Why Does The ADA Say An A1c Of 7.0 Or Less Is Good?

By Richard157 Latest Reply 2009-01-09 20:40:07 -0600
Started 2009-01-06 18:35:21 -0600

My doctor wants my A1c below 6.0 since that is a nondiabetic level. Other sources recommend 6.5 or less. The ADA says 7.0 or less, but WHY???

Here is a response to this question from someone on another site.

"(1)The ADA isn't focused on lifelong Type 1s, they try to serve the interests of all diabetics at the same time. The vast, vast majority of diabetics are midlife and senior T2s.
Among that population, many aren't being treated at all (they haven't even been diagnosed). So, merely getting fasting bG tests done at all, and interpreted correctly, is a big focus.

(2)Among those Type 2s who HAVE been diagnosed, many will still have a short life expectancy no matter how aggressively their diabetes is treated. (Old age, Alzheimers, etc.)
And many of these people are so set in their ways that's it's really hard to get them to do even moderate lifestyle changes.

(3) But by far the most important reason is this: A vast majority of T2 people have A1c values far, far above 7.0, and ADA has decided not to set the bar so high that nearly everybody fails to reach it.

ADA has documented the discussion and reasoning behind this goal of 7.0 and I've read that documention on the web, although I didn't keep the URL.
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On the other hand, DCCT really did, if I recall correctly, demonstrate a high statistical confidence that 6.5, and even 6.0, are significantly better than 7.0 for life expectancy— when you specifically exclude causes of death directly related to Hypos. So, for attentive and dedicated diabetics, 6.5 or even 6.0 is VERY clearly a more appropriate goal— if you can reach it without causing numerous hypos as a side-effect."

The discussion above is another person's opinion but I feel that much of it is correct in my own mind.

What do YOU think?

8 replies

firefightermom 2009-01-10 11:40:07 +0900 Report

hey,I saw this poster at the doctors office that was about AIC numbers this isnt exact but it said something to the effect of if your AIC is between 6-7 youre blood sugars were running around 70-150 on average for 3 months if it was 8-9 B.S running 180-200 on average and so on you know 10-11 would be 200-300 B.S on average of three months,that is what the AIC test does it tells the average of what you blood sugar has been over a three month period thats why it is important to have that test done especially if someone doesnt check blood sugar levels on a regular basis every day same time of day.Hope that helps,it helped me when i saw the poster.good to meet you.

GabbyPA 2009-01-10 10:08:38 +0900 Report

The reason that these numbers are set where they are is that they are still giving you a lot of slack just for being diabetic. If you read your lab reports, you will see that a non-diabetic patient A1c is 4.8-5.9. So if you want a "normal" reading, that should be our goal.
So I don't really see that below 7 is such a high bar...just a high number.

2009-01-10 01:43:39 +0900 Report

My last reading, which was just a couple of months ago, was 6.1, and my doctor was very pleased with that, especially since I was able to get to that point without taking any medication whatsoever. I just got there by watching what I ate, etc. I'm trying hard not only to keep it there, but maybe lower it somewhat. Don't want it to start raising again. That would definately be the wrond direction!!

2009-01-08 12:31:12 +0900 Report

I agree that a goal of 6.0 or below would be better for people in general. My last one was 5.8 and I feel great!! I'd like to try to get mine even lower but I do have a tendency to have lows. (Not so often anymore since I've been on 2000mg of cinnamon a day though hmmm) 45 years of it and simple cinnamon regulated it? Hard to imagine. Anyway, my point was I agree that 6.0 is better for a goal.


Anngelia 2009-01-08 02:11:55 +0900 Report

For years mine was always right about 6.9 0r 7. I thought that was great because I had always heard it should be below 7. Then about a year or two ago I made some changes and now mine always seem to be about 6.4 or 6.5. My fingers are crossed that it will continue to go down.

Anonymous 2009-01-08 01:26:17 +0900 Report

My last A1c was 6.9 and my doctor and I were thrilled because it has taken along time to get there. So for me it was great.

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