# Good, bad, or indifferent

**URL:** <https://forum.fudiabetes.org/t/good-bad-or-indifferent/500>\
**Category:** Type 1 & LADA\
**Tags:** cgm, hypoglycemia, a1c, endo-controversies\
**Created:** [April 15, 2017, 1:35am UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500 "2017-04-15T01:35:58Z")\
**Posts on this page:** 6\
**Page:** 3

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [April 25, 2017, 6:00pm UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500/54 "2017-04-25T18:00:30Z")

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I would say that it is the percentage of hemoglobin that has glucose molecules attached which is Generally proportional to the average blood glucose levels over the previous 3 months

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**Author:** ![Eric](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/eric/32/9209_2.png) [@Eric](https://forum.fudiabetes.org/u/Eric)\
**Post date:** [April 25, 2017, 6:22pm UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500/55 "2017-04-25T18:22:29Z")

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The problem is, I would want to distinguish that it is not a true “average”. An average would add highs and lows and divide by the total number. The A1C simply measures highs, and absences of highs. Nothing about lows.

Imagine two people:

- 250, 325, 190, 400

and the other:

- 250, 325, 190, 400, 80

One would have a lower “average” BG, but if you discount stripping of glucose from the RBCs (which is a minimal factor) both of those people would have the same A1C.

Again, this is probably not important to any newbie. The term “average” is probably okay for most purposes. So your definition is perfectly fine. But for those that like to get into the meaning, maybe we want to be more precise?

I’m not real passionate about this either way, just opening it up for discussion.

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**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\
**Post date:** [April 25, 2017, 6:29pm UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500/56 "2017-04-25T18:29:21Z")

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I get what you’re saying and it may be a topic some people want to explore and delve into… I added the “directly proportional” term to water down the meaning of calling it the “average”

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**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\
**Post date:** [April 25, 2017, 6:41pm UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500/57 "2017-04-25T18:41:51Z")

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@Eric @Sam et al:  
This is an old paper, but it certainly points out some of the problems with A1c, but does endorse it as a (crude) measure of mean Bg over time

> **[Is There a Relationship between Mean Blood Glucose and Glycated Hemoglobin?](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262729/)**
>
> Measurement of hemoglobin A1c (HbA1c) is considered the gold standard for monitoring chronic glycemia of diabetes patients. Hemoglobin A1c indicates an average of blood glucose levels over the past 3 months. Its close association with the risk for...

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [April 25, 2017, 7:26pm UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500/58 "2017-04-25T19:26:30Z")

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> [@Chris](#):
>
> I think we can have a page that discusses A1c and glycolated hemoglobin in detail within a wiki,

I think it would be great to have on wiki on that. In fact, I learned quite a bit in this thread already. Would anyone be willing to take that on?

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**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\
**Post date:** [April 25, 2017, 8:27pm UTC](https://forum.fudiabetes.org/t/good-bad-or-indifferent/500/59 "2017-04-25T20:27:15Z")

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I will take that on.

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