Hba1c and age

[borderter]

After being told for many years my a1c should be between 49 and 58 its now suddenly shot up to 63 and dns and consultant say this is okay because I am in good levels 70 per cent of the time so it begs the question is this an age thing as 80th birthday looms or is it the fact I am older and so they dont worry ,sad because i worry about it but when trying to get help there isnt any and its just the your okay response

 

[Antje77]

I think it's an age thing.
Falls are more dangerous the older you get, hypos can cause falls, so the guidelines want to you to avoid hypos at all cost.
There's also the matter of complications: the main reason to keep BG at healthy levels is to prevent long term complications. Statistically, an 80 year old will have a shorter time left to develop complictions than a 40 year old, hence the loosening of target in older people.

While those guidelines make some sense, it looks like in your case someone is forgetting about the individual approach and quality of life.

sad because i worry about it but when trying to get help there isnt any and its just the your okay response

With an hba1c of 63, your average BG is likely at around 10. Can we help you working out what you can do to lower your numbers a little without going hypo?
Do you use a Libre or CGM so you can spot patterns and make some adjustments?

 

[EllieM]

I think it's an age thing too.

https://www.hey.nhs.uk/wp/wp-content/uploads/2018/05/TYPE-2-DIABETES-HbA1c-TARGETS-v4-March-2018.pdf

Looks like as you get older (and frailer, though I am not suggesting you are frail) the target gets relaxed to 70mmol/mol, which you are nowhere near. Plus hypos can lead to falls and they can be deadly if you have brittle bones (or at least lead to broken bones which you really don't want.) Not saying that you have brittle bones either, but falls are bad news for the elderly.

Can I ask what sort of insulin regime you are on @borderter ? (You don't have to answer).

 

[borderter]

I think it's an age thing.
Falls are more dangerous the older you get, hypos can cause falls, so the guidelines want to you to avoid hypos at all cost.
There's also the matter of complications: the main reason to keep BG at healthy levels is to prevent long term complications. Statistically, an 80 year old will have a shorter time left to develop complictions than a 40 year old, hence the loosening of target in older people.

While those guidelines make some sense, it looks like in your case someone is forgetting about the individual approach and quality of life.

With an hba1c of 63, your average BG is likely at around 10. Can we help you working out what you can do to lower your numbers a little without going hypo?
Do you use a Libre or CGM so you can spot patterns and make some adjustments?

You have made my day with this common sense reason but why couldnt dns or consultant just say this instead of "you are one of our best patients for range "

 

[borderter]

I think it's an age thing too.

https://www.hey.nhs.uk/wp/wp-content/uploads/2018/05/TYPE-2-DIABETES-HbA1c-TARGETS-v4-March-2018.pdf

Looks like as you get older (and frailer, though I am not suggesting you are frail) the target gets relaxed to 70mmol/mol, which you are nowhere near. Plus hypos can lead to falls and they can be deadly if you have brittle bones (or at least lead to broken bones which you really don't want.) Not saying that you have brittle bones either, but falls are bad news for the elderly.

Can I ask what sort of insulin regime you are on @borderter ? (You don't have to answer).

Humalog (latest trial) for bolus and levemir twice daily with carb counting .Odd thing is if i when high give a small extra dose it sends me higher then when i start eating it drops and can only think my resistance is driving this weirdness !