Endocrinology-Diabetes Questions Diabetes risk

My HbA1C reports have reduced from 7 to 4.2. Does it mean I'm no longer at risk for diabetes?

My HbA1C reports were at 7 about 7 months back. I was on a strict diet and workout plan and now my latest report says that my HbA1C has dropped to 4.2. Does this indicate that I'm no longer at risk for diabetes?

12 Answers

You are still at risk for diabetes since you had diabetes when your A1C was at 7, but as you have proved by changing your diet, that you can improve and sometimes reverse diabetes by lifestyle modifications. You can maintain normal levels of glucose control and A1C by continuing to monitor healthy food intake and exercise. However if you go back to eating the way you have been previously, you have a high risk of re-developing diabetes again.
You are still a pre diabetic and as you age the levels will go back up. You need to maintain a normal weight which will delay the disease return for the longest possible time. Diabetes is a cellular resistant state which does not go away permanently.
These results suggest that you are doing a good job in managing your diabetes. Obviously, your pancreas produces insulin and being on the proper diet with a consistent program of exercise ensures that you remain sensitive to insulin's action without resorting to medications. Diabetes has now receded into the background, but may again become an issue if your lifestyle changes drastically with weight gain and inactivity.
It means that the diabetes is well-controlled by either lifestyle changes such as diet and exercise or medications.
Diabetes can be in remission but there is no cure so you are at risk for diabetes even when your HbA1c has normalized.
If this A1c was achieved without medication, great Job! In this case it appears that diabetes has resolved but can come back with improper diet and weight gain.
Only as long as you keep up the diet and exercise... the moment you stop your sugars will rise!!

Yes. It means that you are not a diabetic now; and your risks are that of a healthy individual. However, if you change your lifestyle to a less rigorous one - especially your diet - you can revert back to a diabetic state any time.


Dr. Sunil
This means you are doing much better now. You are still at risk of having high blood glucose in the future, especially if not staying on your diet & increased exercise.
No it does not. What it means is that you have been good & gotten the diabetes under control. Diabetes is a genetic disease we get from our parents & we cannot change our genetics. We can control circumstances & life style & make it better. You have done that well & should complement yourself. You still have diabetes but it under control. Lapse into overeating, under exercising, wt. gain & obesity and you will see your diabetes come back & HbA1c go up. Congrats. on what you have achieved.
You have done a tremendous work by improving your sugar trends and insulin resistance. Now the important part is to maintain it to continue with normoglycemia. Rebound weight gain will predispose you to the same diabetes risk.
First, congratulations on reducing your hemoglobin A1c!

Your hard work and dedication has obviously served you well.

I would like to first point out that the test 'HEMOGLOBIN a1c" is a test that may not always tell the truth. In that, I mean the term hemoglobin loosely refers to red blood cells. Our red blood cells typically live to be 90-120 days. Our hemoglobin is changed in such a way (glycated) when our glucose is at a particular level and we can pick this up in a blood test called hemoglobin A1c. As such, anything that affects the RBC/hemoglobin will alter the HbA1c result. In example, getting a blood transfusion (somebody else's blood!) will lower the HbA1c.

Hence, as an Endocrinologist, I corroborate the HbA1c to fingerstick sugar checks to make sure they are close.

Regardless, it sounds like you have worked hard enough "to beat" diabetes. Diabetes unfortunately has an underlying genetic component (albeit we aren't exactly sure what gene/s), and you will still have some predisposition to diabetes.

In short, you're always at risk, given you had diabetes at one time. I would also caution that if this was not traditional 'type 2 diabetes' that you may have something called 'Latent autoimmune diabetes of adulthood' or 'LADA', in which people can "honeymoon" for many years without need for medication or insulin. This is unlikely, but a consideration.

Hope this helps and congratulations again on your extremely impressive efforts!