For the past few decades, a person with diabetes’ measure of how they’ve been doing has been their hemoglobin A1c. Sometimes called HbA1c or just A1c, this test measures your averaged blood glucose over the last 2-3 months. Before glucose sensors were commonplace, this was one of the only ways to really measure how a diabetic has been doing. It is kind of like a report card, with the goal being an A1c of 7% or below.
A1c levels are quickly becoming things of the past for many people with type 1 diabetes, though, with the accuracy of sensors improving with every update. Doctors who are active in T1D will say that an A1c doesn’t mean much, because just because you have a ‘good’ average doesn’t mean you have ‘good’ control of your blood sugar. You could have an average blood sugar of 125, but you could still be riding above 250 a good portion of the time… It just means that you’re also riding below 70 a good portion of the time, when you don’t want to spend much time in either of those ranges.
The American Diabetes Association says ‘good’ control is an A1c below 7%. A person without diabetes will have an A1c of below 6%, generally the range is put 4-5.7%.
A lot of diabetes culture shies away from discussing A1c levels, as people feel such judgement and shame over imperfect numbers. Diabetes is a full time job, and it’s a lot to manage! When I was in high school, I used my diabetes as a form of rebellion, not realizing the only one I was hurting was myself. Once I got into college and became best friends with another diabetic, I started to take control of my numbers and actually try to take care of myself. For most of college, my A1c was in the mid to low 7%s, and it didn’t seem to matter what I did, I couldn’t get it below that.
After graduating from college, I was placed with Ricki, and as we got to know each other, she tightened my blood sugar range considerably. After a year of being together my A1c was 6.3%, and it stayed there for another year and a half. My A1c was 5.8% at the end of summer, and 5.6% at Thanksgiving. Four years ago, I never would have believed it was possible, but with my dog and my Dexcom, anything is possible.