what should be the target HbA1cfor a diabetic

there is a sharp ,definitive advice from the

worlds flag ship organization of diabetes -


on what should be a target A1c for a diabetic .

it tells -

you decide sitting with your doctor as to what should be the a1c for you individually.it varies from person to person.

as a general advice to all,

they give a1c less than 7 as a target.

the point:

you should not have


simply 'a1c' is no guarantee

that hypo has not visited you.

for eg.

what is the average between

two blood level between 40 and 140

it is 90.

your a1c will be great with this.


in the long run

your brain will be fully damaged.

in hypo states

many people do not get symptoms even up to

40 mg/dL bs, until neuro gycopenic symptoms arrive.

if you want to learn more about this

read topic hypoglycemia unawareness.

and reject all advices that prompt you -

unconditionally, for going lower and lower hba1c.

it will destroy you.


the vast majority of people

will begin getting some symptom when

bs goes below 70mg/dL.

hypo is a silent killer in those whom

adrenergic symptoms do not appear early in course.[ happy to invite criticisms but be kind enough to show me only

university level or equivalent web links. i don't read replies that just repeat stray dot coms, there are thousands of them in the net.]

good luck

21 Replies

  • Diabetes management with medication is a tricky business.It is correct to say that if you achieve HbA1c of 7,it is good control.Problem is,in our enthusiasm and sometimes inexperience,we try to push it further down and more often than not,we face hypoglycemia.When food intake is delayed for some reason or you go through unexpected extra physical activity,the sugar levels will be continued to be pushed down lower and lower because of the action of the medicines.Under such conditions if your A1c is already below say 6,you run the risk of hypoglycemia.In my experience,moderating the drug intake is preferable to pushing down A1c to below 6.

  • you need to clarify if one is not on medication but on diet and exercise,wil hypoglecemia still occur with hba1c at 6 or lower?

  • l think,if one is below six without medication,we should not consider him a diabetic any more.To be on safe side,they should continue monitoring and keep themselves as close to six as possible.

  • will hypoglycemia occur ?

  • I think there is no chance of hypoglycemia if you are not on medicines. I am not able to recall all the details of the processes of metabolism but I think the liver releases it's reserves to keep the body systems going.

  • dear raoji,

    hypoglycemia is a disease by itself unrelated to diabetes.

    i do not remember percentages but it happens in many non diabetics.

    the most common case as we know is:

    excess of medicine or execess of exercise and low food intake in a diabetic on medicine, especially insulin

    in non diabetics.

    for eg:

    if the the hepatic output of glucose is reduced due to impaired glycogenolysis or gluconeogenesis

    and the consumption of glucose by tissues ,

    is more than this output then hypo results--

    this is between meals especially in night .

    post prandial hypo:

    which is just uncontrolled insulin entry.

    similarly inslinoma.

    the above are all in people

    otherwise healthy .

    and the most common case in this group

    as we all know :

    in some people who does not take or postpone a break fast but go for work.no food in the morning stomach=empty

    the case of alcohol :

    is to be considered as a medicine related affair-

    it also prevents hepatic output.

    they get blurred vision and giddy,they may fall.

    good luck

  • dear mr rao and

    mr,ramana 42

    in my main presentation i forgort to add

    the ppbs target by ada is 180

    but by american endocrinologists is 160

    and by WHO is 140

    and kindly note the slight differences in the

    unconditional targets ,general advice..


    the Hba1c also will differ.

    can anybody tell me about the

    endocrinologists or WHO advice as to consulting a doctor

    for finding an individualized a1c target.

    hypoglycemia is the the determinant factor everywhere-- means statistics.

    therefore the central point of discussion should be =

    what are the symptoms of hypo and do i recognize it?

    is it coming consistently within me.?

    it is notorious knowledge that -hypo can cheat.

    good luck

  • Everyone should maintain A1C < 5.7/5.6

    ADA limits are horrible and those limits are set so that High Carb diet to diabetic can be justified.

    Check my last four A1C on ZERO Drugs, but LCHF diet


    ADA experts will say I will have heart attack, but the fact is those who maintain 7 will have higher possibility than me. Even my LIPDIS are great, despite eating so much Saturated fat. This is much like most of diabetics on LCHF. Many have gone of the STATIN drugs also because LIPIDS improve on LCHF diet.

    It is because of ADA Limits that diabetes has become a progressive disease.

  • Finally the cat is out of the bag. ADA admits that there is high danger masquerading under the use of drugs (other than metformin) and insulin. One will never know the numerous hypo episodes till you find out that akl brain cells are damaged. This is what "stray dot coms" have been telling bout excess insulin.

  • "stray dot coms" have always been ahead of the curve and using less and less drugs and insulin and so less and less hypos and yet far better A1C that any ADA follower can every achieve :D

    Industrial doses of insulin to cover huge spikes of High Carb Low fat diet is harmful not just wrt hypos but also to hardening of arteries.

    As they say, Textbooks don't teach experience and when someone cannot explain experience it is called "stray dot com" :)

    You have dropped A1C from 13+ to 5.x without drugs by following "stray dot coms" Obviously this improvement comes as a displeasure for those who follow ADA/WHO/Mayo because you defied the theory of "ada dot coms" like any other diabetic on LCHF diet across the world does.

    The so called premier body has no clue how to reduce the menace of diabetes, because they are busy pushing High Carb Low fat horrible diet.

  • Those who are not bothered about their health and wish to maintain Hba1c of 7 let them enjoy the figure. :D

  • Those who self manage diabetes aim for 5% club. Younger diabetics should do this if they don't want to land in trouble later on. Telling a 30 year young diabetic to maintain A1C of 7 is inviting dangers. I am sure you must have seen how diabetics with so called good control on the other forum are coming with blocked arteries and bleeding in retina. No one can say that they haven't been in touch with doctors.

    Modern C class sedans have top speed limit of 220-240kmph on speedometer. Does anyone drive at 240? Maintaining A1C of 7 is like driving at 240kmph

    Those who have reached a point of no return by being happy with 7 only think of reducing when they have their arteries choked and retina bleeding on a so called healthy and balanced diet from ADA/AMA/AHA.

  • An A1C of 7 can range from 145 to 172 average daily blood glucose. This is a ridiculous target and is essentially saying if you maintain that over time your going to have serious problems down the road. It's not healthy...

    An A1C from of 5.6 or below is commonly referred to as a normal range. The high side of 5.6 A1C is 122 average.

    Normal glucose has been sold as between 80-120 and some now claiming 80-110 two hour post of eating. Anything in excess of 140 two hours after eating a normal meal is considered to be a sign of metabolic disorder or prediabetes.

    Here's a link and if you look closely you can see a wide variety of views and how some charts have moved the diabetes needle either up or down.


  • Jenny Ruhl always maintained that:

    1 Hr PPBS <140

    2 Hr PPBS <120

    Is the level that one should aim for. She has quoted enough research on this.

    Her site is the first thing that a type 2 is recommended to visit to learn about self managing.

    ADA range of "SAFE" is ridiculous at best.

  • Didn't you say they approve 130g carbohydrate per day, Indiacratus?

  • Yes, but only for two years just because ADA says so. All know that ADA cannot survive without money and if drug companies start losing money. If all went on 130 grams carbs for lifelong where will the money for ADA come from? Diabetic Drug and supplies sales can decline by 50%+ on 130 grams Carbs. Simple algebra will prove that :)

  • So, my point is there can't be any unacceptable short-term risks? :-)

  • Yes, if you exclude the financial risks for everyone involved. Health risks on 130 grams carbs are yet to be established even in the long-term. They are still trying to find it out by some 5 day trials and then extrapolating through some simulation through software to 50 years :P

    Ancel keys taught how to simulate more than four decades back through cherry picking :) :)

  • When you say flag ship indiacratus, do you mean semaphore to indicate they are sinking, or having great difficulty doing a much needed turnaround?

  • Flagship = Titanic -- on wrong course destined to sink with their theory of High Carb Low Fat. Just a matter of time because people have started rejecting their theories about good/bad control and good/bad diet. ;)

  • 4.8 to 5.2

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