This isn’t a woo-hoo look at my low A1C post. This is a I so don’t get my A1C results.
I got my A1C today and received a result of 5.0. The lowest in the 13 years I’ve been keeping record and maybe my lowest ever. From a control standpoint(as you can see) it’s OK, but I’m also not killing myself for the perfect sub 100 BS.
I understand that my Dexcom GMI (6.3) will be different than my A1C, but 1.3% seems extreme. But it seems to be a trend as I’ve previously posted about this.
The joy is now I get to have the “your having too many lows” conversation with my doctor, which isn’t the case.
I am not sure about this, but I think they started using GMI (Glucose Management Indicator) instead of “predicted A1C” because that way it was not necessarily supposed to be the same as A1C.
So a user would not be upset if their GMI didn’t match their A1C, because it was not really the same thing.
So the irony of it is that once they started using a different name, for you it matched exactly.
@jim26 I had a similar experience. 5 months ago, my GMI was 6.3 and I was surprised when my lab A1C came back at 5.4. I told my Endo it had to be a lab fluke as CGM/BGM data didn’t support the 5.4. Sure enough, 3 months later my CGM/BGM numbers were about the same, but the lab A1C came back 6.4. While counter-intuitive (I tend to trust science and lab results), I trust the CGM/BGM GMI calculations more than the labs unless I’m there watching the lab test or conducting it myself.
Of note, since dx, I’ve always heard/read the push for A1C <7% for all T1s/T2s, but recently read an article (Wash Post series) that the push for this level based on and pushed by big pharma and ADA (funded primarily by big pharma at the time) about a decade or so ago was opposed by many well respected docs who pushed for 8% and individualization based on concerns of hypo’s. The article related how hypo deaths skyrocketed after the <7% goal was established and years later the ADA admitted the push for <7 didn’t push the “without hypos” part enough. Yet today, we still see the <7 push still without much emphasis on the “without hypos” part. It sounds suspiciously similar to how Oxy got started by big pharma (with pharma backed studies and gov approval). I say this not to ridicule the <7 push or anyone that makes that a goal (I like my GMI and A1C to be close to “normal” too!), but to emphasize the second half of the equation: don’t do it at the cost of frequent hypos! Comments and education from others that know the history and facts more than I are welcome!
Yeah, I suspect mine is a lab error. It just doesn’t historically match what my A1C is.
I agree with your comments on hypos. I spent many years chasing the perfect BS along with more hypos. It just seemed I was constantly chasing a low.
When I switched to Control IQ, I said I would let it do its thing and see where my A1C landed. My average BG went up, my lows went down, and really little impact to my A1C.
My GMI has always been higher by about .6-,8 points than my actual A1c.
The lecture you are worried about might not happen. My A1c has always been 5.1-5.3% and my doctor doesn’t say anything bad about it.She actually is complementary. She can see my clarity report and knows I am less than 1% very low and 1% low. So she knows I don’t drop “too low”.
I always judge what my A1c is by my average glucose. But 125 is higher than the 5% A1c so you could calibrate it closer to accuracy if you wanted to. I always calibrate mine to stay within 5 points of my actual BG number.
