So, this is touchy. Just thinking about an A1C test can make your pulse go up. It defines us. Should it? There’s an argument for both sides–but at the end of the day–yeah, it goes a long way towards determining future complications. In speaking with my CDE (certified diabetes educator), we broached the likelihood of complications topic. This was my question, “What’s the A1C number where complications (foot, kidneys, eyes) are unlikely?” She responded by saying 7 or below.
Alright, according to this calculator, we need to be averaging a sugar of 153 to make it happen.
It seems straight-forward. Keep your sugar below 153 and life is good. Here’s where it gets dicey.
We all have a number–a number where we feel our best. Energized. Competent. Compassionate. That’s the real number. That’s the number that stands alone outside of our targets. This number has been sculpted from years of diabetes education, lessons learned, scars, and regret. For me, I feel like I can save the world at 140. Below it, I wouldn’t say that I feel low, but I would say that feel anxiety. Above it, I feel alright until about 180.
How did I end up with this zone? I’ll give credit to conditioning.
When I sit down to take a test and I go low (below 90), that’s a hellish experience full of doubt. No thank you. That’s why I go into tests at 175.
Ever tried to finish a long run at 55? It’s like battling the forces of all evil in the world with every step. I like to avoid that.
Ever came up with a valuable solution to both sides during an argument when low? Didn’t think so.
We all get that our numbers need to be below 7. I see people brag online all the time about having A1Cs around 6. In the past, it would have made me angry. No more. To each their own. If they feel good there, more power to them. We all have our own number. We all have our own battle with the 153. We all have our own battle built on avoiding complications (keeping my feet) while feeling like ourselves.
Have a similar experience? Please tell us about how you’ve arrived at your own number!
When it comes to complications, take in to factor the big predictors for the major complicaitons. Control those, decrease those, and you truly decrease your risk. Blood sugar levels, blood pressure levels, and blood lipid levels. Other things to consider are weight and tobacco use. Get all of these under control and you are dramatically reducing your risk of complications. The A1c in particular is a safety/risk tool. If you can maintain an A1c of 5-6% without having any significant or frequent lows, well go for it superman… But there are also people out there with A1c of 5.5% because they are simply low all the time. You just have to realize if it is both safe and rewarding.. Otherwise, set your target a little higher to maintain a safe range. This is what I usually teach with my patients, because EVERYONE tolerates particular BG levels differently…
Myself personally 6.5-7% is what I shoot for. 6.9% and 7.0% were my last two… I’m perfectly happy floating around there.
Agreed Kelly! Floating in the 6.5 to 7 range is ideal for me too. Everyone tolerates a given glucose value differently. I love the advice regarding A1C as just one of my risk factors to control. Good stuff!
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