HbA1c and finger prick targets to stay off meds with diagnosed T2

[medidia]

I was wondering what targets (HbA1c and prick test) other people with a full T2 diagnosis aim for, to stay off medication.
What are the maximum values that you want to keep while managing your diabetes through diet/exercise etc without medication (both HbA1c and finger pricks).
I will discuss my targets at my next diabetes appointment, but it would be useful to hear what other people are doing.

 

[Martin.A]

I was wondering what targets other people with a full T2 diagnosis aim for, to stay off medication.
What are the maximum values that you want to keep while managing your diabetes through diet/exercise etc without medication (both HbA1c and finger pricks).
I will discuss my targets at my next diabetes appointment, but it would be useful to hear what other people are doing.

I keep a food diary to track my daily intake of carbs, calories, saturated fat, protein and salt. My targets are:-

carbs - less than 130g
calories - at least 2000
saturated fat - 30g (RDA)
protein - max 90g
salt - 6g (RDA)

My last three eGFR results show that I'm Stage 2 CKD (mild), hence my need to keep a lid on my protein and salt intake to maintain my kidney health. My protein limit is based on grams per kilo of body weight for someone who is moderately active.

I exercise by swimming twice a week and walking as much as possible.

 

[medidia]

I keep a food diary to track my daily intake of carbs, calories, saturated fat, protein and salt. My targets are:-

carbs - less than 130g
calories - at least 2000
saturated fat - 30g (RDA)
protein - max 90g
salt - 6g (RDA)

My last three eGFR results show that I'm Stage 2 CKD (mild), hence my need to keep a lid on my protein and salt intake to maintain my kidney health. My protein limit is based on grams per kilo of body weight for someone who is moderately active.

I exercise by swimming twice a week and walking as much as possible.

sorry I didn't explain it well, I meant the targets for HbA1c and prick test, not food and calories

 

[Martin.A]

sorry I didn't explain it well, I meant the targets for HbA1c and prick test, not food and calories

I don't have targets for either, except to keep them in normal range, and my diet and exercise regime is tailored to keep me there. On that basis my HbA1c target is to be below 42 and my prick test target is to average less than 7 (I actually average less than 6).

 

[Docb]

I am happy with an HbA1c of around 50 and that I can achieve that if I keep my blood test readings between 5 and 10 with an overall average under 8 or a waking average of around 7.

Usual caveat.... thats me, my system and it reflects the way I take blood glucose readings. I take medication because without that my readings would be noticeably higher.

 

[Drummer]

By avoiding high carb foods, eating no more than 40 gm of carbs a day from foods with less than 11% carbs I see HbA1c in the low 40s, and I stopped testing when I was regularly seeing under 7mmol/l at the two hour test

 

[medidia]

Thank you all for sharing your journey.

 

[everydayupsanddowns]

Good question @medidia

The guidelines for people with T2 always used to be:

4-7 before meals and,
No higher than 8.5 by 2hrs after meals.

For HbA1c, there is current research which classes people with T2 as being ‘in remission’ if they can maintain an HbA1c at or below 48mmol/mol without medication to help with their blood glucose management.

Some on the forum like to aim for an HbA1c below 42mmol/mol, as that is the start of the ‘at risk of diabetes’ zone. And while remission is not the same as a ‘cure’ in that you still have diabetes, if a lower HbA1c can be maintained without problems, it seems more likely to reflect the glucose profile of someone without diabetes to aim for below ‘at risk’?

 

[harbottle]

I was wondering what targets (HbA1c and prick test) other people with a full T2 diagnosis aim for, to stay off medication.
What are the maximum values that you want to keep while managing your diabetes through diet/exercise etc without medication (both HbA1c and finger pricks).
I will discuss my targets at my next diabetes appointment, but it would be useful to hear what other people are doing.

Keeping levels between 4-7 most of the time, with the odd spike up to 8/9 that comes down quickly seems to give me a hba1c in the mid to high 30s.

My fasting levels are usually < 6 in the morning
And in the afternoon usually between 4 and 5.6
Depending on the carb and other macro content, I might see a spike up to the 8s but it's usually down < 7.8 after 2 hours. I don't go mad. If I know I'm exercising after a meal, I will just eat what I want (For example, on holiday recently I was doing a lot of walking so didn't restrict my diet at all.)

 

[Alan44]

Hi @medidia

I think I understand what you are looking for, so here is my take on it.
I'm T2 and not on any medication, so these are the figures I look for.

I only do a fasting finger prick test in the morning and average the results over the week and then the month.

If my averages are less than 5.6 I consider myself in the non diabetic range ie less than 42 HBA1c
If 5.6 to 6.9 in the pre diabetic range ie 42 to 48 HBA1c
If above 7 in the diabetic range ie 48 HBA1c plus

My ave's are normally between 5.6 and 6.2

Hope that helps

Alan

 

[JimmyBlue]

Hi @medidia, so in the period between diagnosis (Oct '24) to first review (Jan '25) my objective was to get my HbA1c down from 86 to as low as possible and I achieved 47. That period included taking one 500g of metformin daily for about 8 weeks.
My target it so to continue to bring down the HbA1c and I have insisted that I want to do this without the metformin. My target is to try and get below 42 if possible.
With regards to my finger prick testing, I like to keep the level down to less than 6 during the day and below 8 after my evening meal. Unfortunately I am struggling in respect of this target and I sometimes get a bit frustrated especially when I cannot find a reason why it is going so high.
For June when I will get my next HbA1c test, I am just hoping that I don't go back above 47.
One thing to note from my recent review; the diabetes nurse wanted me to stay on metformin because in the evening I continue to be between 8 & 8.5 on finger prick testing after my meal. Even though the advice on here is that 8.5 is acceptable, my nurse was not actually happy with that result. So be warned that your appointment may not go how you expect it to.

 

[Martin.A]

If my averages are less than 5.6 I consider myself in the non diabetic range ie less than 42 HBA1c
If 5.6 to 6.9 in the pre diabetic range ie 42 to 48 HBA1c
If above 7 in the diabetic range ie 48 HBA1c plus

I don't get your numbers. I thought 7s indicated pre- and 8+ diabetes, if we're talking mmol/L?

 

[Docb]

@Martin.A @Alan44 was talking about waking average and my experience is that a waking average around 7 gives an HbA1c around 50. An overall average of 7 would put my HbA1c in the low 40's.

 

[Martin.A]

@Martin.A @Alan44 was talking about waking average and my experience is that a waking average around 7 gives an HbA1c around 50. An overall average of 7 would put my HbA1c in the low 40's.

Yes, I get that an overall average of 7 is the bottom end of pre- but I couldn't figure out why a waking average of 7 would by 50, and thus diabetes, when conversion charts say that 8.1 would equate to 50.

 

[Docb]

Yes, I get that an overall average of 7 is the bottom end of pre- but I couldn't figure out why a waking average of 7 would by 50, and thus diabetes, when conversion charts say that 8.1 would equate to 50.

My thought on that is that the conversion charts refer to overall average whereas the lower number refers to waking average.

 

[Martin.A]

My thought on that is that the conversion charts refer to overall average whereas the lower number refers to waking average.

Here's the conundrum, then.

My ytd waking average is 5.8, range 5.1 - 6.4, which is pre-diabetic according to Alan's numbers. However, I've been in remission for over 5 years based on both the current definition and the old definition, so it seems I'm both in remission and pre-diabetic.

I'll take the 'in remission' option.

 

[JimmyBlue]

I am not sure that the ytd waking average or any other periodic testing average actually determines you status as they are simply points in time and do not reflect the 24 hours a day that your body is producing, using and disposing of BG.

My last HbA1c was 47 and that comes up as 6.5% under the old measure but my morning average is less than 6.

 

[Martin.A]

I am not sure that the ytd waking average or any other periodic testing average actually determines you status as they are simply points in time and do not reflect the 24 hours a day that your body is producing, using and disposing of BG.

My last HbA1c was 47 and that comes up as 6.5% under the old measure but my morning average is less than 6.

My last 7 HbA1c results have been within +/- 2 of what I estimated based on my waking, pre- and post- meal readings.

 

[Docb]

Part of the problem is how you compute the "average". When I talk about my results I try to always add the caveat that it is specific to me and my system which includes how I derive the readings to get the averages.

 

[Alan44]

Here's the conundrum, then.

My ytd waking average is 5.8, range 5.1 - 6.4, which is pre-diabetic according to Alan's numbers. However, I've been in remission for over 5 years based on both the current definition and the old definition, so it seems I'm both in remission and pre-diabetic.

I'll take the 'in remission' option.

The figs I use are just to measure the trend as I only test my waking ave.
When I was diagnosed my HBA1c was 51
By the time I bought a finger prick tester say 2 weeks after diagnoses the reading were 7.5
My next HBA1c test was by then in two months time, so not the full 3 months

I managed to get my FP tests down to an ave (waking) to 5.6 ish.
My next HBA1c test came in at 46 which had I had the full 3 months I'm sure would have been better, so the figs I have given, I think work for me
I will say that I didn't dream these figs up and I did get them from a reliable source