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HbA1c - What is achievable?

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wallycorker

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I am interested to improve my HbA1c reading by as much as is possible.

Can anyone tell me what is achievable?

I will start by identfying at least five categories:

a) Type 1s on insulin.

b) Type 2s on diet only.

c) Type 2s on Metformin.

d) Type 2s on Metformin plus other medication.

e) Type 2s on insulin injections

I realise that the situation will be different for each category. Moreover, there will be more categories - I'd be interested to hear what they are.
 
Hi John.

That's a tricky one ?
There doesn't seem to be a lot of hard evidence about levels between different groups as you have listed. You might get some anecdotal evidence from individuals but I'm not sure what scientific value that will have.

I have a link to a document: http://www.faqs.org/faqs/diabetes/faq/p ... on-10.html

It is entitled: Why is interpreting HbA1c values tricky?
You might like to read it as it has some merit and there are other pages which may interest you.

Hope that helps.
 
Hi John,

An HBA1C in the 5s is perfectly achievable by all 5 categories that you have listed, if you are determined enough to achieve it, and have the knowledge to achieve it. The great problem that most people have who come onto this site is that they have little understanding of diabetes or how to control it - that's why they are here and asking questions. And in some cases they simply don't want to achieve a non-diabetic HBA1C. Some people are happy to remain around the 7 mark (the point at which most will avoid complications), and don't want the extra effort of going lower, so we have to respect that and help them to reach that goal if we can.
 
Hi John,

Another category would be type 1's on metformin for 'double diabetes'. I think there are one or
two on the forum. I'm sure there will be type 2's using the same insulin/meds combination.

Also, there may possibly be some type 2's who don't get on with metformin, so only use other meds.

It would be nice to think that sub 5.5% would be achievable for all of these categories, but
when you throw things like significant insulin resistance/insulin dependency and problems
with counterregulatory hormones into the mix, things can sometimes get a bit more challenging.

Regards,
timo.
 
Dennis said:
Hi John,

An HBA1C in the 5s is perfectly achievable by all 5 categories that you have listed, if you are determined enough to achieve it, and have the knowledge to achieve it. The great problem that most people have who come onto this site is that they have little understanding of diabetes or how to control it - that's why they are here and asking questions. And in some cases they simply don't want to achieve a non-diabetic HBA1C. Some people are happy to remain around the 7 mark (the point at which most will avoid complications), and don't want the extra effort of going lower, so we have to respect that and help them to reach that goal if we can.
Click to expand...

Yes - I agree Dennis. In my particular case, I found it relatively easy to make the improvement from 8.4% to 5.5%. My GP was quite satisfied when I got below 7%. However, from what I have learnt elsewhere that might have more to do with how GPs are funded rather than his interest in my long-term health situation. Certainly, I wanted lower and achieved it - as I said above - quite easily through a change in diet and coupled with weight loss.

I'm very well aware that some people will find similar improvements very difficult and might even consider such change impossible in their particular case - and they might very well be. Certainly, I agree that we should all be doing all we can to help people reach any improvement goal whatever they may be. However, are you saying that we didn't ought to be considering how much further it might be possible for any of us to go?
 
Hi John
For some people A1cs in the 5s are easy to achieve. For others it takes dedication. It's probably possible for everyone IF they WANT it. For some it's not a target they can be bothered with and for others the "Holy Grail". I suspect that's where some of the conflict over carbs comes in. Some people they can handle carbs and get 5% for others it's impossible without loads of medication.
 
wallycorker said:
However, are you saying that we didn't ought to be considering how much further it might be possible for any of us to go?
Click to expand...
Hi John,

Not at all. But bearing in mind that an HBA1C in the low 5s is pretty much non-diabetic range, how much lower would it be wise to go? Not being a medical man I can't answer that, but logic tells me that at levels below 5 a diabetic must be at greater risk of hypos.
 
I suppose the simplest answer is get as low as you comfortably can.I'm in the 6's it remains to be seen if i can lower that just by diet.
 
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