What’s the perfect hba1c

[ariaxo]

What is it

 

[MarkMunday]

You can't get better than 'normal', which is 4.3%-4.8% (24-29 mmol/m). The level at which diabetes is diagnosed is well above normal.

 

[Antje77]

What is it

On glucose lowering medication or insulin it's as low as you can get it without going hypo all the time.
So the ideal number is different for each individual.

So I do not agree with @MarkMunday . You posted in the type 1 subforum so I assume you are talking about T1's, and not about non-diabetics.
For almost all T1's the numbers Mark quotes would mean dangerous hypo's.

 

[MarkMunday]

That normal blood glucose is healthier than abnormal blood glucose goes without saying. Whether normal blood glucose is achievable or even desirable is another issue. It depends on the circumstances. According to the DCCT study complication risk starts ramping up when HBA1c goes over 42, but this is not easily achievable for many T1s on insulin. The AACE (American Association of Clinical Endocrinologists) recommends keeping HBA1c below 48 for people with diabetes, which is what I try to do. But 48 is just an achievable number, and it is way above the 'perfect HBA1c'.

 

[Jaylee]

What is it

Hi @ariaxo ,

Ideally, this is what you should be aiming for... 48 mmol/mol (6.5%)

If it can be got a little lower without a shed load a lows or loss of hypo awairness? Then fair play.

 

[In Response]

What do you mean by perfect?
If achieving the values @MarkMunday suggests means being obsessed by your diabetes management and unable to do the things you enjoy, totally avoid the food you love, never bring spontaneous, avoiding friends and family because they may tempt you, not have time to concentrate on work, ... in my mind, that is not perfection.
That is treating a very small part of who you are and letting diabetes control your life.

We are all different and some people maybe able to achieve these levels without being overly controlling but, for me, it is important to minimise the impact diabetes has on my mental health which means balance between perfect numbers and living my life.

 

[ariaxo]

What do you mean by perfect?
If achieving the values @MarkMunday suggests means being obsessed by your diabetes management and unable to do the things you enjoy, totally avoid the food you love, never bring spontaneous, avoiding friends and family because they may tempt you, not have time to concentrate on work, ... in my mind, that is not perfection.
That is treating a very small part of who you are and letting diabetes control your life.

We are all different and some people maybe able to achieve these levels without being overly controlling but, for me, it is important to minimise the impact diabetes has on my mental health which means balance between perfect numbers and living my life.

Is 52 ok?

 

[ariaxo]

You can't get better than 'normal', which is 4.3%-4.8% (24-29 mmol/m). The level at which diabetes is diagnosed is well above normal.

Ok is 52 ok?

 

[In Response]

Is 52 ok?

We are all different.
Only you know what balance is right for you.
You may feel you can reduce this without obsessing and letting diabetes take over your life. Or you may feel the mental cost is not worth the hb1ac reduction.
It is personal to you.

 

[ariaxo]

We are all different.
Only you know what balance is right for you.
You may feel you can reduce this without obsessing and letting diabetes take over your life. Or you may feel the mental cost is not worth the hb1ac reduction.
It is personal to you.

Well there are obviously dangerous hba1c levels and I want to know if my hba1c is okay

it has already taken over my life. it is a part of me and has already worsened my eye sight

 

[EllieM]

Well there are obviously dangerous hba1c levels and I want to know if my hba1c is okay

If it's any consolation, I've been T1 for 50 years and my hba1c has been (much) higher for many of them. But I've been running in that sort of range for last few years and my body and my endocrinologist seem happy with it. I had my annual check up last Tuesday and my endo was happy, and guess what my level was.....? 52. (feet, eyes, kidneys, etc all passed their checks). Though I do have friends with better control who've had way more diabetic issues than me, so diabetic life isn't remotely fair.

Would I like it to be lower? Yes, I would prefer it to be a bit lower but I'm certainly not losing any sleep over it at this level. In old money aka a %, it's 6.9, and a few decades ago the guiding lines seemed to be that you were doing pretty well if you kept your levels below 7. (I was overjoyed whenever I went that low).

But it really is an individual thing, as far as fine tuning your individual target. I start losing hypo awareness if I go much below that level, so my endo complains if I'm down to 48.

But I certainly don't regard 52 as a "dangerous"hba1c level.

I just looked at some of your previous posts and want to say that I got my first glucometer at your current age and had absolutely appalling control in my teens. (If symptoms of thirst and feeling sick are anything to go by.) I've had on again off again background retinopathy for years and improvements in control really do seem to help (eventually). It's never to late to improve your control and 52 isn't bad at all. Specially if your levels have been a little ordinary before that.....

But what does your clinic say? (And depending on your eye issues, my eye doctors always wanted me to avoid rapid changes in blood sugar....)

Good luck.

 

[Jollymon]

The perfect a1c is really dependent on the person, and what that person can comfortably achieve. We are all different.

 

[Stefp]

I have maintained my hba1c at 6.1 or 6.2 (sorry not sure what that is in mmol) for many years. This is far from the perfect level and still takes an almost obsessional focus on my eating, insulin and exercise to achieve - so I can’t imagine how the levels akin to a normal, non diabetic could be achieved much as I would like to get there. I know that I really could not do any better And that has to be enough for me. At the end of the day I think that is the best any of us can do - so the perfect hba1c is the one that you can achieve when you absolutely try your best!

 

[KK123]

To me, the perfect hb1ac is the one that keeps you as healthy as possible, ie, avoids (or at least reduces) the risks of complications. If your hb1ac of 52 is leaving you free of 'diabetic associated problems' then that's fine. If it's not and you are experiencing deterioration then it's worth trying to get lower. I loathe this 'you MUST get it down to a non diabetic level or you'll lose a leg' implication because it leaves people thinking they are inferior in some way. Having said that, personally I do try to keep mine within reason and work hard to do so and recognise that there is a level which to go beyond would be more risky, underneath that level though can be a wide range of 'numbers' and some people will still thrive on a higher number, some won't and vice versa.

 

[hyponilla]

According to my endocrinologist the perfect HbA1c for a type 1 is 42 mmol/mol. Since this is also the answer to life, the universe, and everything I'm assuming she's correct

On a serious note I think you need to be a bit obsessed with your diabetes if you want to go below this number, so it sounds like a healthy target to aim for.

 

[Japes]

I'm well aware if I'd had an Hba1c back in the summer after 5 months of working from home, out of all my normal activity routines, with insulin ratios all over the place, I would not have been at all happy as I know how hard I'd worked over that lockdown to try to keep my diabetes as well controlled as I could, without becoming totally obsessed. .

Having been more in my usual routines since September, I am happy enough with last week's mid-50s (7.something%) result whilst working on getting it a little nearer to where I'd prefer it to be.

Life is not straightforward right now, and I am balancing keeping all aspects of my health as good as I can.

 

[MeiChanski]

Hello could I add that if it’s 52mmol as a hba1c with a time in range of above 79%++ (79-90%) then you are doing well compared to someone who is bouncing like a yo-yo to get 52mmol.

My consultant stopped looking at my hba1c because I use to hypo a lot and hba1c was in the low 40s. Now she looks at my TIR, graphs and readings to help me adjust my ratios etc.

 

[Ushthetaff]

I ran with a Hb1ac at over 90 for years and suffered the consequences , my hb1ac is now constantly in the mid to low 50’s , my diabetic consultant is happy, I’ve had a few cuts one which resulted in cutting an artery in my hand , had 8 stitches after a day and a half 2 of the stitches had come out however the cut had already started to heal , within 10 days the cut was healed. Something that never happened when my bloods were in the 90s. Keeping my bs at the levels they are means I’m not a slave to diabetes and I don’t worry if I get the occasional high I would say 52 is acceptable well it would be for me, as someone who has had serious complication , keeping hb1ac in low 50s shouldn’t result in loss of anything .

 

[searley]

If it's any consolation, I've been T1 for 50 years and my hba1c has been (much) higher for many of them. But I've been running in that sort of range for last few years and my body and my endocrinologist seem happy with it. I had my annual check up last Tuesday and my endo was happy, and guess what my level was.....? 52. (feet, eyes, kidneys, etc all passed their checks). Though I do have friends with better control who've had way more diabetic issues than me, so diabetic life isn't remotely fair.

Would I like it to be lower? Yes, I would prefer it to be a bit lower but I'm certainly not losing any sleep over it at this level. In old money aka a %, it's 6.9, and a few decades ago the guiding lines seemed to be that you were doing pretty well if you kept your levels below 7. (I was overjoyed whenever I went that low).

But it really is an individual thing, as far as fine tuning your individual target. I start losing hypo awareness if I go much below that level, so my endo complains if I'm down to 48.

But I certainly don't regard 52 as a "dangerous"hba1c level.

I just looked at some of your previous posts and want to say that I got my first glucometer at your current age and had absolutely appalling control in my teens. (If symptoms of thirst and feeling sick are anything to go by.) I've had on again off again background retinopathy for years and improvements in control really do seem to help (eventually). It's never to late to improve your control and 52 isn't bad at all. Specially if your levels have been a little ordinary before that.....

But what does your clinic say? (And depending on your eye issues, my eye doctors always wanted me to avoid rapid changes in blood sugar....)

Good luck.

Only 10 years ok my consultant told me to aim for 7 or less

 

[annliggins]

What do you mean by perfect?
If achieving the values @MarkMunday suggests means being obsessed by your diabetes management and unable to do the things you enjoy, totally avoid the food you love, never bring spontaneous, avoiding friends and family because they may tempt you, not have time to concentrate on work, ... in my mind, that is not perfection.
That is treating a very small part of who you are and letting diabetes control your life.

We are all different and some people maybe able to achieve these levels without being overly controlling but, for me, it is important to minimise the impact diabetes has on my mental health which means balance between perfect numbers and living my life.

Absolutley perfect response... live your life ...lowish numbers ..under 10 , happy days for me ...no 4.0 to low !