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What Hba1c level do you aim for?

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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There are different types of anemia (not sure what I have but the iron pills work). The different kinds affect the HBA1C in different ways. That's all I remember but you can Google it.
 
DEBBIESCOTT said:
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
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Captain_Sensible said:
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
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Do you use a pump or MDI? I can’t get the numbers I used to get and I now have a pump and CGM.
 
Captain_Sensible said:
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
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I have had numerous arguments with doctors and consultants in the past about HBA1c levels and how much they focus on them. For a long time they kept me on unsuitable medication and my sugar levels would swing wildly from very low to very high and all they would say was “Your HBA1c level is good so things are OK”. They couldn’t or wouldn’t see my argument that the test gives an average and an average of seven could be from values of 2, 2 and 17 just as well as it could be from 6, 7 and 8. The test is undoubtedly a useful tool but it needs to be viewed alongside other information. The time in target on the libre system is more useful in my opinion but no medical practitioner has ever bothered to look at mine. I agree with you about it getting harder to keep a tight rein on blood sugar levels as we get older. For me I think this may be in part down to a bit less activity and it being more sporadic as there are some days when I just don’t feel able to do as much as I would like to. Plus these days I have some autonomic neuropathy which among other things affects my digestive system and I expect that probably affects the uptake of nutrients and consequently the ability to control blood sugar as well. It feels like a bit of a vicious circle but again it is something that the medical profession ignore completely. If I mention it they just change the subject so I am on my own with that one and just do my best.
 
ModyGirl said:
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.
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My most recent one was 57, a year ago it was at 45.
I expect it to go up over the winter ( 6 months of cold and wet, here in the UK) and drop back during Summer/ Autumn.
My next checkup is November. I'm aiming for the low 40s.
My primary focus has been weight loss for the last two years, but now I'm maintaining at a healthy weight, so I can concentrate on cutting down excess fat and sugar in my diet.
 
Antje77 said:
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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How easy is it to get a fructosamine test on the NHS?
I am slightly anaemic (just below the bottom of the reference range) but with no obvious impact.
However my average BG and estimated HbA1c from Libre 2 is always much lower than an HbA1c.
I have so far assumed that the Libre 2 is reading low because that is what a finger prick comparison tends to show.

Targets:
below 6.5% for many years
below 7% for the last few years (hoping to ease back down to the 6.5% in time)
 
For the last two annual reviews my HBa1c was 44 but this year it was 43 and had my knuckles rapped and told they want to see it in the low 50s so that's what I am now aiming to achieve .
 
Filumo said:
My libre 2 app says a1c of 8.2%. How does that translate please?
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8.2% is 66 mmol/mol

Note that it’s mmol/mol not mmol/L like the units for blood sugar tests. That’s because HbA1c isn’t really an ‘average’ blood sugar level for a 3 month period (even the units are different, Hba1c is a percentage per mole, BGL isn’t a percentage) but it’s often used as a proxy for an average. Also worth mentioning is that the libre 2 HbA1c estimate really is just that: an estimate based on the readings the libre 2 has collected (which measure interstitial blood glucose as a proxy for venous blood glucose, so the estimate is for a proxy based on a proxy… it’s still very useful though). The libre 2 estimate is a great tool but I think it’s worth remembering that it’s an estimate. Some CGM systems (e.g. Dexcom) no longer call it estimated A1c anymore but instead call it a Glucose Management Indicator (GMI) to emphasise the difference. This paper explains the rationale behind using the term GMI rather than estimated A1c if you’re interested: https://diabetesjournals.org/care/a...ucose-Management-Indicator-GMI-A-New-Term-for The libre 2 estimate might be close to your A1c measured by blood test, or it might be different (in my case it was close… libre 2 estimated 5.3, blood test 5.5)
 
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My hb1ac was 106 when I was first diagnosed at the end of March. At that time my finger prick testing was giving results up to 25 or so, however after going low carb in early April my results are much lower. So while I don't have a target hb1ac in mind (and don't have another blood test scheduled as yet) it would be good to get down to the sort of levels where I could stop taking Metformin.

I trialed a Libre2 for a couple of weeks and that suggested my hb1ac would be about 40 based on its results. I'd be pleased with that if true however I did think the Libre2 readings were a little low compared to the finger prick testing I was also doing.

The Libreview app also now calls the estimated hb1ac a Glucose Management Indicator (GMI) as was mentioned above for the Dexcom.
 
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