Your HbA1c of 51 doesn't seem too bad to me. With diet, exercise and a sulphonylurea I gor my HbA1c down to about 50 and was almost classified as 'in remission'. However this didn't last for very long and HbA1c started to climb to almost 100, which is what it was on my intial diagnosis, and I was referred to the diabetes clinic and was started on a once daily injection of Lantus a long acting insulin, and later NovoRapid was added to be taken with each meal. My HbA1c is now down in the 50s again and I'm pretty well contolled.