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Re: [IP] A1c refetence diferentiation question...



While it is true that an A1c reflects blood sugar over 2-3 months, it is
actually more heavily weighted towards the more recent blood sugar levels.
I know someone sent me a scientific article at one time explaining it, so
I'll see if I can dig it up. So, the last month of your blood sugars will
have a greater effect on your blood sugar than the previous months, which
may explain part of the trend you see.  I remember my own A1c dropping
nearly by over 10 in the month after I was diagnosed.

Also, it is possible to get two different values from the same testing
machine on the same day, probably not as much as 0.7.  I don't suspect that
the A1c machines, like our home blood glucose monitors, are 100% precise.

As to what constitutes good control, that varies.  There are different
guidelines out there.  My impression was that the ADA said aim for less than
7.0, while the American Association for Clinical Endocrinologists has
published <6.5% as their goal.  Personally, I think my own endo's office
aims for A1c between 6-7 for type 1's with between 6-6.5 being preferred.  I
say for type 1's because I know when mine were in the high 5's, they were
concerned about me having too many lows.  I think that your CDE has the
right idea, that goals should be based on the individual and it should be
based on more than just an A1c.  Day to day fluctuations are just as
important, so I would trust the opinion more of someone who had carefully
studied your blood glucose records, rather than making a blanket judgement
based on a single number.

~Emily
.
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