Endocrinology-Diabetes Questions HbA1C

What should be the ideal HbA1C for a diabetic patient?

I've been diagnosed with diabetes last year. I was not taking medication for a while, however, because my last HbA1C level was 11, I started out on medicines. What should be my ideal HbA1C to aim for?

9 Answers

That depends on your age and underlying medical conditions. Ideally we want A1C under 7%
Ideally, your HgbA1c should be in the normal range (below 6.0) with proper control of your diabetes. The usual minimal target for diabetic patients is a level below 7.0.
You should focus on your blood glucose result before breakfast ('fasting').
The target we recommend is between 80 - 120 mg/dL. If you are consistently in this range and you observe diet guidelines and exercise regularly, your blood glucose level will stay near this range throughout the day. Your hemoglobin A1c (HbA1c) will improve. Targets for HbA1c are 7 % or less. To use nutrition to your advantage in achieving these goals read my book
'A Blueprint for Healthy Eating: Your Diet Guide for the New Millennium.' available through www.mer-llc.com
This is a slightly more controversial question than you would expect. The simple answer is that you would like your A1c to be as low as possible without experiencing hypoglycemia. So if you could get to an A1c of 6.5% or lower without hypoglycemia, that would be great. However as people age, the risk of hypoglycemia becomes greater because it stresses the heart.... so for older individuals, endocrinologists generally use the rule of thumb of keeping A1c <age/10.... so for a 75 year old person, <7.5% and for an 84 year old person <8.4% is ok, etc.
< 6.5 to 7.
The ideal Hbaic is determined by your age. If you are under 65 the goal is 6.5-7.0 without hypoglycemia. Every time your Hbaic is one point above 7 the cardiovascular risk doubles. eg. 8 double, 9 times 4, 10 times 8. So you clearly want to be 6.5 to 7
Around 7% is great
It’s dependent on your age and other medical issues. The data though is very consistent that the lower the a1c the longer you will be able to prevent diabetes complications. The trick is to work with your doctor and address your daily routines and medications to assist you in improving your control.
This is a bit controversial right now. The American Diabetes Association has said for a long time (based on long-term outcomes studies) that HbA1c should be less than 7%. The International Diabetes Federation says <6.5%, as does the American Association of Clinical Endocrinologist (AACE). Recently, a group representing internal medicine physicians said that the value should be between 7% and 8%. I believe, based on many outcome studies (including studies I have done), that the value should be 6.5% or less, but I would except 7% or less in some people. Some of this disagreement has to do with age and other factors. My father was 91 years old when he developed diabetes and I wasn't too concerned that he would develop blindness in 30 yrs. So age and social conditions must be taken into consideration, as do other factors. BUT 11% is much too high as is in a level that is almost certain to cause complications such as blindness, neuropathy, kidney damage, heart disease, stroke, etc. If I were treating you with a HbA1c of 11%, you would have started insulin right then. AACE says start insulin injections at HbA1c >9.5%. I start it at 9% as I want to prevent any dire complications.