I already voted 6 times
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I’m wondering if you should have a separate poll for different age groups. There are definite BG targets–and thus A1C–based on age.
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That is a good idea. My initial thought was to just understand the overall group, and it appears that we are not anything close to a normal distribution of diabetic A1c’s. If we get enough responses we may be able to do an age group distribution. Even so, it appears to me that this site is represented by a large array of people who have found a recipe that works for them.
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I understand all good intentions here, but looking at various DOC’s over the past few years I’ve come to realize that A1c polls, badges and such tend to be counter-productive. So, I am abstaining on this poll.
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I would also be curious as to the age range when they were diagnosed.
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I would, too. It’s not foolproof, but generally from what I’ve seen online a lot of people diagnosed as adults tend to have lower A1c levels than those diagnosed as kids (even though both are now adults).
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Do you think that’s a physiological difference or a difference in maturity and ability level when they are learning to manage?
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I think it is a bit of both BUT I also assume there is physiological difference between people in general.
I work super hard to get low A1C - not trying to compare here or say my diabetes is worst than your diabetes - but my last few A1Cs are 6.0 and 6.1. I find it impossible to break into the 5’s. I do keep trying. Apart from increasing my exercise to an unsustainable levels (like Eric’s Levels 
), I am out of ideas on what I could do.
I suspect that how my body’s red blood cells act plays a part in this. I also know that there is a history of T2 in my family which may play a part in insulin resistance.
Need to do some reading… on this topic.
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I don’t doubt there are physiological components… I just think that the age/maturity level thing shouldn’t be minimized either though. People learn to respond to situations in life very differently at different ages… and the age at which you learn something has a major impact on your relationship with something you learned at any given age for the rest of your life.
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It’s hard to tell. It may be that people diagnosed as adults have more insulin production or other physiologic differences than people diagnosed as kids, or between people who have had diabetes for 5-10 years compared to those who have had diabetes for 20-30+ years. We also know that kids have more volatile blood sugar levels the younger they are. So maybe spending years with harder-to-control blood sugars before hitting a stage where aiming for really tight control is possible does some sort of permanent damage that hinders achievement of really tight control
Like @Aaron, I work extremely hard at tight control and have never yet broken into the 5s, and experience highs and lows on a daily basis (though not extreme…well, not daily at least). It seems fairly common for engaged, interested people with diabetes who were diagnosed as adults to hit an A1c in the 5s and stay there, while it seems much harder for those of us who have had diabetes as kids to achieve that same A1c level even though we are trying just as hard.
With most other skills, though, people would generally be better at them the younger they learned and the more experience they had. Someone who started playing the piano or swimming at age five and kept it up throughout their life is going to be better at it than someone who picks up those skills when they are 35. So why would this be so vastly difference for diabetes management? Shouldn’t someone who has been at this for 25 years be better at it than someone who has been at it for five years? Especially among those who are participating in a site like this one (ignoring for now the wider population of people who may rely primarily on their doctors to manage their blood sugar…a whole different topic!). Yet, the opposite seems to be true in many cases.
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This is what I was thinking. I head the “hyperglycemic memory” concept on the other site a little while ago. I have meant to read some papers on it to see if this is part of the answer to @Sam 's question on whether longer exposure to high blood sugars can make control harder in older age.
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This is true in many cases but in others it’s not. Give an average 15 year old a million dollar inheritance and an average 50 year old the same and check back with each 10 years later to see what’s left of it…
Yeah, but which one had more fun with the money?
This is the the explanation that I believe to be most likely.
Also, I’d add that some people are willing to run with lower (or higher) average BGs than others, and that obviously skews where A1c ends up. Some people seem happy to keep their BG in the 60’s (or whatever) while others would never do that.
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Yes - A friend of mine’s brother runs his BG in the 60’s. I can function ok in the 60s but I would rather be in the 80’s or 90’s and I guess I make that choice.
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Of course. Most notably, we all differ in the amount of residual endogenous insulin production. T1D is not an on/off switch. Upon diagnosis, some but not all of our beta cells are compromised. Evidence for this is pretty clear: honeymoon. Beyond diagnosis and honeymoon, endogenous insulin production does not drop to zero abruptly, it just decays at some rate (which differs from person to person). Even long-term T1D’s still retain some non-zero insulin production capability. What is important is that even small residual endogenous insulin production capability can have large impact on day-to-day bg control.
Someone mentioned that people who are diagnosed as adults tend to have (on average) better A1c than people diagnosed as kids. This is not difficult to explain: adult-diagnosed T1D (on average) start with substantially larger residual endogenous insulin production capability upon diagnosis (evidence: longer honeymoon), and as a result tend to retain more significant endogenous bg regulation capabilities over longer periods of time.
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Is this based on just a general perception though?
Could be people who are struggling with it are more likely to be online in the DOC than those who are not. Could be that those diagnosed as adults are also more likely to be in the DOC.
I don’t really know.
I am curious if this is actually true. Not saying it is, or is not. Just that I don’t know.
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Yes, it is. I don’t know if it’s true, it’s just the general impression I’ve gotten from hanging out in the DOC over the past 12 or so years (especially on sites that list A1c in a user’s profile or signature). I’d be interested in knowing if it’s generally true, too (of course there are always some exceptions).
I generally think people who seek out the DOC are interested in improving their lives with diabetes and, later on, helping others with diabetes. There are lots of people out there with an A1c of 9 who just don’t really care or have any incentive to improve their control, but I don’t think those are the types of people who would be active in the DOC in terms of spending lots of energy writing blogs and forum posts and so on.
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Sure, but I don’t think this is a good analogy, since diabetes control isn’t a finite thing that’s “used up” unless you are talking about the development of complications. A better analogy would be someone who, at age six, had to start managing a budget with their parents’ help and guidance, who took over management of that budget gradually as a teenager, and continued to manage that budget until they were 50, compared to someone who never had to think about managing a budget because all their needs were provided for until they were 45 years old, at which time they suddenly had to start managing their own budget. In that situation, I think the 50-year-old with 44 years of experience would be more skilled than the 50-year-old with five years of experience, assuming they were both motivated to be fiscally responsible, unless there was some sort of handicap placed on the person with the long-term experience (i.e., physiological differences).
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This may still be due to some sort of physiologic difference, though, such as some people having more protection against hypoglycemia than others. I’m not comfortable running in the 60s because I can drop from the 90s to 40s in a matter of minutes, even with a CGM and even when I attempt to “head off” the low by catching the drop early. If I never dropped rapidly like that, I’d be totally fine running at a lower level. I’m guessing that most people who run in the 60s comfortably must not have rapid or severe lows.
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I know of at least one person who can be in the 60’s comfortably, but who does have occasional rapid and severe lows. 
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