me.
I eat quite a bit of carbs per meal! For instance for dinner tonight I had 70 grams of carbs.
I am very weary of being too low with my blood sugars at the moment, but at the same time if I was on the high end I would be terrified of all the complications. I suppose it is about getting the right balance and I have a lot to learn about all of this.
Hopefully things will pick up soon!
Bruce Stephens
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With that much testing, maybe 5.8 really is nearly your average. And if you're not going below 3.9 too much, that's really good. We'll all be interested in your HbA1c result! (My last one was 49, which is pretty good for me.) I scan (on average) 35 times a day, and apparently my average is 7.8 (which the software estimates is an HbA1c of 49).
(If you're testing that much, it's definitely worth asking about a Freestyle Libre.)
(If you're testing that much, it's definitely worth asking about a Freestyle Libre.)
- Relationship to Diabetes
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The national guidance suggests people with T1 should be supported to AIM for 48mmol/mol (6.5%) or lower.
This doesn’t mean that it’s achievable for everyone, or that people should be made to feel that they are failing if they cannot happily live at that level, but the best evidence we have is that the improvements in long-term health below 48 are really levelling out... and that desperately trying to get into the 5% club can cause some to experience high levels of hypoglycaemia with significant extra risk and reduction in quality of life.
But everyone is an individual. And as you are just diagnosed you could well still be in the honeymoon phase where a small amount of your own insulin production remains which helps to even out the extremes making lower HbA1c more possible without lots of hypos. So if you DO get a few results in the 30s then great!
In the long term though, the more important thing is to aim for as low an A1c as you can manage with minimal hypos and maximum quality of life.
This doesn’t mean that it’s achievable for everyone, or that people should be made to feel that they are failing if they cannot happily live at that level, but the best evidence we have is that the improvements in long-term health below 48 are really levelling out... and that desperately trying to get into the 5% club can cause some to experience high levels of hypoglycaemia with significant extra risk and reduction in quality of life.
But everyone is an individual. And as you are just diagnosed you could well still be in the honeymoon phase where a small amount of your own insulin production remains which helps to even out the extremes making lower HbA1c more possible without lots of hypos. So if you DO get a few results in the 30s then great!
In the long term though, the more important thing is to aim for as low an A1c as you can manage with minimal hypos and maximum quality of life.
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The other thing to bear in mind is that there is no absolute way of converting estimated average BG to HbA1c (especially from fingersticks, but even if derived from 24hr sensors). One is measuring capillary glucose, the other is measuring glycation if red blood cells.
So while there will be a relationship... it’s not one that can be converted by a mathematical formula. The conversions you see are estimates not maths. 🙂
So while there will be a relationship... it’s not one that can be converted by a mathematical formula. The conversions you see are estimates not maths. 🙂
trophywench
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Joe - I'm laughing to myself here! Way back when I and a good many others were diagnosed, the only way we could test was by boiling up our pee and you certainly didn't do that more than once a day and Oh Look Here We Are Still Alive and some of us don't even have any 'diabetes complications' yet.
Like you I had millions of questions to start with but since I couldn't take my diabetes home with me, there were only Medical Textbooks one could consult and even though I did, I couldn't understand a lot of the terminology used despite my O Level Biology They hadn't even invented the internet, so in order to not drive myself batty I just had to stop pondering 'what if' - outwardly at least.
Back then, we were asked to aim for an HbA1c of 7.5% so we did ! However I reflect that we didn't eat very much at all that was highly processed before it went in our mouths simply because it wasn't available in shops, visits to the chippy, the Indian or Chinese or out to a restaurant of any kind weren't more than occasional really - most of us didn't have that kind of money to spend. We also walked more, generally, end of story - not everyone owned a car by any means or ever expected to.
Like you I had millions of questions to start with but since I couldn't take my diabetes home with me, there were only Medical Textbooks one could consult and even though I did, I couldn't understand a lot of the terminology used despite my O Level Biology They hadn't even invented the internet, so in order to not drive myself batty I just had to stop pondering 'what if' - outwardly at least.
Back then, we were asked to aim for an HbA1c of 7.5% so we did ! However I reflect that we didn't eat very much at all that was highly processed before it went in our mouths simply because it wasn't available in shops, visits to the chippy, the Indian or Chinese or out to a restaurant of any kind weren't more than occasional really - most of us didn't have that kind of money to spend. We also walked more, generally, end of story - not everyone owned a car by any means or ever expected to.
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