A Good A1c Just Got Harder to Get

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For the last few weeks I’ve been putting off getting my quarterly blood work done. The reason, as ridiculous as this may sound, was that I didn’t want the effect of my post surgery high blood sugar to show up in the test.  I had my surgery four months ago and my blood sugar was really affected for a couple of weeks.  But since Jess was going in for a blood test last week, I decided to join her.

 

So, this morning I sat in front of my computer nervously checking to see if my results were in (i.e. How bad is my A1c?).  I sat there, waiting to hit the Enter key and feeling the kind of pressure I used to feel when checking final exam results back in school.  Why does diabetes make me feel like I’m being graded?  Maybe because, like many people with diabetes, I view my A1c as a test or a periodic review of how well I’m keeping my diabetes under control. I know that there are other parameters, like how often you go low, but since I hardly go low (and this has been consistently true for a while) my A1c does reflect how high my blood sugar is most of the time.

 

I have worked hard to keep my A1c under 7%, the diabetics benchmark, but I really strive for a “normal” A1c of under 6%. I haven’t been there for a long time but I always hope that I’ll do better and I always hope I’ll see my result in blue – the color of the normal range – and not in red.

 

Jess saw her test results first.

 

“You won’t believe what they did?” she said, calling me over to her laptop.  “They changed the A1c range. They made it harder to be normal.”

 

“What?” I said, not sure what she was talking about.  

 

The “normal” A1c range used to be 4.7%-6.4%, but n 2005 it was changed (I don’t know who did it or why) to 4%-6%. Now it seems it has been changed again, lowering the “normal” or healthy A1c range to 4%-5.7%.

 

The truth is that these changes don’t have very much effect on me, since I’m not in the “normal range” under any of the criteria, and every A1c result correlates to an average blood sugar number which in my case is always higher than normal.

 

But as I sat in front of my computer, about to hit the enter key, it did matter for some reason. Being “healthy” just got harder.

 

I looked at my result – 6.8% again, the same result I had last time. I guess that’s okay, I thought to myself. I was afraid it would be over 7%.

 

But I felt a little sad.  Even though I’ve been told a million times that I don’t need to strive for an A1c below 7%, I don’t ascribe to that school of thought.  I believe my A1c should be “normal” and the chance of being normal is now very far away. 

Comments (6)

  1. keith at

    Interesting…. Reminds me when they rearranged the food pyramid & meat was moved down a notch or two and they (meat board) protested. And believe it was moved back up.
    Do wonder how quickly the new number range will be updated
    So far my numbers have been good, think I’m still in range too.
    For me the captchas here are harder to pass than the AC1 test
     
     

  2. Deborah at

    Interestingly, these new lowered standards have not appeared in the media yet. ???
    I need to get my blood work done soon. Like Mike, I also feel like I need to postpone a little and “behave myself” until then to get a normal A1C. (It has been a hectic fall & I have eaten less healthfully than I would like.) Sort of stupid to scramble to get a good “grade”, but it should help me regain more consistent good health habits for the winter ahead. And that is a fine goal.

  3. I totally feel your pain. I had a horrible summer, resulting in a 6.8%, and was really pissed off about it (like you, I strive to be “normal” despite my diabetes). Then I had a couple months that felt better, and it only went down to 6.7%. It’s really frustrating, and makes me wonder how people who do not have the access to all the technology that I do — insulin pump, CGM, test strips — manage this disease. Making it even worse is that I don’t know how much I should trust the number, since according to the ADA conference this spring, there’s  no agreed upon interpretation of what the A1c numbers actually translate to, blood-sugar-wise. Maybe I’m a “high glycolator” and my average blood sugar is lower than my A1c suggests. Maybe it’s the opposite. Who knows? But despite the uncertainty over what the number actually *means*, it can make or ruin my mood/feeling of self worth. Oh, diabetes.

  4. Onoosh at

    Who is the “they” who have raised (or lowered, in this case) the bar? And when was this announced? Where? 

  5. Michael Aviad at

    @Onoosh. 
    Who ever tells the lab where the cut off is.
    They seem to know this kind of thing before the doctors do.

  6. I’ve been hit by these changes in the past. You should have seen the A1C ranges in the mid 1990s!
    If nothing else, I would take this to mean that they really don’t know what ‘normal’ is.
    I see the A1C value as a risk indicator. The higher values increase the risk of problems down the road. The question for me is, do I want to risk severe hypos to make my A1C ‘normal’ (for me, no).
    Remember also that there’s a growing body of research that indicates glycemic variability may be more important than the A1C range.

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