March 31, 2007
Question from Los Angeles, California, USA:
I hear that diabetes treatment has really come a long way in the past 25 years. What was the typical blood glucose level and A1c level 25 years ago?
Nobody knew the actual average blood glucose levels 25 years ago because that was just at the introduction to home blood glucose monitoring and even before hemoglobin A1c tests. Probably the average glucose was 250 mg/dl [13.9 mmol/L] and the average A1c around 11% for most type 1s and probably about the same or worse for type 2s in those days. We do know that while many people with diabetes still do not get adequate education and support, those who do intensive treatment with targeted blood glucose goals, can safely bring A1cs below 7% for type 1 patients using multi dose insulin regimens or a pump and below 6% for type 2 patients. This translates into far less heart disease and circulation problems including far less retinopathy, neuropathy and nephropathy, but only if glucose goals are achieved.