I just had my A1C done and was looking over the blood work. My fasting BG was 139 then off to the side it gives normal range of 65 - 99. I have always been told that if your under 140 it is good but the lab work says I'm high.

For the A1C I am at 6.9 and off to the side it says normal is 5.7 or less. And again I have always been told I need to keep it below 7.0 and that is good.

I am wondering if the lab is right in there range or the doctors I see? Now I know why I stay confused all the time.

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Any BG above "normal" is causing damage to your body. Currtent thinking says over 140 is dangerous. This does not mean anything under 140 is good.

This is a great point Randy.

However, I'll even go further and say that if you read the research cited to make the claim that 140 mg/dl is the threshold for damage, the research itself makes no such claim. They aren't even designed to find the exact threshold where damage begins.

What they do, generally, is seperate subjects into cohorts based on an oral glucose tolerance test. Using ADA guidelines, they determine who is normal and who shows Impaired Glucose Tolerance (IGT). The ADA guidelines say that anybody with a glucose tolerance between 140 and 200 mg/dl is considered impaired for glucose tolerance. What they show clearly is that a higher percentage of people with IGT versus normal glucose tolerance have any number of common diabetic complications regardless of whether or not they have actually been diagnosed as diabetics.

Current thinking, then, interprets these results to mean that damage begins at 140 mg/dl, which I think is a bit of a loose interpretation. Not necessarily wrong, but certainly not one that the resarch fully supports. Nobody is going to be surprised to find out that if they look at all of us diabetics, who all would be a lot worse than 140 mg/dl on a glucose tolerance test, that there a greater incidence of diabetic complications compared to a group that scores normal.

I don't think 140 is, necessarily, a number to get wrapped up in, either way.

We all want to be normal. Why not shoot for normality, whatever that number actually is? For us diabetics though, it's a game of averages. If I roll into a lab with a BG of 139, I know that's not what it would be if I did not have diabetes. But I do have diabetes, so the only thing I can do is work to make sure that my BG is going to be lower than that a lot more often than not.

Thanks FHS. I know this is all subject to our individual D challenges. I believe that everyone here is trying their best to manage their D successfully. To a greater or lesser degree our results will vary. Both person to person and day to day. Unfortunately, due to my own bad choices, I had severe retinopathy and PN at diagnoses. I tackled D like my hair was on fire. I didn't know if these things could be reversed, but I was not going to loose my eyesight or anything else if I could help it. Fortunately I have been able to reach and maintain a great A1c and have very consistent BG's. None of which I could have done following the professional dribble. I have seen and felt what the future holds for that kind of management and I want no part of it. If I had accepted the "7.0 is where you want to be" party line I would NOT be able to drive today. My job would be gone and my life would be miserible.

That's awesome.

I got off to a good start with some excellent care. I kept my A1cs in the 4s and low 5s for the first 5 years after my diagnosis and received nothing but support and encouragement for my efforts from my endo and other diabetes care folks. Unfortunately, I squandered that great start with years of neglect, to the chagrin of the same team that kept me on the right track at the beginning. It took a slap in the face by complications to wake me up to the realities of diabetes.

I got back in the saddle, got my BGs back under control, and have been fortunate enough to see those complications reversed. Again, I have a new supportive endo and diabetes folks who do not force feed me teh standard lines. I have to admit that he shows concern when my A1c drops below 6.0, but he's satisfied with the results and doesn't make a big deal about it.

Hi Uniboy. I understand your dilemma.

The trouble with A1C is that it is an average - and if you spend half your time in the mid-200's and the other half in the 20's (God forbid!!) you'll have a fabulous A!C, right? But you won't feel or be healthy.
I think the medical establishment is gradually realizing that the lows, especially deep ones, are also damaging to our bodies - At my last visit my doc mentioned that I should avoid lows because research is finding they do cognitive brain damage (I think I could have told him that, but not when I'm low - ha!). I also wonder if retinopathy is related to too many lows, though that is totally my own private theory.

So perhaps we need to aim for the lowest A1C we can manage without too many deep lows?

That's the best I can figure it, anyway. None of this is easy. All we can do is keep trying.

-Linda

This is what Dr. Bernstein calls "the power of small numbers". If you stay pretty tight and low-carb, then you only have to make small corrections. Smaller corrections = fewer wild swings in blood glucose.

Worms are pretty high in protein and low in carbs, but...no. I've never heard him recommend them. ;0)

Because medical professionals either don't know how to guide patients to having good control, or don't have the time or inclination, they assume that serious lows are inevitable. A cop out. I'm weary of hearing this party line. Feels like they've thrown up their hands in defeat regarding education. Why we've got to educate ourselves.

Forgive me here but around 15 years ago when I started haveing some lows that hit the record book my Endo said that when that happened and depending on how long they were taking place I was warned about the barin being depribed of insulin during thats and he toldme to really watch out when they happened. Now given this was a few years back and it's probably changed since then but just wanted to say it. I hopethings are much better now.

Oh c'mon, there's no record book, I've seen 11, 12, etc. on uh, a few occasions... not for a while, I think the Ultra-Mini doesn't go as low?

As someone who is going through a longish rough stretch with control due to female hormones, it's given me the perspective that perhaps the doctors realize how frustrating and disheartening it can be when some patients *can't* (and yes I mean *cannot* despite eating almost carb free, logging, cgm-ing, and monitoring constantly) stabilize bg levels where they need to be.

I'm doing my very best with every ounce of effort I have to give and can't get where I need to be. All I can do until the menopause is done with me apparently is chase a moving target.

Right now, for me, the truth is that control *is* near impossible.

Uniboy, work as hard as you can and celebrate your successes. Your numbers are still really good.

That sounds rough, smileandnod and I hope your support system understands. I think doctors are braced for the many people with Diabetes that are not doing their best to manage their D, and when they see us coming it's like they expected elephants and got unicorns. (I was going to say zebras but I decided to make a judgement call!)

I'm lucky I was diagnosed after menopause (as well as after many of life's travails.) Hang in there until the ride slows down and treat yourself well.

Over the last three months my diet has been terrible and as a result I have a high A1C. Trying to curb my diet is the hardest part of being diabetic. There have been nights I have gone to bed in the 300's and have woke up just as high. In the last few weeks I have stopped this kind of behavior. I keep trying to do better. I'm shooting for a 6.5 A1C next time.

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