February 9, 2002
A1c (Glycohemoglobin, HgbA1c), Tight Control
Question from Wells, Maine, USA:
I am 35 years old, have had type 1 diabetes for 33 years, I am on a four shot a day program with Lantus and Humalog, and my last A1c was 6.3% giving me a average daily blood sugar of 124 mg/dl [6.9 mmol/L] over the past three months. What is the target that is suggested for people with type 1 diabetes in order to maintain good long term health? How will going on the pump help improve my control better than it is now?
Answer:
To answer your last question first, I am not sure your control will be better if you use an insulin pump. The exception is that pump therapy allows you more flexibility throughout the day.
If you are happy with your results, it is not required to change, and I would say your hemoglobin A1c is very good. Most intensive regimens have been unable to maintain less 7% for any length of time. In addition, a value of 6.3% is within the goal the American Diabetes Association has set forth, which suggests a value of less than 1% above the upper limit of normal for your laboratory. Good work. Keep it up and share your success.
JTL
