Diabetes: What is a good A1C?

Depends on who you listen to. Most docs are satisfied with anything under 7.0 (which reflects a 2-3 month glucose average of 170, so as you can see, that's not very low). Endocrinologists would like to see 6.0 or less (average of 135 or less). Depending on what lifestyle changes (diet, exercise) you're willing and able to make, and what meds you're on if any, it's quite possible, especially if you're not too obese and haven't had diabetes for very long, to get an A1c of 5.5, sometimes even lower. Non-diabetics' A1c would be in the 4.8-5.0 range (average of about 90-100). Although not impossible for a diabetic to achieve, getting there for us might mean an extremely low carb diet, a lot of rigorous exercise, and possibly insulin therapy.

And the problem with intense insulin therapy, with an eye to achieving the kind of tight control that will result in a 5.0 A1c, is that you risk going too low, too frequently. That patient will have to test their glucose several times a day and be willing to do a lot of dosage tweaking and very possibly follow a very low carb diet. Lows are no fun, and especially when they come on suddenly and leave us shaking, sweating and fuzzed out, they can actually feel quite debilitating not to mention dangerous. Not a very practical idea to allow to happen very often. We're all different, at different ages and stages of our condition. It's very hard to make generalities- - we're not machines, after all, or algebraic equations, where x+y always equals z.

So the docs talk about ranges of desirable A1c levels with us, recommending we get down to 6.0 and even a bit lower if we can, in order to delay the long term complications of diabetes. Some can achieve that 5.0 level and stay there for a while, and some can't.