"Normal blood sugars" vs "Normal A1c"

#1

Hello all!:grinning:

A question, which has been on my mind, pertains to “normal blood sugars” vs “normal A1c”

For example- Say my A1c currently runs 5.7 on a low carb diet without exercising; and if I am very disciplined (working out and eating perfect) I can get it down to 5.3.

I am assuming that if I go to a doctor, asking to be treated for diabetes- they will say that I am doing fine and not to worry. I have heard some say that a normal blood sugar is 83 and normal A1c around 4.4. So- Say that I would like to do the best I can and say I buy into striving for “normal blood sugars” or an A1c of 4.4 - I am going to need some help (meds or insulin).

I am still trying to understand “diabetes”. When I check my blood sugars- I don’t see large increases after meals (maybe a little over 100) (because I don’t really eat any carbs. I actually often see blood sugars in the 70’s when I get home from work, bc I skip lunch to stick with two meals a day. Unfortunately, my morning blood sugars are often 90-100 range (suspected dawn phenomenom).

My initial impression is that even though these are not “wild swings” in blood sugars- perhaps I could/should minimize these swings even more. Following this line of thinking- perhaps small dose of insulin before my breakfast and dinner; and/or some in the evening to counter my dawn phenomenom may balance out my blood sugar (make it more uniformly stable).

I have been shooting for a “good A1c” but i’m now thinking it may not be the best approach to achieve it by having somewhat lower blood sugars half the time; in order to compensate for the inevitable blood sugar rises after eating and that are due to dawn phenomenom.

Sorry to be long-winded. I appreciate any thoughts or input.

Thanks!:grinning:

(KCKO, KCFO) #2

This chart made sense to me, so we use it.

https://www.joslin.org/info/Goals-for-Blood-Glucose-Control.html

#3

That chart looks good to me. I am not diabetic but my BG hovers in the 90s most hours of the day. My A1C is 5.7.

BG dips into low to mid 80s when fasting.

But no way would I want to take pills or insulin to just fall lower in the normal range. LCHF eating and IF should naturally lower your BG.

I once asked my doc about putting me on Metformin for just the reason you asked —afraid of pre-diabetes. I was at BG 98 -102 normally. He refused. He said I was insulin resistant and needed to get my weight down. He was enlightened and correct. Thirty less pounds later and I am thanking that doctor big time.

We all need to rethink our personal dilemmas and set priorities. Biggest thing is to simply not quit trying.

#4

Thanks for the reply.

I think I get where you are coming from. I’m curious- if I may ask you- did your doctor check an Insulin Level when he diagnosed you with Insulin Resistance. If you did have one then- has it gotten better along with your BG and weight loss?

The reason I ask is that I continue to have a hard time understanding my situation. My current Insulin Level is 1.8 well BELOW the normal range. My HOMA- IR is 0.4 which suggests I am very insulin sensitive (at least on Keto). My HOMA- B is 32%- which sounds low to me and suggests to me that my pancreatic function is low. So it is in this setting that I am considering something to help in lowering or stabilizing my blood sugars.

It is fair to say that A1c of 5.4 and 5.7 are fine and not to worry; because most consider that to be “normal range”. But I was surprised to find some fairly reputable people advocating for even lower blood sugars.

I feel great on Keto and have no problem adhering to it. I am just concerned bc I have no more weight to lose and unless I am misunderstanding (which i could be) fasting is supposed to help lower insulin; but my insulin level isn’t going to go much lower.

Thanks again.

#5

You just might be suffering from stress related excess insulin production because of your cortisol secretion. Worrying about your blood numbers could indeed skew your results. Chill. Your numbers sound great. Keep doing what you’re doing. Just relax. And how’s your sleep?

(Heather~KWOL for life!) #6

Normal fasting blood glucose range is 80-100 and A1c should be below 6.4

(KCKO, KCFO) #7

In this one, Richard has explained about beta cells being damaged/destroyed whenever BG is above 6mmol, and regenerating when BG is below 6mmol.

Also in one of the theads he states optimum should be below 5.7 for pancreatic health especially.

Sorry I can’t find the link, got too many of them LOL.

My husband’s dr. if fine with his a1c at 6, I want it lower. But I refuse to nag him, I just remind him I want him healhy and around for many more years. He is great at keeping it right at 6, but he would be healthier at a lower number.

Sorry I can’t find the link, got too many of them LOL.

(carl) #8
#9

Thanks for those links! That first one of Richard and Carl at San Antonio really gets to what I was thinking about.

Thought experiment- so even though my A1c never went over 5.7 except one reading of 6.0 it is theoretically possible my pancreatic B cells were dying off from “mild hyperglycemia”.

Another thought- That link suggests to me- that a lot of people in general are underestimating the level of blood sugar we should be aiming for. If 5.5 A1c is the highest level that pancreatic B cells remain safe- who would want to skate right on that line? On the other hand- is it possible that b-cell toxicity to glucose is variable (the old N=1) and that some people are just more or less lucky than others in that regard?

Thanks again.