Your A1C is largely a reflection of your lifestyle habits and the accuracy of your insulin doses if you take them, says Jones.
Chris Szoke, NP, CDCES, a nurse practitioner and diabetes specialist based in Tucson, Arizona, says that if you have diabetes and experience regular low blood sugar, you need to check in with your healthcare providers. “This is a clear sign that your insulin doses aren’t meeting your body’s needs. You need to work with your team to adjust them.”
Szoke recommends starting by testing your blood sugar more often. “If you have diabetes or you’re concerned about your A1C, your doctor can help you get a glucose meter or a continuous glucose monitor (CGM) to look more closely at your blood sugar levels.”
And Szoke says that older people with diabetes may experience some hypoglycemia unawareness after decades with the disease.
“That means it simply isn’t safe for them to aim for tight blood sugar levels and a target range between 70 and 140 mg/dL,” he says. “Instead, they may need to aim a bit higher for their daily safety, and this will correlate with a higher A1C level, too, closer to 8 percent instead of below 7.”
People with heart disease and chronic kidney disease are also at particularly high risk if they develop hypoglycemia, and they may need to set higher glycemic targets, too.
It’s important to consult with your endocrinologist or doctor to decide what your own blood sugar targets should be, and how careful you need to be about the risk of hypoglycemia.
