a1c levels

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Norcross Burt posted on Fri, Jun 27 2014 5:47 PM

I have recently received conflicting guidance from two doctors--one in our summer residence and one winter residence.

 

One doctor thinks I need a target of 6.5.  The other doctor says anything up to 7.5 is ok.  He says they have recently reset the levels for people who are older.  I am 77.

 

I am confused--have the target been changed recently for people with Type 2 diabetes as they get older?

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RobertIA replied on Fri, Jun 27 2014 6:20 PM

Interesting that they don't agree.   The latest from the 74th ADA Scientific Session suggested A1c's of 7.5 for the elderly, but it is not official yet.  The American Association of Clinical Endocrinologists have maintained 6.5 as their official A1c level.

However, many doctors, including Endos, have recommended for years of letting the A1c levels rise as people age.  My endocrinologist has asked me to let mine rise to 7.5 or higher and this is because I am a type 2 on insulin.  They are deathly afraid of hypoglycemic episodes and this drives them to encourage people over 65 to let their A1c's rise.  I just tell them it will be what it is and my last was 6.7 and I am unhappy that it is this high.

Another patient who is a good friend and about five years older than I am had an A1c of 5.4 and the endo went ballistic and told him to have an A1c over 7.0 percent on his next appointment.  He is also on insulin and a type 2.  He has not had a blood glucose level below 64 mg/dl in the several years I have known him.  He is about five pounds under ideal weight and I am obese by most doctors.  He is not insulin resistant and I am very insulin resistant.  Both of us limit our carbohydrates and eat low carb-high fat, medium protein. 

My thought is doctor will be doctors and if they fear hypoglycemia, the will recommend a higher A1c.  Doctors that really know their patients will normally let the patient manage their blood glucose levels where they desire them.  At my age, 72, I am very unhappy with an A1c over 6.5 percent as I know my risk for diabetes complications has greatly increased and above 7.0 it will be just a matter of time until they are affecting my health.

I hope this gives you some food for thought.

Type 2 (10/2003)   Lantus and Novalog   Now added Metformin      Retired

 

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roxanne replied on Thu, Jul 3 2014 12:57 PM

I'm going to keep mine at what a non-diabetic person has.  That's what makes sense to me

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I am not surprised that you received conflicting reading at all. I was told that 7.5 is very normal and that going below 7.0 is not good for many people. I am new to diabetes and it seem that there is no perfect number for everyone. My wife's mother has type 2 diabetes and is on glimmerpride but her doctor was careful that her numbers not go too low.

The New York Times recently had an article on diabetic medications causing too low a drop in blood sugar in senior citizens resulting in emergency visits and worst.  For me my legs have been my best indication of my blood sugar number. It was tired heavy legs that first lead to my diagnose. Diabetes is very much connected to P.A.D(Heavy legs/artery blockage ). This was revealed on Plymouth News. Here heavy legs tired

 

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My A1c is always 'just under' 8    after 56 years still no sign of any complications.. :))

How can one get an A1c test done???  Cannot just pop in to have blood drawn....

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