8 Responses

  1. SaraMyers
    SaraMyers January 5, 2013 at 7:21 am | | Reply

    Thanks Will for your brilliant answers. I found one lab where I consistently got lower a1c numbers and instantly became a better controlled diabetic. The range of bs results in meters combined with different potency in insulin and the ignorance & arrogance of doctors can be frightful. Your advice is refreshing and educating.

  2. Vicki Baker
    Vicki Baker January 5, 2013 at 8:23 am | | Reply

    Thank you Wil for this article. Just enforcing not putting so much weight on the A1c but what is happening with patients in their daily lives with diabetes.

  3. susan f
    susan f January 5, 2013 at 9:58 am | | Reply

    I also curious about the role of standard deviation in diabetic complications, which the DCCT did not cover.

    For example, let’s say you have a very very flat curve – you hardly have any lows or highs, but your a1c is 7.5.

    On the flip side, let’s say you are a constant roller coaster with lots of high and low excursions, but an a1c of 6.5.

    Which is better? Does that 7.5 really bode worse for you than the 6.5?

    I wish the DCCT group would analyze this. As we age, many of us can’t feel our lows. That 7.5 is very enticing if you seem stable, well controlled, and avoid lows!

  4. Mike Ratrie
    Mike Ratrie January 5, 2013 at 3:49 pm | | Reply

    Wil, as usual you have made me laugh, thanks! Oh, you also provided some much needed enlightenment to a measure that gets taken for granted.

    I always remember when I was beating myself up for having a 7.0% A1C, and my endo said,

    “Stop! By all other measures (weight, eyes, heart, activity, etc, etc) you have almost no diabetic complications/symptoms. A1C is just one of the things we look at.”

  5. Doug
    Doug January 6, 2013 at 11:14 am | | Reply

    Will as always thanks for the background

    Ive always seen the A1c as a liars test. A way for Drs to independently get some clue as to BG. So when patients show up with NO BG data or with data that is pencil whipped to show better results than reality. The Dr has some information that is unlikely to be altered by the patient.

  6. Susan Whittieru
    Susan Whittieru January 11, 2013 at 10:16 am | | Reply

    Will – you just made my day / year! Having been Celiac all my life with diabetes close behind [60 yrs], no-one ever told me that low iron stores would raise the A1c – do you have a source? – As well my A1c has almost always been above 8. But looking at the whole picture everythiing still works – reasonably well. One thing I find very frustrating though is as per your inquirer ‘it’s alway’s my fault’ according to the MD No one has ever been able to explain why the bumpy road my diabetes has travelled hasn’t yet killed me. I’ve instintively known Celiac Disease was part of it, but not for that reason. Thanks!

  7. {Type 1 Tuesday} 01.15.13
    {Type 1 Tuesday} 01.15.13 January 15, 2013 at 5:17 am |

    [...] Ask D’Mine: A1c Follies Very interesting explanations from Wil Dubois about A1c tests and what could cause them to be off. [...]

  8. Karen Heflick
    Karen Heflick July 13, 2013 at 8:25 am | | Reply

    How should this info be applied to the diagnosing of pre-diabetes, which in reality is just early type 2? I have never had any high blood sugars but first a1c was 6.4. A month later I asked for a recheck and it was 5.3. Since then it has weighed in at 5.7, 5.3, 5.8, and now 5.5. My doctor and diabetes educator say “good job, your diabetes is well controlled with diet and exercise”. Even when I wore a CBGM for a week and drank milk shakes with 107 grams of carbs my readings were never greater than 140, the average over all was 93. This is disturbing to me that I may have been misdiagnosed.

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