What's in a Number?

If you are a type 1 diabetic like myself, you know that Hemoglobin A1c is a measure of your average glucose over the past 2-3 months. It is presented to you multiple times a year in the form of a percentage. The higher your glucose levels, the higher the percentage and vice versa. If you happen to meet another T1 you might discuss HA1c, however you would never have the guts to ask. It's a taboo subject. It's synonymous with asking how much they weigh or how old they are. It's off limits. Because it is a way of comparison, a way of telling how well you are managing your disease compared to others. And since this number is controllable (for the most part) by you, it becomes a competition. How low can I go? How am I doing compared to others?

At one of our first meet ups for Young and Type 1, I was introduced to Jacob, a 21 year old male with T1. He sat down on the sofa with his coffee, introduced himself and proclaimed, to prove to all of you that I am diabetic, I'm going to measure my glucose right now. He then proceeded to whip his meter out of his backpack and take his blood sugar. Since you are all wondering what it is I'll show you. He then flipped around his meter and to reveal his result of 96. And thing is, we did want to know. Badly. We all wanted to know.
So what does Hemoglobin A1c really mean for us diabetics?

This is THE number that determines whether we are in control or out of control.  It is the primary tool we have to measure our success or failure. It is the number that every physician wants to know.  It is the number we measure ourselves by or try not to measure ourselves by. It is the number no one wants to reveal.  It is the number we feel self-conscious about and the number we strive to have lower and lower. It is the number we celebrate and the number that can cause tears.  If you want to become pregnant, like myself, it is the bane of your existence for months. It determines whether or not your womb is safe to be occupied. Everything weighs on this number. Which is why I am happy to report most recent result of  6.0% that I thought was impossible to achieve.

Yet, does everything really weigh on this number? My current targets are 70-100 before meals, 140 one hour post meal, 120 two hours post meal. That's a narrow range I have to keep. If I am able to maintain these targets consistently, my average would be 105 which is the equivalent of an HA1c of 5.3%. However if I maintain a range of 30-180, my average is also 105 or 5.3%. The latter is not necessarily a place I want to be in, yet would I be satisfied with a number of 5.3% even if I was bouncing from 30 to 180 each day? While I strive to have my number lower and lower and wait in anticipation for each result, I try to remember that this number is not flawless. It is simple math, an AVERAGE, which might not always tell the whole story. It is not the bane of my existence nor the sole measure of how well I am managing my diabetes. Nonetheless, with my number of 6.0%, I've been cleared to put a bun in the oven and it's not going to get burnt. I feel good about that.


  1. WOOO!! Congratulations! I hope it doesn't take long! I didn't realize the sharing of the A1C was taboo. That just goes to show how out of touch I am. Haha.

  2. Well, I should have specified that it is not taboo online, however I find in the real world face to face T1's don't care to share.

  3. WAY TO GO!! That's wonderful news - the A1C, and the go-ahead on all things Baby. It's hard to not think of the A1C as a report card, but that's exactly what it ends up being.

    And, in that spirit, congrats on your A. :)

  4. Great post..but I have to disagree with you. I openly tell people my A1C when they ask. I'm not ashamed and I'm not shy to ask. It's just a number.

    I think in the D community, we need to start reminding each other that the A1C isn't a report card. It's just an average. If you want a report card, chart your levels and keep track of the spikes/drops. You can have a perfect A1C but have levels that spike then drop drastically. That's not good as all D's know.

    Different D's have different A1C targets. I've met D's online who target for A1C's in the 5's..where as my target is 6.5-7, because I tend to drop low too often if I aim for anything else. Right now, I'm steady in the 8-8.5 range but it's fine because I'm not spiking high too much, I'm not dropping low too much and my average is consistent. While a lot of D's tell me I've got "bad control", I don't feel that way just because my A1C is 1% above my target range.

  5. You are totally right. I try to be as open and honest about my A1C (and my blood sugars and my insulin requirements, for that matter) as possible but it's easy to feel like you might be judged. But I think it's important for REAL people with REAL diabetes and their REAL numbers to be out there.

    I blogged about this exact same thing a couple of weeks ago!! Ironically, my last A1C was 5.3% and, yes, I did a quick happy dance because of the pretty number . . . but I also knew right away that this number ISN'T as "pretty" as it first appears. Because it reflects all of those night-time lows in the 30s and 40s and it also reflects a few of my after-meal spikes to the 180s-190s. It's an AVERAGE and it's so easy for us to forget that and just focus on the number. I have a baby on board to think about and being happy with a falsely pretty number won't do either of us any good.

    But you deserve a big CONGRATS on your 6% A1C and (more importantly) all the hard work you put into it! Rock on! And good luck on the baby-makin'!! ;-)