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From Kuwait:

I am a 19 year old male who has had type 1 diabetes for two years, and my A1cs (done every four months) range 6-9%.The most recent tests are 8.5% whereas most of the earlier tests show results that range from 5.8-7.5%. Is there are chance I will develop complications in the future if the A1c test results remain within this range? What range could be considered critical for developing the complications?


One value does not predict complications. The best long-term data followed patients with type 1 diabetes for over nine years. The individuals with intensive control (three or more shots per day or an insulin pump) had hemoglobin A1c levels around 7.2% over the duration of the study, compared to usual treatment at around 9%. The intensive treatment group had a greater than 50% reduction in complications, including eye, kidney, and nerve complications. [See the DCCT webpage for additional information.]

I think the best policy is to aim for a normal hemoglobin A1c, unless low sugars interfere. That means setting daily goals for sugars in the appropriate range and gradually working toward the goal you want. The American Diabetes Association recommends a hemoglobin A1c less than 1% above the normal range for the test. Some labs have slightly different normal ranges, depending on which lab performs the test. Above all, the recent high hemoglobin A1c is a reminder that you need to intensify your treatment. I would not dwell on the higher value now. It is not necessarily true that you have a higher risk for complications.


Original posting 13 Aug 2003
Posted to Tight Control


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Last Updated: Tuesday April 06, 2010 15:09:48
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