The best AIC goal for type 2 diabetics

Posted by dorisena @dorisena, May 25 1:07pm

A doctor writes in my local paper that there is controversy over the best AIC number, depending on age and other medical conditions such as heart conditions, and whether or not medications are used. A study showed that below 6% can make heart disease worse. The suggestion is that persons who wish to go off medication should not do it abruptly, which is common sense. Experts may not use medications for someone below 7%. Changes in weight, diet, and exercise factor into deciding a goal, and 6% or less goal is not necessarily better for an older person who may have heart disease. Dorisena

Liked by pdilly

Thank you so much! I am 78 and have been concerned that my A1c has been a little above 7 recently. Ihave no intention of going off medication (or careful diet) . All of this is confusing.

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Here is some information on Mayo Clinic guidelines for A1C results,

"Results
A1C test results are reported as a percentage. A higher A1C percentage corresponds to higher average blood sugar levels. The higher your A1C level, the higher your risk of developing diabetes or complications of diabetes.

For someone who doesn't have diabetes, a normal A1C level is below 5.7 percent. If your A1C level is between 5.7 and 6.4 percent, you have prediabetes (also called impaired fasting glucose), which means you have a high risk of developing diabetes in the future.

An A1C level of 6.5 percent or higher on two separate occasions shows that you have diabetes. An A1C level above 8 percent means that your diabetes is not well-controlled and you have a higher risk of developing complications of diabetes.

For most adults who have diabetes, an A1C level of 7 percent or less is a common treatment target. Lower or higher targets may be appropriate for some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan."

If you would like to read the entire article, here is the link, https://www.mayoclinic.org/tests-procedures/a1c-test/about/pac-20384643

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@hopeful33250

Here is some information on Mayo Clinic guidelines for A1C results,

"Results
A1C test results are reported as a percentage. A higher A1C percentage corresponds to higher average blood sugar levels. The higher your A1C level, the higher your risk of developing diabetes or complications of diabetes.

For someone who doesn't have diabetes, a normal A1C level is below 5.7 percent. If your A1C level is between 5.7 and 6.4 percent, you have prediabetes (also called impaired fasting glucose), which means you have a high risk of developing diabetes in the future.

An A1C level of 6.5 percent or higher on two separate occasions shows that you have diabetes. An A1C level above 8 percent means that your diabetes is not well-controlled and you have a higher risk of developing complications of diabetes.

For most adults who have diabetes, an A1C level of 7 percent or less is a common treatment target. Lower or higher targets may be appropriate for some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan."

If you would like to read the entire article, here is the link, https://www.mayoclinic.org/tests-procedures/a1c-test/about/pac-20384643

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@hopeful33250 My A1c has never been over 7 from what I remember, and the last two tests showed it under 5! I definitely am diabetic though, if I eat many carbs or sweets my blood sugar skyrockets. I asked my endocrinologist and my PCP who handles diabetes for many of his patients, if it is possible that I am no longer diabetic and they both said once you are diabetic you always are. I am finding this very confusing.
JK

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Since my recent test was 6.1, down from 6.8, because of strict eating and more active working outside, I don't think I should be taking as much Metformin. I get nauseous after three hours, and I was nauseous when I first took two Metformin pills. My endocrinologist dismissed me, and my doctor says nothing.
According to your guide, I am pre-diabetic, but I avoid spiking blood sugar like the plague. My blood pressure is down, and I have cut my one BP prescription from three pills a day, which made me feel awful, to one pill a day, and I feel so much better. I have plenty of greens from my garden now and intend to spend the summer eating them, both raw and cooked, with a little beef and chicken, and a lot of fish, no white potatoes or white bread. I still feel I need to lose weight for the diabetes management and for fitting into clothes in the store. My waist size is out of range. I feel there is more work to be done in my case.
Is too low a number bad for my heart? I have an irregularity which the doctors say is no problem. I am not at risk for strokes. I am 84. Now what? Dorisena,

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@dorisena

Since my recent test was 6.1, down from 6.8, because of strict eating and more active working outside, I don't think I should be taking as much Metformin. I get nauseous after three hours, and I was nauseous when I first took two Metformin pills. My endocrinologist dismissed me, and my doctor says nothing.
According to your guide, I am pre-diabetic, but I avoid spiking blood sugar like the plague. My blood pressure is down, and I have cut my one BP prescription from three pills a day, which made me feel awful, to one pill a day, and I feel so much better. I have plenty of greens from my garden now and intend to spend the summer eating them, both raw and cooked, with a little beef and chicken, and a lot of fish, no white potatoes or white bread. I still feel I need to lose weight for the diabetes management and for fitting into clothes in the store. My waist size is out of range. I feel there is more work to be done in my case.
Is too low a number bad for my heart? I have an irregularity which the doctors say is no problem. I am not at risk for strokes. I am 84. Now what? Dorisena,

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@dorisena That bl.sugar sounds good I assume this is you A!C which is great . By the diet and exercise you should be able to give it up but see what the Dr says . I know I was pre diabetic a good while ago my Dr at the time did put me on Metformin and told me if I wanted to go of it i could . So I did as this was to much sugar before I went to see her . The night before I ate a big helping of cake lots of icing and we contributed the increase to that .

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@dorisena

Since my recent test was 6.1, down from 6.8, because of strict eating and more active working outside, I don't think I should be taking as much Metformin. I get nauseous after three hours, and I was nauseous when I first took two Metformin pills. My endocrinologist dismissed me, and my doctor says nothing.
According to your guide, I am pre-diabetic, but I avoid spiking blood sugar like the plague. My blood pressure is down, and I have cut my one BP prescription from three pills a day, which made me feel awful, to one pill a day, and I feel so much better. I have plenty of greens from my garden now and intend to spend the summer eating them, both raw and cooked, with a little beef and chicken, and a lot of fish, no white potatoes or white bread. I still feel I need to lose weight for the diabetes management and for fitting into clothes in the store. My waist size is out of range. I feel there is more work to be done in my case.
Is too low a number bad for my heart? I have an irregularity which the doctors say is no problem. I am not at risk for strokes. I am 84. Now what? Dorisena,

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I have an irregular heart beat too and I think it's called PVC's? Not sure, but the doctors don't seem to be concerned about it. When it's bad, it's very scary.

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@dorisena Did the article say why below 6% can make heart disease worse? That seems somewhat contrary to what I thought.

Since my recent weight gain, I am definitely feeling different from before. I now get somewhat lightheaded when I am hungry which had not been a problem for a very long time. I am trying so hard to lose this extra weight but it is very resistant. I am exercising but I guess it is not as much as when I was going to my health club.
JK

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Hello, good topic. I like 1. Know Your Numbers and 2. Be an Active Self Manager. Thanks again for information.

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@hopeful33250

Here is some information on Mayo Clinic guidelines for A1C results,

"Results
A1C test results are reported as a percentage. A higher A1C percentage corresponds to higher average blood sugar levels. The higher your A1C level, the higher your risk of developing diabetes or complications of diabetes.

For someone who doesn't have diabetes, a normal A1C level is below 5.7 percent. If your A1C level is between 5.7 and 6.4 percent, you have prediabetes (also called impaired fasting glucose), which means you have a high risk of developing diabetes in the future.

An A1C level of 6.5 percent or higher on two separate occasions shows that you have diabetes. An A1C level above 8 percent means that your diabetes is not well-controlled and you have a higher risk of developing complications of diabetes.

For most adults who have diabetes, an A1C level of 7 percent or less is a common treatment target. Lower or higher targets may be appropriate for some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan."

If you would like to read the entire article, here is the link, https://www.mayoclinic.org/tests-procedures/a1c-test/about/pac-20384643

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Thank you Teresa for the accurate information. All healthy people like it.

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@contentandwell

@dorisena Did the article say why below 6% can make heart disease worse? That seems somewhat contrary to what I thought.

Since my recent weight gain, I am definitely feeling different from before. I now get somewhat lightheaded when I am hungry which had not been a problem for a very long time. I am trying so hard to lose this extra weight but it is very resistant. I am exercising but I guess it is not as much as when I was going to my health club.
JK

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The article didn't say what made heart disease worse, but I know the heart is a muscle, so it seems to me that it should be exercised to keep healthy. I read about muscle wasting in the elderly who sit around, so that may be a factor. I think old bodies eventually wear out and die regardless of how hard you work at it. But I don't feel ready for that eventuality yet. I can't get the weight to budge, either, but at least I don't have a problem with gaining if I stay active. I don't need as many calories each day, and I eat slowly and chew a lot. If I ever get it figured out, I will let you know. Ha Ha! When I was first married, I was dizzy if I stood up fast after getting a pan out of the lower cupboard. I must have been in really poor condition because of an inactive life. That soon changed on the farm where I worked myself too hard, had allergies, and worried my self terribly over financial debt. Those days are over for me now, and I concentrate on peace and happiness doing the things I enjoy first and the jobs I don't like eventually when I get around to it. Dorisena

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@dorisena

The article didn't say what made heart disease worse, but I know the heart is a muscle, so it seems to me that it should be exercised to keep healthy. I read about muscle wasting in the elderly who sit around, so that may be a factor. I think old bodies eventually wear out and die regardless of how hard you work at it. But I don't feel ready for that eventuality yet. I can't get the weight to budge, either, but at least I don't have a problem with gaining if I stay active. I don't need as many calories each day, and I eat slowly and chew a lot. If I ever get it figured out, I will let you know. Ha Ha! When I was first married, I was dizzy if I stood up fast after getting a pan out of the lower cupboard. I must have been in really poor condition because of an inactive life. That soon changed on the farm where I worked myself too hard, had allergies, and worried my self terribly over financial debt. Those days are over for me now, and I concentrate on peace and happiness doing the things I enjoy first and the jobs I don't like eventually when I get around to it. Dorisena

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I agree, @dorisena The heart is a muscle and you do need exercise to keep it in shape as with all other muscles. This does not address why an A1c under 6 would be bad for your heart though.

Yesterday I took a shower in the afternoon and suddenly felt very light-headed and almost like I could pass out. This would happen to me when my diabetes was worse so as soon as I got out of the shower I went downstairs and grabbed a Kind snack bar. That helped a lot. I was literally at a point where I was afraid I might pass out and that's the last thing I need — that was what caused a fracture last July.

When I was young I too would get dizzy when I stood up, particularly from a crouching position. That was from low blood pressure which mine generally was.

I really am being good with my diet and am getting exercise daily, but the weight is not budging. 😖 I am getting very discouraged.
JK

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dorisena, i hope you are very strict about whole foods, avoiding hidden sugar and eating fairly routinely so your sugar can be managed. I am healthy but have a few extra pounds and I am giving up sugar, white flour and most highly processed food and I find I am much happier, feel better, and I can eat as much as I want because, I don't want so much of the healthy foods and I get satisfied and stay satisfied. I have never been big on junk food but I was plagued with 10 extra pounds from time to time. Ten pound is equal to 4 extra inches on my waist which is unhealthy visceral fat and very ugly fat. I am committed to getting rid of my ugly fat with a healthier diet.

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I appreciated your comment strictly adhering to nutritional value. Thanks for covering it.

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@hadit17

Thank you Teresa for the accurate information. All healthy people like it.

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Hello @hadit17 and welcome to Mayo Connect.

I see that you have an interest in the A 1 C discussion. I appreciate you sharing comments. Are you a recently diagnosed diabetic? As you are comfortable doing so, please share with us a little about your experience with diabetes.

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I have an interest in: 1. Know Your Numbers and 2. Be an Active Self Manager. I take an interest in self care too. I was diagnosed with Type 2 Diabetes in 2019. My Dad had Type 2 Diabetes. In 2014 a severe accident was the cause of taste and smell distortions. I need more tender, leafy greens.

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