What is a normal A1C & cholesterol?

Dr. David Erani


Let’s start with A1C. A normal A1C for a person without diabetes is an A1C less than 5.7%. One who has an A1C between 5.7 and 6.4 is considered to have pre-diabetes. I’m not sure if what you are asking about is a “normal” A1C or a good target A1C for someone with diabetes. I’ll assume you mean the latter as it is a more interesting question. There is no one right answer to that question. Until 15 – 20 years ago, we did not have solid evidence that lowering A1C was beneficial for people with diabetes. We now know that controlling blood glucose, as indicated by A1C can decrease the risk of many of the complications of diabetes. Once that was established, the question was “How low should you go?” From more recent studies we know that lower is not always better. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial was stopped early because the group of patients in whom a lower A1C goal was pursued was found to be more likely to die. The A1C goal in this group was less than 6.0%. The lesson that came from ACCORD and other studies published around the same time is that there is no one A1C goal that is right for every person. The A1C goal must be individualized. Coming up with this goal is a matter of weighing the potential risks and benefits of blood glucose lowering. Joslin’s guidelines and the ADA (American Diabetes Association) guidelines call for an A1C goal of less than 7.0% for most people with diabetes. In general, those who are younger, have had diabetes for a shorter period of time, and have fewer other medical problems can benefit from a relatively lower A1C.

January 1, 2013 at 6:33 pm