Hi everyone. So, back in April, my A1C was 8.7 when I had just been diagnosed with type 1. I’ve since managed my sugars incredibly well, micromanaged, I’d go as far to say, and due to that plus my OCD and not eating more than 30 carbs per meal, generally speaking, I’ve managed to get my A1C down to 5.6! I’m astounded. That was just in 3 months time. I’m on the Tandem Tslim x2 since May, and I truly feel it’s made a huge difference. With MDI, I was still running really high all day and night. My average sugars are 114 now, whereas 3 months ago they were 198. I guess I just wanted to celebrate the small victory of well managed sugar because this stuff can be so SO hard.
Is this kind of A1C typical with well controlled type 1?
@HisWifeTheirMama staying under 7 is recommended but not necessarily easy to achieve, so congratulations!
According to Understanding A1C Test | ADA When it comes to the numbers, there’s no one-size-fits-all target. A1C target levels can vary by each person’s age and other factors, and your target may be different from someone else’s. The goal for most adults with diabetes is an A1C that is less than 7%.
… so if you start having lots of lows or circumstances change - your doctor might recommend upping it a bit. But otherwise, keep up the good work!
Sarah @HisWifeTheirMama, you asked, and you earned, so Congratulations!!!
Your 5.6% is directly reflective of a long-term [90 day +/-] average body glucose level; if you combine that HbA1c with a TIR of 90% you have my “Three Cheers” to go along with Congratulations.
Personally, I couldn’t live on 30 grams of carb per meal unless I ate at least 4-5 full meals per day; I stick with the eating pattern, recommended by the international diabetes consortium, that has kept me going for seven decades living with diabetes of at least 230 grams of carb per day. But, each of us is different. I’ve just succeeded in getting my HbA1c up to 6.0%, where some doctors suggested, from 5.3% while keeping my TIR above 90%.
Congrats!
When I was dxd my A1c was >14, within 3 months it was an 8.7, and at my 6 month checkup I was a 6.2.
From what I’ve heard, a 5.6 is relatively difficult for most diabetics to achieve.
I’ve consistently achieved an A1c between a 5.4 and a 6.2 over the last several years by paying attention to my BG using my tandem and dexcom and by counting my carbs. I eat between 170-250 carbs a day. It definitely helps that my body is still making a minuscule amount of insulin. (I think) if your body stops making insulin completely it can make it harder to get a lower A1c.
From one blood sugar control freak to another — be careful not to get burnt out! You’re gonna have rough days when you’re sick and it’s definitely worth eating a slice of birthday or wedding cake when it comes your way. Don’t worry about a few “bad diabetes days” messing up your numbers, especially since a 5.6 is awesome. Like Dorie said, you’ve got wiggle room. Great job!
Congrats. this is great. My daughter started at A1c on 14 when diagonsed in April and today she was 7.8 and doctor think this is good but yes 7 or below 7 is awesome,
Sarah,
Your dedication is incredible! I’m happy for you. How do you feel? Last year, a friend told me that I was obsessed with my pump. Lol.
I often get an average BG of under 120 for a 24 hour period, then blow it for some reason. Still, I’m in 6 range. With my Medtronic 780, there’s really no reason that I can’t achieve under 6 as well. I’ll think of your success as inspiration. I average about 100 carbs per day, but intend to do more.
I’ll look forward to seeing more tips from you. Oh, almost forgot to add that some people I know who have been type 1 for many years….like over 30 years, are able to maintain in the 5 range.
I’m not fully sure how A1C really works given my values have been strange. I get it tested every 6 months.
11.9 (a day after I was admitted to hospital with DKA),
then 5.8 (when on MDI with limited carb intake),
then 4.6 (two months after starting on iLet pump),
and a month ago at 4.3.
My last three tests were taken ~5 hours after breakfast and before lunch - where my BG is typically between 80-100 depending on activity during that time.
What I don’t understand is how my A1C lowered like crazy after getting on the iLet pump. Am thinking my hemochromatosis might have something to do with the test results… but jury is still out on that. As much as we know about the human body, it feels we are barely scratching the surface.
That is truly a phenomenal accomplishment. Congratulations. I cannot answer whether it is typical as well as your endocrinologist might be able to answer. I keep my own A1C’s in the under 6 range, but there would be some doctors who would warn that in that range, it is important to be concerned about hypoglycemia.
@lee.s.schwartz, I’m with you and would believe having A1C in the 4% range would come with significant lows. Fortunately for me, that’s not happening. Here is my Beta Bionics 90 day values showing .2% low and no very low’s. The majority of my low is from early sensor funkiness and not real low’s as I maximize the 12hr grace period and put up with sensors warming up issues on my reports. My endo is also trying to understand this as well.
Hi @gmershon . An A1c in the 4s -that’s amazing! That works out to numbers ranging from roughly 70-95, depending on whose scale you look at.
I do marvel at people who feel just fine at 80 or 90 because I don’t feel “quite right” if get to 100 or lower. Maybe I would be fine if adapted to it but for various reasons I aim a higher. If you don’t mind my asking, do you/did you feel any different since your numbers tightened up so much? And how is it when you exercise?
Apologies if I’m being nosey and thanks for sharing your experiences.
@wadawabbit, I do feel best between 90-110 and will feel low when I reach the low 70s. My average BG is in the low 130’s and has been there since getting on the iLet pump in Oct ‘23. Which makes no sense to get a low A1C that doesn’t correlate with my BG average. Would expect to be in the mid to upper 5% A1C range. Something is off on my tests that do not make sense.
A question for others here… when you get your A1C test are you fasting at time of the blood draw?
@gmershon, I see why you scratch your head when seeing the 4%l but before getting into that - - - your Sd, your CV, and the miniscule % of CGM reading outside your 70 - 180 range show that you have a really good management technique. All the values I mentioned tie very closely together and strengthen each other.
BUT, that A1c [I’m presuming it was a lab test] and your average glucose level scream at each other. My first thought is to ignore that 4% and relegate the reading to “lab error”; lab reports are not always correct.
Bottom line, you and your iLet appear to be a wonderful match I wonder occasionally if I should have chosen that route.
@gmershon, miaaed answering your question.
I try to have my blood draw for HbA1c done 2-3 hours after a meal, usually after lunch when I’ve eaten 70 grams of carbs. I find this practice more closely mimics the purpose of blood over an 80 - 90 day period.
Interesting that my most recent blood draw, while having been fasting for 11 hours was my highest in years; a 6.0% as opposed to my usual 5.3 to 5.6%. I’ve made a deliberate attempt over the last several months to bring my average BGL from about 117 to mid 120s and while, like you, minimizing the over / under range %. My t-Slim range has been set at 75 - 165 for a couple of years.
I recalled hearing a long time ago that abnormally high or low results at the time the test is done could affect the results. I did a little web surfing and didn’t see that but did find this from a Healthline article on Type2 diabetes: Several medications and supplements can also cause falsely low A1C levels, including vitamin C, vitamin E, antivirals, and certain medications used to treat cancer and some skin conditions
@Dennis, Am thinking either A) the lab test is inaccurate, B) my high ferritin levels are causing the test results to be low, or C) still undetermined…. My guess is C but don’t want to rule out B. Hopefully will have my ferritin at to normal levels before my next A1C test.
I do try to manage my BG’s and especially my deviation (ie, I don’t eat more carbs if I’m already high), but I can’t take credit for the above results as the iLet pump manages it for me.
Have been thinking what my existing 90-day results would be if I used the tighter low/high metrics you do. I’d expect my high percent would definitely go up, however doubt I’d have much of an increase in low’s.
@wadawabbit, Interesting read. Thanks for sharing!
Believe I failed at answering your above comment about how I handle exercise…. It’s a bit of a loaded question as it depends on the type of exercise, intensity and length. I’ve found that I use the pause button on my pump frequently when exercising, and for intense sports I remove it completely so not to damage it. When I went to Laguna Seca for the Indy race it was a ton of walking and climbing to watch the race from different locations as well as watching them work on the cars before the race. All is all it was moderate to low intensity, but was all day. For that I kept the pump connected but went into pause mode unless I ate a carb amount that required a meal announcement then back to pause. Didn’t have any lows or highs however later in the day I unpaused the pump when my BG’s reached 150-160 from lack of basil doses. I do the same for skiing, but would carb up for the day and not disconnect the pump as I rarely fall and it’s challenging to disconnect and reconnect with all the clothes layers, goggles, etc… And the only break I usually take is for the restroom. My exercise can burn glucose but later in the day when I’m tiring out I burn less energy and my BG’s will climb with no basil insulin. Usually at 3:00pm I’ll find my BGs around 160 and climbing and will unpause my pump.
Racquetball is very different. I have to carb up to 180-190 before playing, disconnect the pump and 1.5hrs later I’ll be in the 80s and dropping slowly. The intensity of racquetball chews up glucose quickly. For pickleball I can usually eat a Kind bar before playing and pause/disconnect my pump while playing then reconnect after playing.
The pause insulin button is my go to, however I usually make sure I eat some carbs before playing. The best part is 24 hours after playing sports my BGs don’t peak as high after eating.
I got my a1c result yesterday of 6.7%. I’m pretty pleased, but feel I can do better. If my Guardian 4 sensors would stay consistent, I think I’d be able to.
