I am 46 years old, weigh 210 pounds, I am 5 feet 8 inches tall, and I have type 2 diabetes. My morning sugar levels are very high (130-180 mg/dl [7.2-10 mmol/L]), but my hemoglobin A1c values are always below 6% (5.6% the last time). Should I be concerned enough to do something about the high levels in the morning?

I can see why you’d be confused! The hemoglobin A1c, as you may know, gives an average of blood sugar across the past 2-3 months. That means, if morning blood sugars are 130-180 mg/dl [7.2-10 mmol/L], they are being averaged with much lower blood sugar values. Are you having low sugars, maybe undetected?

One other possibility — the A1c depends on red blood cells hanging around for about 120 days (their normal lifespan). Anything that causes these red cells to not last 120 days can affect the A1c value (making it lower). You might confirm with your doctor that there is nothing interfering with your red blood cells that might affect your A1c.

BS