What is a "normal A1C" for a T2 diabetic?

Booksandbeaches

I'm asking this because I'm concerned about my father who has Type II diabetes. He was prediabetic in his late 40s. He didn't control it with diet and exercise. It became full-blown T2. Then he didn't test himself as he should have and control his A1C. He had a really bad endocrinologist who never really tested his A1C.

At one point, several years into his diabetes he was to have surgery for something else, and when the A1C was tested, it was a whopping 11! They postponed the surgery and put him on insulin shots, which he hated. That was a real wake up call for him. Since that happened about 8 years ago, he is off the shots and just medication for the diabetes. Now he walks daily (not all the fast if you ask me) and eats a very clean diet. There has been damage to his kidneys from the bad A1C of the past, but he doesn't need dialysis. His A1C now is 7.0 My mom said she thinks that's fine since dad is a diabetic. But it seems high to me. He's on at least two medications. His morning fasting sugar is 100 or below, so I don't get how his A1C is 7.0. Couldn't he get it lower? Maybe his medication has to be adjusted or increased or changed? My mom thinks the culprit could be exercise. He isn't overweight. Looks skinny actually. The only exercise he'll do is walk in the neighborhood, but I'd say he walks at maybe a 2.8-3.0 mph pace. I know he's capable of going faster. He doesn't have other health problems.

amberj32

You will probably get several answers for a "normal A1c" number- online and from people in this group.

The Mayo Clinic says -"For someone who doesn't have diabetes, a normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 8 percent.

When the A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes.

For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals."


Webmd - "For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes. Because studies have repeatedly shown that out-of-control diabetes results in complications from the disease, the goal for people with diabetes is a hemoglobin A1c less than 7%. The higher the hemoglobin A1c, the higher the risks of developing complications related to diabetes."

ADA - "The American Diabetes Association suggests an A1C of 7%, which is an eAG of 154 mg/dl, but a more or less stringent glycemic goals may be appropriate for each individual. - See more at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/#sthash.WtXqm7xU.dpuf"


His A1c should be checked every 3 months. A1c should be lower than 7%. I don't know how the kidney damage all comes into play with everything. How many carbs per day does he eat? Personally I'm a strong advocate for exercise - some type of cardio and weight training. It's made a huge difference in my numbers. Always check with the doctor to see about how much exercise he can do and how much exertion he can put into it. I really started pushing hard when I exercise lately. What medication is he on? Age?


I'm not a doctor - just my opinion.

GlucernaBrand

Your father is lucky to have you advocating for him. As Amber said, the American Diabetes Association recommends that each individual work with their physician to determine the most appropriate A1c goals based on their personal medical history. The A1c is based on overall blood sugar control over three months, and it's possible that his blood sugar level is higher at other times of day than he realizes. How many times per day does his doctor recommend he test his blood sugar? ~Lynn /Glucerna

Booksandbeaches

amberj32 wrote: »

His A1c should be checked every 3 months. A1c should be lower than 7%. I don't know how the kidney damage all comes into play with everything. How many carbs per day does he eat? Personally I'm a strong advocate for exercise - some type of cardio and weight training. It's made a huge difference in my numbers. Always check with the doctor to see about how much exercise he can do and how much exertion he can put into it. I really started pushing hard when I exercise lately. What medication is he on? Age?


I'm not a doctor - just my opinion.

He is in his mid-70s.
He takes Glipizide and Acarbose.

I'm not sure how many carbs he eats a day, but I know he barely even eats the little bit of rice he's allowed each day. He eats mostly salads and lean protein. He said that he was once on 4-5 meds and now down to two.

Booksandbeaches

GlucernaBrand wrote: »

and it's possible that his blood sugar level is higher at other times of day than he realizes. How many times per day does his doctor recommend he test his blood sugar? ~Lynn /Glucerna

That's what I'm thinking too, but he says this is what diabetes is...that if it's A1C were lower, he wouldn't be diabetic. I don't know what to say to that.

I'll ask my mom how often he has to test his blood sugar.

NK1112

Diabetes is such an individual disease that it's best for your dad to work with a doctor or endocrinologist on his targets, and he probably should be testing more often. However, an Aic of =<7.0 is considered good for someone with Diabetes and if it can be brought down even lower it signifies tight control. Unfortunately, it's not a disease that goes into remission or gets cured ... it can only be controlled and that's for the rest of your life.

Good luck to your dad, he's lucky to have a child who is looking our for him.

Booksandbeaches

Thanks, NK112.

GlucernaBrand

Booksandbeaches wrote: »

GlucernaBrand wrote: »

and it's possible that his blood sugar level is higher at other times of day than he realizes. How many times per day does his doctor recommend he test his blood sugar? ~Lynn /Glucerna

That's what I'm thinking too, but he says this is what diabetes is...that if it's A1C were lower, he wouldn't be diabetic. I don't know what to say to that.

I'll ask my mom how often he has to test his blood sugar.

A1c is used to diagnose diabetes, but once someone is diagnosed with diabetes it doesn't go away and can't be cured, even if the A1c is lower than 7.0. There's a good article from Joslin here: http://www.joslin.org/info/will_diabetes_go_away.html ~Lynn /Glucerna

Booksandbeaches

Thank you! It's a good article.

GlucernaBrand

You're welcome! ~Lynn /Glucerna

myfitpal_2014

I would have his medicines double checked. I'm not sure if it is the same medicine I am thinking of but if it is then there are much better medicines now than Glipizide. Don't quote me on that but I would look into it. I personally feel that 7 is too high because it indicates a sugar average in the 150 range. Any time your blood sugar gets above 140, you are doing a bit of damage. I work hard to keep my spikes even 1 hour post eating to less than 140.

Just to add into the conversation where people say diabetes can't be cured. Yes, this is true but bariatric surgery can come really close to it. People who have this surgery often see their sugars drop into normal ranges within a few months and they go off most or all of their medications. It changes something fundamentally in the hormones or how the body responds to insulin even before people lose weight. Yes, diabetes can 'return' if one regains weight but for many it is pretty close to a 'cure'.

Naughty_ZOOT

I would highly recommend Dr. Bernstein's Diabetic Solution. The ADA has not come up to speed on current science. Your dad is entitled to a normal blood glucose reading. Bernstein is a type 1 and knows his stuff. My last reading after eliminating my meds was 5.7, my goal is between 4.5-5.0. Anything over 5.0 starts in cardio damage but conventional physicians will argue higher. My internist told me not to go too low at 6.3-ridiculous. Read Bernstein's book because you are also at risk.

Booksandbeaches

Thank you both..I'll get that book (Diabetic Solution) and get my mom to ask the doctor about another med other than Glipizide. My dad treats doctors like gods (he's from that generation), so he's reluctant to ever question them. Ha! I should go with him because I don't have that problem.

Booksandbeaches

Naughty_ZOOT wrote: »

Read Bernstein's book because you are also at risk.

I have an A1C of 5.0
I figured I was at risk, so I started eating a ketogenic diet almost a year ago.

earlnabby

Booksandbeaches wrote: »

Thank you both..I'll get that book (Diabetic Solution) and get my mom to ask the doctor about another med other than Glipizide. My dad treats doctors like gods (he's from that generation), so he's reluctant to ever question them. Ha! I should go with him because I don't have that problem.

I am on glipizide and it has worked really well for me. It usually is prescribed for people whose kidneys are not happy with other diabetes meds. I was on metformin to start and my EGFR dropped 20 points in 3 weeks. I switched to glipizide and my EGFR and other kidney function tests show normal function now.

BTW: my A1C averages around 5.5

Gentyl

earlnabby wrote: »

Booksandbeaches wrote: »

Thank you both..I'll get that book (Diabetic Solution) and get my mom to ask the doctor about another med other than Glipizide. My dad treats doctors like gods (he's from that generation), so he's reluctant to ever question them. Ha! I should go with him because I don't have that problem.

I am on glipizide and it has worked really well for me. It usually is prescribed for people whose kidneys are not happy with other diabetes meds. I was on metformin to start and my EGFR dropped 20 points in 3 weeks. I switched to glipizide and my EGFR and other kidney function tests show normal function now.

BTW: my A1C averages around 5.5

The major problem with glipizide is that is causes your pancreas to burn out. It forces your pancreas to push out insulin and burns out your beta cells (these can not regenerate)--the producers of insulin. Once that function is gone you will have no choice but to be on insulin.. You transition from a type 2 diabetic to a type 1 diabetic.