What is an acceptable A1c Range?

By Courtney | 6 Rookie Marks »

There was a recent tweet about an A1c. And to generalize, for the most part, as far as I can tell, in the ODC, we’re all pretty OCD about our A1c’s. We want them lower, we want them in range, we want them better than they are.

Serveral years ago, I believe that it was Team Type 1 that launched the “Strive for 6.5” campaign. An A1c of 6.5 sounded glorious seeing as how my lowest A1c at the time was 7.8 and it had only happened because I was constantly bouncing from low to high. But an appropriate range for A1c’s has never been discussed between me and my doctor. I think this is because seeing me below my current 6.7 is a ways off, I’m not in danger of having an A1c that’s “too low” any time soon. But what is too low?

I can remember in high school, one of my friends had an A1c of 5.8…I was telling the school nurses of this (13 years ago) and they said that’s impossible, that’s too low. It turns out that an A1c of 5.8 is equivalent to averaging 107 for a 3 month period (which I’ve heard is more accurate to a 6 week period but I guess that’s for another post).

So again, what is too low?

The A1c that was tweeted today was 4.8. That too me, in an instant was to low. A little research showed me that an A1c of 4.8 was equivalent to a 74.

Now everyone is different. I understand that, one person’s low might be another person’s normal and vice versa…but some basic thought put into this to me says there must be a lot of numbers in the 50-60s range to even out a number that may be a little higher, like in the 100s in order to get an A1c of 4.8.

This immediately made me ponder the effects of running numbers like those, the biggest concern being the desensitization to low blood sugars which can easily cause bigger issues down the line.

So that leads us back to, what’s an acceptable A1c range, and is it valid to say “acceptable” when each and every person is different?

6 Rookie Marks On What is an acceptable A1c Range?

  1. Hmm, in an online diabetes group a couple of years ago there was a guy who was quite vocal about, “My A1c is under 5 and yours could be, too.”
    The response by most people in the group ranged from, “Maybe that’s OK for you, but I don’t want to be running low all the time.” to “Wise up! We don’t want to read about your death in the papers.”
    In my experience, people that do this, get a lower than normal A1c in spite of diabetes, are not open to the idea that it might not be the best thing to do. They work hard at it, and think they are successful.
    Different people are different. For most people, their brains would be a little starved with an average blood sugar of 74.

    We all know a lot of the dangers of a high A1c. What are the dangers of a low A1c?

    1) As you said, insensitivity to lows.
    2) Living close to the edge. Something that would knock a 100 down to 60 would knock a 74 down to 34… in a hurry.
    3) Walking around with a sub-optimal supply of sugar to the brain. Grumpy? Hard to concentrate? Hard to think?

    Anything else? What damage might be done by chronic hypoglycemia?

    ...said Jerry Nairn on September 23rd, 2009
  2. I know the guy that posted that tweet, and I know that he has a Navigator and a pump, and is more anal than most about his numbers. He’s also an accomplished professional athlete. What he can, and chooses, to do is not necessarily something that those of us who are leading “normal” lives should, or could, do. We don’t have the tools, or the mechanisms (or maybe the desire), or the sponsorships, to make that lifestyle choice. On the other hand, I have run 5.7 for the past year, and I do that mainly by sticking close to 100 all the time. Rarely low (never lower than 72), and rarely high. I don’t work at it; I just have a system that works for me. We are all different, and we all deal with this disease differently, and I would not presume to tell anyone else how to manage their life – all I know is, my lifestyle choice works for me…each of us should strive to find the lifestyle that we can live with…

    ...said Bill Arnold on September 23rd, 2009
  3. I’m an accomplished athlete…maybe not professional, but accomplished, nonetheless.
    I too have a pump and Navigator and do not feel comfortable in that low range. (I am VERY anal…Courtney knows that I think..LOL!)
    The only time I had an A1c lower then 6 is when I was first diagnosed. Over time I felt (mentally & physically) much better at 6-7%.
    Jerry…agreed…on all 3 points! The “tweeter” may not have any those “symptoms” if you will…but your points are valid and are my worries for having a low A1c.
    This is my 2 cents worth anyway:)

    ...said Nancy on September 24th, 2009
  4. Bill,
    I am also an athlete, more or less, and I have my own accomplishments, though nothing like the “tweeter” we are discussing. I have a CGM, but I’m not anal about my control. I know I could and should do better.
    When I read about your 5.7, with most of your readings close to 100, I think, “Way to go!” That’s something I would aspire to reach. My last A1c was 6.7, but I don’t think I’ll hit that on my next one. Too many goof-ups with infusion sites.
    When I read about a 4.8, I can’t feel that way about it. I give any compliments to anyone for doing that.
    If you’re aiming for 4.8, do you do a “correction” bolus when your blood sugar is 110?
    I just strikes me as a little nuts. It is over-achieving in a dangerous area.

    ...said Jerry Nairn on September 24th, 2009
  5. Oops, typo.

    I CAN’T give any compliments to anyone for doing that.

    ...said Jerry Nairn on September 24th, 2009
  6. How do you do the math to get your a1-c number

    ...said Nate on November 23rd, 2009

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