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Daily Blood Glucose vs. A1C numbers

Hi All,
I'm confused and puzzled by my glucose numbers vs. my A1C numbers. I take my glucose readings in the morning, before breakfast. The numbers are always high- 150 to 200 range, and have been trending higher lately. Rarely I get a reading up as high as 300 and that scares the bejesus out of me.
But, when I go to the doctor for my semi-annual visit (was quarterly before Covid 19, but I'm content with semi-annual now) my A1C readings are always very good. Last reading- 2 weeks ago was 6.2 and doctor was very happy with that. He told me I should just "keep doing what I am doing" even though I told him about my daily high BG numbers.
Does anyone else have this kind of situation? High daily BG numbers but good A1C number?

  1. – this is a great question and one that is quite confusing, so I'm glad you're asking this. The A1c is an average of glucose numbers over the course of 3 months, so it averages out both highs and lows of glucose numbers. These articles can explain more: https://type2diabetes.com/living/understanding-a1c-test-results & https://type2diabetes.com/living/blood-glucose-measurement-methods.


    Also, if you are experiencing morning highs, you might want to speak with your doctor about something which is known as the dawn phenomenon: https://type2diabetes.com/video/dawn-phenomenon.


    Hope this helps!


    Best,
    Minel (Team Member)

    1. Thanks for the reply. I guess my real question is which number should I be most concerned about when they seem to give me two different messages. Basically, should I change my diet to try to get the blood glucose number down, or accept the doctor's advice that I'm doing OK as is, and not worry about the daily numbers? I'm not trying to be difficult, I truly don't understand which "goal" I should be trying for.

    2. This is a great question!

      Do you ever have any low blood glucose numbers? If you're numbers are consistently in the 200-300 range then your A1c would be higher. As in the article Minel linked above, the A1c is an average so if you're having high highs and low lows, the average may look great. You are right to be concerned about those high numbers and we know that complications are more prevalent when numbers are high.

      Have you ever met with a Registered Dietitian to help you make some tweaks to your diet that may help you improve you glycemic control? Any diet changes you've already made on your own? In addition to speaking with an RD, this article on Diet and Nutrition may be helpful: https://type2diabetes.com/diet-nutrition. Sometimes, some simple changes to what foods we choose, can really make a big difference.

      Also, physical activity is a great way to bring numbers down. Are you able to safely exercise? Let's keep this conversation going because you bring up some great points. I'd encourage you also to follow up with your doctor and let them know again, your concerns and goals.


      Best, Kelly, Type2diabetes.com Community Moderator

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