A1C of 6.5%
Diabetics will often refer to their “A1C” in terms of a number they got as a result of their A1C test. This number is usually considered to be a fair indicator of how well (or poorly) their glucose levels are controlled.
The A1C (HgbA1c) test measures glycated hemoglobin, the approximated average percentage of red blood cells that have linked up with glucose molecules. The more glucose in the blood, the more glycated hemoglobin.
Since these glycated blood cells last about three months in the bloodstream, it is a good indication of glucose control over that period.
Years ago, my doctor — following the American Diabetes Association guidelines at the time — told me that I was doing okay with an A1C near 7%. But I was not doing okay. It was one of the factors that led to a heart attack.
An A1C of 7% indicates an average blood glucose level of 150 mg/dl (8.5 mmol/l). Studies by both the American Association of Clinical Endocrinologists (AACE) and the International Diabetes Federation (IDF) show that anything above 140 mg/dl (8 mmol/l) significantly raises the risk of heart attack.
The AACE Position Statement
The IDF Guideline
The maximum glucose for optimum diabetes control then should be 140 mg/dl (8 mmol/l). It shouldn’t be even that high all the time. That’s the maximum glucose level up to two hours after meals. But between meals it would be better to have a level closer to 100 mg/dl (5.5 mmol/l).
These glucose levels should result in an A1C of 6.5% or less. This is the targeted goal I recommend for every person with diabetes, whether type 1 or type 2.
It is always important of course to determine your own A1C goals in consultation with your doctor.
