A1C is just an "average" so you have to be careful how much (weight) you give that when trying to determine how well you are managing sugars overall.

As an example an A1C of 5.9, which is consided "managed" would equate to an "average" glucose level of 6.8 (UK) or 122 (US).

But what it doesn't tell you is "how" your sugar levels ended up at that average.

If you blood sugar (swung) from a low of 72 (4.2) to a high of 172 (9.6) your "average" would be 122 (6.8) which would give you an A1C of 5.9

But if your swings were only between 92 (5.1) and 152 (8.4), which are "far better controlled numbers that will result in less long term complications", your averge sugar level is "still" 122 which again is the same A1C of 5.9.

So while 5.9 "looks good" in isolation, unless you also know "how" you arrived at that average, you may have a false sense of "well controlled" when in fact you are at "greater risk" because the distance between peaks and lows is "not controlled".

@A DiabetesTeam Member his age and condition of his heart will factor in to the level of control the Doc will be looking for.

There was a study conducted by the Veterans Administration that they ended up cutting short because they were looking for "very good control" and found they were causing heart attacks in a (statistically significant) number of those participating - they were shooting for an A1C of between 6.0 and 6.5 and it was too much of a drastic change for the heart to take in some patients who had starting A1C's in the 8.0 range.

While the national guideline says to shoot for an A1C "under 7" it is not uncommon for someone in their mid-70's or older to have a target of 7.5 or even 8.

Most complications can take a decade or two to really develop so maybe shooting for a level that will take 20 years to "pay off" would restrict life "today" more than necessary for a benefit that (statistically) wouldn't be seen by the patient - those are the considerations that will be taken by the Doctor knowing the full medical history.

Hey, my Great-Grandfather (51 years diabetic) lived to be 101 - so no "one size fits all" target - everyone's diabetes is "unique and personal".

But those are just "in general". If everything else is doing well the Doc may look for "a little better control" regardless of age.

If he is seeing some numbers in the 90's on a daily basis now and doing well otherwise, I could see the Doc shooting for a target A1C in the low 6 range with a target BG in the 90-150 range "with the insulin" or a little wider (100-180) if they plan to wean him off of it

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A Diabete...

It will work like that almost every time. The only accurate test is the A1C we get done every 3 months or so. I brought this up to a Doctor before and they did some investigating... the test strips have a disclaimer. Each brand has an "accuracy range" . They can be out by huge numbers sometimes. The important thing to remember is that it is a tool to help you know when you are maybe higher or lower. Like a cycle of highs in the morning, or when you eat something different, etc....

I get a new one every three or four years - one of the companies always seems to be giving one away for free if you simply buy the test strips.

Having said that, I have been using them for close to 20 years now and can't say that I have ever had one go "whacky" on me. But I do stay to meters made by the (big) makers - Bayer or Roche.

You can get a "test solution" from the drug store. Kinda like an eyedrop bottle with a "known" glucose level. You put a drop on the test strip and check the reading on the meter against the (value) on the solution (10.0/180 or whatever) to see if it's reading accurate.

Sometimes two different readings within minutes to each other can be the result of some (substance) on your finger that contaminates the blood drop. But if you are always careful to wash hands immediately before testing, or using an alcohol wipe, you can disregard that possible cause.

Thank you. Don't know if they plan to wean him off insulin. He has had heart problems,10 years ago is when that started, but now that the blood sugar is being medicated and is much lower, his heart has settled down. He was going to have ablation to control the newly discovered A Fib, but after 3 days on the digoxin pill, his heart settled down, so they didn't do the procedure. He has some cardiac screening tomorrow.
Two of the blood glucose monitors have not worked , so he called the co in CA. They are sending 2 new replacements, but he is back to all the finger pricks, which he dislikes, until they arrive. He was doing well with the meter, as he could look at it in real time and see how his blood sugar was reacting. Without that constant monitoring, his numbers have become more erratic. Who knows what causes fluctuations, but psychologically, the monitors seem to help him.