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What Hba1c level do you aim for?

M

ModyGirl

Well-Known Member
Messages
55
Type of diabetes
MODY
Treatment type
Insulin
Hi everyone.

I just had my latest Hba1c result back which was 49 (6.6). My consultants are always very pleased with my numbers but after reading the average blood sugar results for this - I feel it could be much better.

What does everyone else aim for? I realise this will be individual.
 
ModyGirl said:
I just had my latest Hba1c result back which was 49 (6.6). My consultants are always very pleased with my numbers but after reading the average blood sugar results for this - I feel it could be much better.
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49 is a very good result for someone on insulin!

But to answer your question, I aim for as low as possible for me without having many hypos.
This means that I'm not aiming for a specific hba1c but rather for low numbers with little highs or lows throughout the day.

What kind of insulin regime are you on? Basal (long acting) only, a mixed insulin, or basal and bolus?
Do you use fingerpricks or a sensor?
 
well, the reference values of hba1 are 4.3-6.1, but for people on insulin, doctors consider higher values to be good results because hypoglycemia is more dangerous than hyperglycemia. If you don't feel when your bg is too low, you may just fall unconscious, but if you don't feel the spike, nothing bad will happen to you.
You have a really good result.
 
Thank you @Zhnyaka. When I was first diagnosed a few years ago, my Hba1c's always used to be in the 30's and 40's without much effort. However, MODY is progressive so I know I am now producing less insulin than I was. It's frustrating to see higher Hba1c's so I think more effort is required.
 
I’m happy with anything beginning with a 4, last one in February was 42 (lowest I can remember)
Consultant wasn’t too happy & suggested going without medication for 48-72 hours to see what happened, asked if I could take the medication if it got into double figures & he said no stick it out for 48 hours
2 years ago I was sat with nurse b/s 18 & not eaten anything & she wanted me taken off to hospital in an ambulance
I’ve not tried it
He also said statins do not increase blood sugar, said no to them as well
 
My last HbA1c was 5.3 but during the 3 months preceding that I was having far too many hypos. I expect that my next test (due end of this month) will probably be around 6.5. I‘m not sure if I’m aiming for that exactly as I’m not really aiming for anything except for slightly higher daily average BSLs, so it’ll be higher. No hypos for awhile now (touchwood) so the slightly higher HbA1c is ok with me. For me, at the moment anyway, my daily averages are my aim and hopefully that translates into an ‘acceptable’ HbA1c… logic tells me it should but I don’t know Edit: I think I answered the question accidentally: I’d be happy with 6.5
 
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ModyGirl said:
@DEBBIESCOTT nice to come across another MODY! Do you know what time? I have the faulty HNF1A gene. Have you been diagnosed for long?
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Had gestational diabetes in 1997 with my son, diet controlled until 2 years ago when hba1c was 128, formally diagnosed with Hnf4a MODY last May even though no one in my family has ever been diagnosed with diabetes, now on 20mg of gliclazide & have to eat up to it
How are you getting on?
you’re still on insulin I see, is there any way you could go onto tablets or do you not want that?
I’ve been offered insulin 3 times but not since I’ve had a MODY diagnosis
I still get libre on prescription though
 
@DEBBIESCOTT I was also diagnosed as gestational during my first pregnancy in 2016. Hba1c was 54 but wasn't medicated - came on accutely and nearly ended up in DKA. Told I was Type 1 and 2 before MODY testing was done.

I have been offered oral meds but I was used to insulin and think it gives you more freedom - for me anyway. Only recently had the libre though.
 
I tested this week and was 6.6 too . I wear a CGM which was telling me my estimated a1c could be 5.6 so I was disappointed, though I understand 6.6 is pretty good. Also, I stopped metformin two weeks ago and life feels like the wild wild west just about now, so even more dismal thinking my new numbers will take the average higher.
 
I put my emphasis on TIR 'time in range', because I have anemia and that skews HBA1C results, although I take strong iron pills, prior inaccuracies affected my trust level in the test. Also HBA1C is an average that does not indicate how high or low your blood sugar goes.
 
@JAT1 I also just found out that I am extremely iron deficienct - I didn't know this effected Hba1c results? Can you explain more please. Thank you!
 
ModyGirl said:
@JAT1 I also just found out that I am extremely iron deficienct - I didn't know this effected Hba1c results? Can you explain more please. Thank you!
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Iron deficiency can decrease the number of red blood cells your body produces and therefore your circulating blood cells are older (normally they’re replaced roughly every 3 months). Since the HbA1c test measures the percentage of red blood cells that have glucose ‘stuck’ to them and assumes an average lifespan of 3 months if your red blood cell turnover is lower (as iron deficiency or anaemia can cause) you have a higher percentage of older red blood cells with glucose stuck to them, meaning higher HbA1c

Edit: this article is for nondiabetic patients, but the gist of the idea is the same https://pubmed.ncbi.nlm.nih.gov/15345893/
 
Antje77 said:
Do you get fructosamine tests instead of hba1c's?
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No, at least not as far as I am aware, sometimes I have to deal with a blood requisition form so vast I don't bother with knowing what's going on. However; I usually only eat fruit (half an apple) when I'm hypo (maybe twice a month at most) and that makes me feel better in 15 minutes.
 
I have been on insulin now for alm fifty years and I aim for about fifty for Hba1c but it is usually a bit higher than that. Since getting covid last autumn though I have had major difficulties in stabilising my blood sugar levels and control has not been as good as it used to be. I keep trying to improve things though as long te high blood sugar is certainly best avoided!
 
Hi there! I've been Type 1 for 62 years now and I agree with your comments. I actually aim for 7mmols or a little under at best on my HBA1c, but really for me I just try and keep within bounds on not having high bloods. In fact I'd rather be heading towards lows than highs which make me feel lousy. I've found over the years it's the doctors who are always going on about HBA1c 's and numbers. I just try and be sensible and the HBA1c tbh, is whatever comes out in the wash. It is after all, only an average. And to be really honest - after 50+ years with T1, we know more about the balancing act we go through every day than they do anyway. That balancing act can be very difficult and it gets more so the older we get I've found. On the positive front- Thank God for Libre 2 though
 
I've had T1 nearly 30 years and am glad when my HBA1c is 50 or 51. My best ever was 47. I do agree thank goodness for Libre 2! Before Libre my HBA1c was often in the low sixties, which I look back on with horror. Also, by this point, with that tech help, we know more than the doctors about how to achieve good control for ourselves. And the best medics understand that too.
 
Just in case you're interested in your hba1c despite the anaemia, the fructosamine test is an alternative to hba1c testing, which will work better in people with aneamia because it isn't dependant on red blood cells.
 
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