From Sturgeon Bay, Wisconsin, USA:
The most recent Hgb A1C results for my 7 year old daughter with Type 1 diabetes have been 7.8 and 7.6. Her pediatrician says that Hgb A1Cs less than 8.0 are acceptable for her. Do you agree?
HgbA1C is a test which reflects the average blood sugar over the past 2 - 3 months. It is a relatively crude test that tells you nothing about the blood sugars that make up the average. For instance, you can have the same average blood sugar with either wide variations in blood sugar or minimal variation in blood sugar. No one really knows if there is a difference in these 2 patterns regarding the risk of complications in the future.
Different laboratories have different "non-diabetic" ranges of Hemoglobin A1C, so you really can't talk about a value without knowing the normal range for the laboratory where it was measured.
I think it has become clearer that ideally everyone would be able to keep all their blood sugars in the normal non-diabetic range (with non-diabetic range of Hemoglobin A1C's). I think it has also become clearer that at the present time, this goal is unattainable for most individuals with insulin dependent diabetes after the remission phase is over.
In my opinion, one should aim for "as close to normal blood sugars as possible while avoiding frequent or severe low blood sugars". I don't think one can say what's "acceptable". I think each individual should aim for their "personal best". Some individuals can obtain better control with less effort than others.
Fortunately, there is intensified research going on to find new ways to better control the blood sugar. Try to keep in mind that even if you can't get perfect control, every effort pays off in better health for the future.
Having been educated in the "strict control" philosophy many years before the DCCT trial, I have always believed that "nature knows best" and that ideally treatment should aim for normal blood sugars. On the other hand, after years of trying to find the means of perfect control, I feel that the DCCT study has confirmed that this is not possible for the majority of individuals with our present tools of control and am pleased that the results of the DCCT study seem to be leading to renewed interest in research towards new, innovative methods of control or cure.
Keep up the hard work and enjoy life to the fullest!
[Editor's comment: There are efforts underway to standardize the "normal ranges" for glycohemoglobins; eventually, the range for the test should be the same in every lab, if these efforts succeed. But don't hold your breath while waiting for this to happen. WWQ]
Original posting 25 Aug 97
Last Updated: Tuesday April 06, 2010 15:08:53
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