Saturday, 20 June 2009

Here's how the A1c numbers correlate to glucose averages

>With all the talk of AIC's, I was wondering what is the 'normal' range I should be shooting for. Anyone know off the top of their head?<

Non-diabetic' s A1c's run like 4.8ish to 5.2ish. Unfortunately, doctors are so damned pleased to see any of us diabetics get near 6.0 and stay there, they happily tell us that's just wonderful, we can be satisfied now, no reason to get it down more... while every week, month, and year that goes by, there's a toll being taken on our small blood vessels (eyes, kidneys, heart, brain) and our nerves (sensory nerves of the feet, legs, hands, as well as the autonomic nerves controlling digestion, heart function and breathing).

So... I often wonder.... would they tell their own loved ones that it's just peachy to walk around with a 6.5 A1c (about a 150 glucose average)for years, knowing full well the risk of longterm complications at that level? I doubt it. One person's 'normal' is absolutely not... normal. Just FYI, here's how the A1c numbers correlate to glucose averages, reflecting what the blood sugars have done over the preceding 2-3 months:
A1c --> glucose average
5.0 --> 100
6.0 --> 135
7.0 --> 170
8.0 --> 205
9.0 --> 240
10.0 --> 275
11.0 --> 310
12.0 --> 345
13.0 --> 380
14.0 --> 415

Do you just assume if 7 or 6 is good, then closer to non-diabetic is better? There is no preponderance of evidence so far to support that idea, and there is evidence it is definitely harmful in some cases. For instance, we now know that if you have had diabetes for 20 years and start a program of intense control, you will fare poorly. Prior to 15 years, it MIGHT be helpful, but the advantage is vanishingly small. I know that flies in the face of the ethic that prevails in here, but evidence is evidence.

And there is plenty of reason to fear hypo episodes. I have only had one really bad one, but I sure am afraid of em. More seriously, since so many diabetics have heart disease to one degree or another, as a population anything that puts the heart at risk should be avoided. Hypos definitely put the heart at risk.

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