A1c Question

[Maine66]

I am new to the forum and was hoping someone could help me with a question I have. I Have had type 2 diabetes for a little over 5 years. I tried all of the pills but they did not lower my numbers enough. My Dr. suggested a switch to insulin about 3 years ago and I now take Novolog and Lantus insulin and no pills. When I started out my A1c was 10.4 the last few times I have gone it has been 7.5. Much better I know but is it low enough?? I hear that optimally it should be under 7 but my Dr. seems happy to leave it there. When I asked him about bringing it lower he seemed unconcerned and said that is good enough. I am only 40 and have 7 children I would like to raise to adulthood and worry about long term complications. With all the kids I need to be active and feeling well. Has anyone heard about numbers being okay above 7 ??? Thanks.

[Lloyd]

A lower risk of microvascular complications (nerves, kidney, eyes) has been shown to be associated with a lower A1c value. The lower you go, the lower the risk, but going so low you get frequent hypoglycemic episodes is not a good idea.

For most people, A1c's in the 6's are safe, if your glucose is pretty stable (not a huge range from highest to lowest) then an A1c in the 5's might be ok.

-Lloyd

[Phonelady61]

First off god bless you for having 7 kids omg i would be in the looney bin . LOL !! anyway I think maybe you should talk to an endo but I must say 7.5 is really good coming down from a 10 . that is really good and I understand your concerns . dont believe everything you read as well . sometimes you just have to believe . good luck and god bless you .

[Evermont]

Hi Maine66, and welcome to DF. I know some ways to get that A1c down. You didn't give us much to go on. I noticed that you didn't' mention either diet or exercise. Where are you at with those things? There are certainly T2's who have no excess weight to lose, but if your like most of us that do - you know that will help too. So not only will diet and exercise each directly lower an A1c, but they are also the key to weight loss which itself leads to many improvements among them a lower A1c.

7.5 isn't ideal, but it's not terrible either. I say don't panic - just resolve to work at it. With some effort you might see 6.5. I'm 43 myself and newly diabetic. I have kids, and my kids have - well, 1 kid. I'm sure with as many as you have that you are already 'active' one way or another everyday. I would also wager that a good bit of your day is up to your elbows in food. Buying it, prepping it, cooking and serving, cleaning up after, and so on. Maybe you get a little help from the tribe but still... I can imagine.

So where are you with diet and exercise? Any room for improvement there?

[pdxdennisj]

American Society of Endos shoots for under 7.0. I've been running ~6.2 for a couple of years now. Many docs like it in the 6's.

[sprzepiora]

Diet and exercise will be key, and the biggest problem with a large family will be diet, I know as we have a large number of kids and buying healthy foods for everyone is expensive! We have slowly been converting to more healthy foods for the whole family, we now serve at least two vegetables with dinner. We have cut most "white" foods out, just work a little bit at a time and you'll get there.

Good luck!

[jerryn]

Hi, Welcome!

Like Evermont said. 7.5 is not ideal, but not terrible. Your goal should be to get it lower. I'm currently at 7.0 and am working now to get it to 6.0 since you minimize the risk of complications there. As far as the risk of complications with an average 7.5 that's a tough call, it depends on your body. Some people have a higher tolerance than others. It's better to be safe than sorry though. I'd say stay on top of it, watch the carbs, work out, get active. This disease is actually a blessing for me. I'm in better shape now while I'm in my 40's than when I was in my 30's.

[xMenace]

For every 1% reduction in A1C, the risk of developing eye, kidney and nerve disease is reduced by 40%. (http://www.google.com/search?q=For+every+1%25+reduction+in+A1C%2C+the+ri sk+of+developing+eye%2C+kidney+and+nerve+disease+i s+reduced+by+40%25.&rls=com.microsoft:*&ie=UTF-8&oe=UTF-8&startIndex=&startPage=1)

I shoot for 6.0% or better.

[Nita]

My endo team wants my numbers to be 6.5 or less. I have been working on mine to get them out of the 7s and have gotten them down to 6.9 but that is not good enough. I just have to eat less carbs (or less food). I have been covering my carbs with more insulin and that has to change!

I don't know if that is the "norm" for my endo or if it is because of my age....me being older. I will ask soon.

Nita

[mortis505]

Hi Maine66 and welcome to DF. Good job on getting it down to 7.f from the 10.4. I have to ask if you are seeing a GP or are you seeing an endocrinologist. As stated above, diet and exercise are paramount to getting that A1C lowered but also getting the Basal(Lantus) doses and the Bolus(Novolog) doses tweaked to work best for you. How much of each are you taking? Whats your insulin to carb ratio? Whats your typical daily meal? Are you exercising? How often are you testing at home? All of these are important factors and can help to get that A1C lowered.

Good luck and welcome to DF!