A1C Less Accurate As We Age and Other Fun Things You May Not Know

A1C test

Great. So, there’s more to the A1C number than just the result?

Yes! Many factors can interfere with the A1C result (keep reading to see the loooooong list) but your Sweet People Club diabetes care and education specialists, Stephanie Bouquet and Theresa Garnero were surprised by what they learned at American Diabetes Association’s Post Graduate recently held in San Francisco.

We made a quick summary video of key points along with 2 nutrition-related resources. Other insights gleaned were shared during our recent virtual Office Hours and are worthly of future blog posts!

Famed Dr. Irl B. Hirsch reviewed several areas about the A1C that are relevant.

  1. Only compare your A1C value against your own. In other words, don’t compare your A1C to someone else.Why? The A1C result is given in a percentage value with an estimated glucose average. That value represents a range of numbers.Consider for example:
    An A1C of 5% has an estimated glucose average of 97 mg/dL (or a range from 76-120).
    An A1C of 6% has an estimated glucose average of 126 mg/dL (or a range from 100-152).
    An A1C of 7% has an estimated glucose average of 154 mg/dL (or a range from 123-185).
    An A1C of 8% has an estimated glucose average of 183 mg/dL (and a range from 147-217). So it is possible that one person with an A1C of 6% (range of 100-152) and another person with an A1C of 8% (range of 147-217) may actually be in the same range (since values overlap from 147-152 in that example).
  2. A1C values become less accurate as we age.
    This especially holds true is you’re over age 65 and your A1C is 5.7-6.4%. To get the best data, your provider can do a 2-hour glucose tolerance test but many find that impractical, so just keep self-monitoring your glucose via a blood sugar meter at various times during the day (like before and 2 hours after a given meal). Your provider may consider a professional version of a continuous glucose monitor (you’d wear the device for a week – like a Holter monitor – and return to the office to have the numbers analyzed).
  3. Achieve your A1C target early on as it becomes harder to do so overtime.
    When blood sugars are above an ideal range, many people prefer the wait and see approach to try to find a way to lower them without medication. Research suggests that by going on medication early in the diagnosis, ideally two different kinds of medications, can help you to maintain an ideal A1C over the rest of your life.
  4. MANY things can alter an A1C. This is a partial list!

A list of what can alter an A1C result

My take home and personal favorite is to not compare A1Cs with someone else because of the wide range of variability. It sure helps not to tap into the guilt trip when your A1C inches upwards meanwhile your pal’s A1C is lower.

Hopefully these insights will help you to see the big picture of the many variables and to not give up when your A1C “report card” comes in. It’s a useful, personal tool.

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One Comment on “A1C Less Accurate As We Age and Other Fun Things You May Not Know

February 15, 2020 at 11:35 am

Awesome Theresa!
I initially had no idea what you were talking about AND one can glean an important awareness from the specifics. Well written. Thanks, Janelle


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