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Type 2 What is a good H1ac?

I

infinitemantra

Active Member
Messages
31
Type of diabetes
Type 2
Hi - I am 45 diagnosed type 2 in june 2016 with H1ac of 147

my last 2 tests were 40 and 39 respectively

by some sites online these numbers are in the normal not diabetic range - however I suspect that the line is arbitrary and in fact healthy non diabetics have lower H1ac's than this.

So my question is what do people think represents a healthy H1ac? is it less than 35? 30?

Some more info

I am not overweight
I have a desk job but am reasonably active and enjoy exercise
I cannot devote huge amount's of time to lowering my blood sugar as I have 2 young boys and a job - however I am motivated to remain healthy and fit so that I can be an active dad including playing sport with my boys as they get older. So intend to do more exercise and tweak my diet to improve these numbers.

o
 
I agree that the line is pretty arbitrary, with the USA and the UK choosing different thresholds for pre-diabetes, and different ways of thinking suggesting what constitutes good control.

Have you come across the www.bloodsugar101.com website yet? It is a really good read.
One of the things I like about it is that it explains the studies (both the good and bad points) that are used to set these arbitrary guidlines, and reassesses most of them. There is also a good section on what constitutes normal, and what does not. And the risks of being at different blood glucose levels.

Dr Bernstein also has some pretty firm views on the subject, and he advises his patients (he is a T1 diabetic doctor who has run a diabetic clinic for decades, title of his book in my forum signature) to aim for an HbA1c in the 20s, not the 30s. But I suspect that this is an unrealistic goal for many of us without the use of medication.
 
Lower is better, that much is for sure... That said, post meal spikes concern me more than a1c. Less than 2 rise keeps it nice and stable.

I know for sure if I hit the carbs and reach 9 or 10 after a meal it affects my wellbeing for days.
 
I pay little attention to my HbA1c as a marker of control. I prefer to use my pre-meal base levels and my postmeal rises as better markers - with as little variation as possible. Nice gentle curves with no mountain peaks, and all within my personal target range.

It is easy to see a good HbA1c if your base levels and overnight levels are good even if you have big spikes post meal because the average of lots of 4s and 2 or 3 8s will still be good., It is the spikes that do the damage, and they can never be undone. The glucose sticks and doesn't fall off no matter how low you are until your next meal.
 
Bluetit1802 said:
I pay little attention to my HbA1c as a marker of control. I prefer to use my pre-meal base levels and my postmeal rises as better markers - with as little variation as possible. Nice gentle curves with no mountain peaks, and all within my personal target range.

It is easy to see a good HbA1c if your base levels and overnight levels are good even if you have big spikes post meal because the average of lots of 4s and 2 or 3 8s will still be good., It is the spikes that do the damage, and they can never be undone. The glucose sticks and doesn't fall off no matter how low you are until your next meal.
Click to expand...
Do you have any idea how much impact these spikes have on a1c?

I recall reading somewhere that it is negligible amounting to no more than 15% of the overall figure.

The reason I ask, I'm just curious whether a spike of 9 or 10 while testing meals has any real significance on overall a1c if not repeated over and over.
 
infinitemantra said:
Hi - I am 45 diagnosed type 2 in june 2016 with H1ac of 147

my last 2 tests were 40 and 39 respectively

by some sites online these numbers are in the normal not diabetic range - however I suspect that the line is arbitrary and in fact healthy non diabetics have lower H1ac's than this.

So my question is what do people think represents a healthy H1ac? is it less than 35? 30?

Some more info

I am not overweight
I have a desk job but am reasonably active and enjoy exercise
I cannot devote huge amount's of time to lowering my blood sugar as I have 2 young boys and a job - however I am motivated to remain healthy and fit so that I can be an active dad including playing sport with my boys as they get older. So intend to do more exercise and tweak my diet to improve these numbers.

o
Click to expand...

Have a look at what this site itself advises.
http://www.diabetes.co.uk/what-is-hba1c.html
 
Jamesuk9 said:
Do you have any idea how much impact these spikes have on a1c?

I recall reading somewhere that it is negligible amounting to no more than 15% of the overall figure.

The reason I ask, I'm just curious whether a spike of 9 or 10 while testing meals has any real significance on overall a1c if not repeated over and over.
Click to expand...

I can't answer that question as it depends how long the spikes last as a percentage of the total time. The HbA1c is a rough average, so the lower the lows are and the more time you are low the less impact the spikes will have on an HbA1c.
 
My (new) doctor seems to think that my H1ac is far too low at 43. She has reduced my metformin, so I'll see how I go. I'm low carbing so It may not go too high. At least she's taking an interest in me, and says it's unusual to see anyone being so motivated. Actually she's lovely, and didn't bat an eyelid when I said I had made a considered decision not to go down the path. of statins. I'll take her opinion. with my usual pinch of (Maldon) salt.
 
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