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What is an acceptable HbA1c ?

Juicyj

Expert
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9,266
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Worcestershire
Type of diabetes
Type 1
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Pump
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Hypos, rude people, ignorance and grey days.
I've just had my recent results in and i've gone up to 65mmol/l, previously I was 61 and at my best I have been 56.

I discussed this with my DSN and she said this was ok, I don't feel it is, so here is the golden question, what is acceptable in so much that I won't suffer complications in later life ? or at least have a reduced risk of complications.

Thanks
 
Given that the new NICE guidelines suggest T1s should target <6.5% or 48mmol/mol in new money, then that's what I would suggest is a good target.
 
SweetLucie said:
Here you see, not commenting
Click to expand...
The only thing to bear in mind with this though is that very low HbA1c's for T1's can often result in serious hypo issues. Over the last few years mine have ranged from 35-45 but I often had serious night time hypo's when I was unconscious as well as a much reduced hypo awareness.

Things have improved for me since I went onto a pump in May (after 6 weeks of some very bad teething problems) so it will be interesting to see what mine is at my next appointment in about a months time. I have been told that slightly elevated results do not exponentially increase the risk of complications though.
 
SweetLucie said:
Personally I am at 39

Here you see, not commenting

Good -----> Less than Ideal -----> Poor
Click to expand...

Thanks - yes it has confirmed what I felt, I wasn't exactly pleased with this. I am hoping to be considered for a pump as I try everything but I still cannot win at remaining constant with my BG and when I tip over the edge I really do go head first..
 
As @tim2000s says a good level to aim for would be the Nice Guidelines of 6.5%.
 
tim2000s said:
Given that the new NICE guidelines suggest T1s should target <6.5% or 48mmol/mol in new money, then that's what I would suggest is a good target.
Click to expand...

Thanks Tim, not sure how I can ever get to this, been diagnosed 3 years now and best result was 56 before I started rebelling against Levemir and went haywire, just had another month of elevated results so working with my DSN to get a pump. I eat low carb I cycle 2-3 times a week for 20kms a time, test regularly, not sure what else I can do..
 
To be brutally honest, I struggled with it and it's only the libre and low carb diet that really has me in the non-diabetic realm. The CGM/FGM is what really made a difference to me.
 
For me anything below 7% I think is good. I usually sit in the 6.5%-6.9% range and my DSN always tells me that's a good number to be at. I'm hoping that now since I have the pump it will come back down from the 7.5% it was last time I had it done (I was disappointed with that result)
 
you just need to try your best, as a lower long term number is a smaller risk of complications........

but none of us are the same, 2 separate folk could maintain a long term sugar of exactly the same number but one could suffer more than the other with complications.......
 

My last HbA1c was 6%. But to get there I was getting so many hypos where I was mismatching carb content. I was really struggling because due to the nature of my job I often have to stay and eat in hotels. Then I got into the LCHF diet thanks to the help of tim2000s and a few others on these forums to get better bg control and lose weight. I am at the very LCHF or keto diet end of the LCHF diet spectrum. Because I have removed almost all the carb out of the bg equation it is interesting to see when the bg does change due to stress and exercise for example. I have been taking bg readings at normal times but also seeing what it peaks at i.e. within the two hours after meals.

if you take the nice readings 6.5% 48mmol/mol according to the HbA1c calculator roughly equates to 7.7mmol/L so in theory if you dont get many readings above this figure your HbA1c should be lower than the NICE guidelines
 
I'm a T2 and when mine was at 54 my nurse said that is around the level at which the risk of microvascular complications would start. She could be wrong, but it did propel me to get things under control and eventually I got to 37. Which is great for a T2 but way too low for a T1, from what I've read.

If I was a T1 I would probably be happy if the number was in the 50s, unhappy in the 60s and distraught in the 70s.
 
What can I do if i'm already trying my hardest...

Well i've come to the conclusion then that I have to have a hysterectomy as this gives me hell for one week of the month with surging hormones that despite increased basal and correction doses is incredibly hard to reign in, I have to give up work as I am on my bum whilst i'm working and this gives me insulin resistance, give up my 3/4 glasses of red wine a week and probably think about having all my teeth removed so I don't have dental infections.

Then I might/just might achieve the 'NICE' guidelines..
 
nmr1991 said:
mine isnt even in the table, above 16% or 150mmol/mol as it were
Click to expand...

Question is are you happy with this ? Ultimately we all know the risks/possible consequences, but it's what your happy with that really matters..
 
We can only do our best.

I thought the jury was still out on red wine?

I have endometrosis and pretty severe menstrual issues. Came close to deciding to have a hysterectomy, then tried another option and found things were much, much better. I'll send you a PM about it.

FWIW, I think you are doing great and your HbA1c is not that bad. Hugs.
 
CatLadyNZ said:
I thought the jury was still out on red wine?
Click to expand...

I hope so as this is the only thing I think I would really miss, my teeth have become a pain since being diagnosed type 1 and my regular once a month hell I would quite happily do away with but red wine..
 
Juicyj said:
Question is are you happy with this ? Ultimately we all know the risks/possible consequences, but it's what your happy with that really matters..
Click to expand...

i've ran this high for some months now. well the first high hba1c i got was about 9% which was in october 2012, so it sort of went up from there, going up by 3% each year until the hospital nurse gave me a reading in July that couldn't be read by their machine. I guess I just lose all motivation to test glucose/inject insulin. depression takes over and i'm no longer in control of my actions. It's not about being happy, i don't live happy because I have no job, no income, borderline homeless, doctors keep referring me to hospital as they seem to think its doing some good, DSN keeps lecturing me on the complications resulting on HbA1c being dangerously high, and as it can't be recognised on their machines it could may as well be at 20% by now. I've not got any complications yet, but even if i do, whether it be retinopathy, nerve damage, renal failure or amputation, I still wouldn't be phased by any of it, depression in a way eliminates denial, fear and death from your mind, and you're practically a walking dead man.
 
 
My last one was 7.5% which is right at the top end of the "Good" level. I've been between 7 and 7.5 for as long as I can remember...

I do worry sometimes that I should be a bit lower (I've been diabetic for 32 years now and, barring a miracle cure, hope to have it for much more than that again!) BUT I know i couldn't get much lower without hypoing all of the time.

I think the most useful bit of the new NICE guidelines is the individual targets. There are always going to be things that we can't change that affect levels, whether that be "Monthly Hell" (which I'm thankful I don't have to deal with!) or having a 17 month old that takes up all of your time (something that I wouldn't change for the world) or a job where you have unpanned / no notice bouts of exersion.

I'm a firm believer that a diabetics life shouldn't be totally about diabetes, yes it's important to try as hard as you can, and yes a HBA1C of 6.5 with no hypos would be brillaint but we're only here once and there's so much more to life than blood sugar readings.
 

Depression and high blood glucose go hand in hand..

Have you done any courses through the NHS yet, like Expert Diabetes or DAFNE ? If not please try and push your nurse to get you on one, these will give you support and from reading your post you need alot of this right now.

Sending you a big virtual hug.
 
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