What's a "good" HbA1C?

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zippyjojo

zippyjojo

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Relationship to Diabetes
Type 3c
This is probably really obvious to a lot of you but I just realised that whilst I know that my starting HbA1c (I think I've just about worked out how to remember the order the letters go!) was high (95%) and that I'm bringing it down (currently 76%) I don't really know what I'm aiming for. I see some people's start figures are SO much lower than mine and yet they're still diabetic - help please 🙂
 
Hi. Firstly, you have got the order and case of the letters right but unfortunately you have got the units wrong by the look of it. An HbA1c of 95 will be mmols/mol not % and the same for the 76. If those were % results you would most likely be dead as they would be astronomically high. 95mmols/mol is equivalent to 10.8% and 76 = 9.1%.
The point at which diabetes is diagnosed is 48mmols/mol. Ideally, if you can get down to below that you are doing really well. If you are using insulin then aiming for below 48 might mean that you are having too many hypos to achieve it. Some people can, others can't.
Since you are currently just on Metformin then aiming for under 48 is fine BUT when you start off at a very high level like 95 it is best to bring it down slowly and steadily. Also, because you are Type3c it is likely that you will not be able to get it down that far just with Metformin and diet, so whilst below 48 is OK as a target, it may well be an unachievable one in your situation so don't feel like you are failing if you can't get close to it. Any reduction on your 76 is a success. If/when it starts to rise, then that would indicate that you need to start insulin in my opinion, if your dietary efforts haven't slipped. Obviously if you start eating lots of carbs then you would expect it to rise. Once you start on insulin that will give you more freedom with your diet.

For me as a Type 1 on insulin I would love to be below 48 but the best I can manage at the moment is low 50s and I hypo quite regularly at that, so aiming lower is not healthy.

Hopefully that makes sense, but if not, ask me to explain again or @Proud to be erratic can maybe explain better as a Type 3c himself.
 
Firstly, I don't think HBA1C is measured as a percentage any more.
The numbers you give are in mmol/mol.
They used to use percentages but the numbers were close to finger prick which tended to lead to confusion.
But I digress.

An idea of "what is good" is the level at which type 2 diabetes is diagnosed is 48. It's 42 to 47 for pre-diabetes.
With Type 1 (and I assume Type 3c), the target is often higher as it is a challenge to achieve these numbers on insulin without hypos.

I hope that helps.
 
Just in case you didn't know what your a1c results are in terms of what you would see on your meter (average)
95 - 14.7 on meter
76 - 12 on meter
I use: https://www.accu-chek.co.uk/tools-and-resources/hba1c-calculator#

And remember, it is the previous 2-3 months average so often when there are big changes either way, it might not always be a complete picture on the a1c result.

Hope this helps you to wrap your brain around it a bit more even if its not what you actually asked. (so much to get to grips with in a short space of time right).
 
I was told yesterday by DSN at D clinic that my HbA1c is perfect - at 57. I begged her pardon and asked how she worked that out? She said it was well within range. I said what range - I've never been informed I have a range! Apparently mine is 48 to 58. Now if I wanted a number 'well within' that range, it sure as hell wouldn't be 57. Whatever.

Spoke to consultant about thyroid. I'm being stupid apparently, PWD do best with TSH between 1 and 2, mine is over 2 and has been the last twice, so being bloody froze most of the day and dog tired ALL the time won't be caused by that, it must be something else, so I should discuss it with my doctor.

I was grumpy after that and still am.

Consultant did say he'd do a blood test (to shut me up was what he didn't say) and that includes Free T3 and T4 plus repeat TSH as well as other things. Interesting - to my knowledge I do not believe they've tested T3/T4 ever previously. I know quite a lot of people say they get them tested regularly. If they have, they never told me they were doing it!
 
This pic may be helpful:

1651146490990.png

Your initial HbA1c of 95 mmol/mol (not "95%") was up in the orange-ish zone. Your recent 76 mmol/mol is is better, into the yellow zone. The general goal is to get it down more into the green-ish or greeny-yellowy zones.
 
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rebrascora said:
Hi. Firstly, you have got the order and case of the letters right but unfortunately you have got the units wrong by the look of it. An HbA1c of 95 will be mmols/mol not % and the same for the 76. If those were % results you would most likely be dead as they would be astronomically high. 95mmols/mol is equivalent to 10.8% and 76 = 9.1%.
The point at which diabetes is diagnosed is 48mmols/mol. Ideally, if you can get down to below that you are doing really well. If you are using insulin then aiming for below 48 might mean that you are having too many hypos to achieve it. Some people can, others can't.
Since you are currently just on Metformin then aiming for under 48 is fine BUT when you start off at a very high level like 95 it is best to bring it down slowly and steadily. Also, because you are Type3c it is likely that you will not be able to get it down that far just with Metformin and diet, so whilst below 48 is OK as a target, it may well be an unachievable one in your situation so don't feel like you are failing if you can't get close to it. Any reduction on your 76 is a success. If/when it starts to rise, then that would indicate that you need to start insulin in my opinion, if your dietary efforts haven't slipped. Obviously if you start eating lots of carbs then you would expect it to rise. Once you start on insulin that will give you more freedom with your diet.

For me as a Type 1 on insulin I would love to be below 48 but the best I can manage at the moment is low 50s and I hypo quite regularly at that, so aiming lower is not healthy.

Hopefully that makes sense, but if not, ask me to explain again or @Proud to be erratic can maybe explain better as a Type 3c himself.
Click to expand...
Thanks for explaining and I've changed my signature to take the % off!
 
gll said:
Just in case you didn't know what your a1c results are in terms of what you would see on your meter (average)
95 - 14.7 on meter
76 - 12 on meter
I use: https://www.accu-chek.co.uk/tools-and-resources/hba1c-calculator#

And remember, it is the previous 2-3 months average so often when there are big changes either way, it might not always be a complete picture on the a1c result.

Hope this helps you to wrap your brain around it a bit more even if its not what you actually asked. (so much to get to grips with in a short space of time right).
Click to expand...
That's great - thanks so much. My numbers tend to be between 4.8 and 8.1 so I'm hoping that when I have it done again in 12 weeks time it will have reduced quite a bit.
 
Eddy Edson said:
This pic may be helpful:

View attachment 20760

Your initial HbA1c of 95 mmol/mol (not "95%") was up in the orange-ish zone. Your recent 76 mmol/mol is is better, into the yellow zone. The general goal is to get it down more into the green-ish or greeny-yellowy zones.
Click to expand...
Thank you!
 
Hello @zippyjojo , my HbA1c is 52 and my endo was content with that - so I am.

But my circumstances are a little different, simply because I have absolutely no panc'y and therefore don't (shouldn't) have an aspiration to get below some specific target. I just try to do as best I can with my daily management and wherever that brings my HbA1c is a consequence that tells me something about how I've been doing. This is realistic for my circumstances. You have some residual pancreatic functions and therefore inevitably, as a responsible individual, interested in not only protecting what you still have but probably see a potential goal to aspire to. Whether you can actually get to a pre-diabetic level, time will tell. Whether getting there, or thereabouts, is such an intrusion on your daily living is something only you can answer. But once there, it still has to be sustained which might mean further intrusion.

I know only a little about pancreatitis. What I've read has told me that it's a nasty, painful and debilitating process. So, you might want to focus on doing all that you can to fend that off and protect against that, meanwhile let your HbA1c be whatever it is. I think the diabetes is an unfortunate consequence of your pancreatitis but best DM practice for an optimum HbA1c won't particularly result in better pancreatitis outcome. But I could be completely wrong and perhaps the 2 are inextricably intertwined. Your Endo' should be able to clarify that.
 
zippyjojo said:
This is probably really obvious to a lot of you but I just realised that whilst I know that my starting HbA1c (I think I've just about worked out how to remember the order the letters go!) was high (95%) and that I'm bringing it down (currently 76%) I don't really know what I'm aiming for. I see some people's start figures are SO much lower than mine and yet they're still diabetic - help please 🙂
Click to expand...
zippyjojo said:
This is probably really obvious to a lot of you but I just realised that whilst I know that my starting HbA1c (I think I've just about worked out how to remember the order the letters go!) was high (95%) and that I'm bringing it down (currently 76%) I don't really know what I'm aiming for. I see some people's start figures are SO much lower than mine and yet they're still diabetic - help please 🙂
Click to expand...
A 'good' HbA1c is hitting the target agreed between you and the Doc taking into account your age , duration of diabetes, type of diabetes, co-morbidities, NICE Guidelines on yours Type and existing complications. A meta-analysis of many scientific papers by Prof. Craig Christie of Cardiff Uni in 2012 suggested that 7 to 8.5% ( 53 to 69 in new money) was the optimal A1c for Type 2s with problems developing above and below those figures. He also suggested that Metformin monotherapy was the most effective management.
The ACCORD study in 2009 put the cat among the pigeons by finding that, contrary to popular assumptions, Lowest is NOT Best.
 
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