An update with my first HbA1c result since starting Afrezza and the FreeStyle Libre.
My previous HbA1c results have been around 6.5%, which is inline with the recommendations from the Australian Diabetes Society, who recommend “a general target HbA1c of ≤7.0%” for Type 1 diabetic patients.
My latest test result, which reflects the average glucose level over the previous three months, was likely somewhat affected by the basal mix-up I described previously. The result of 6.0%, although a lifetime best, was therefore a little disappointing – especially with some incredible A1c results being posted online by other users.
If I continue with the same level of control as I have now, my next A1c test is likely to be better – as it will not be impacted by the basal mixup. It’s also worth noting that unlike most users posting great A1c results, I do not have a continuous glucose monitor, and therefore do not benefit from alarms when my glucose is going out of range. The FreeStyle Libre samples blood every minute and provides CGM-like historical data, but requires a manual scan to view this data.
I suspect that using a CGM might change the way I use Afrezza, and would provide a further reduction in my HbA1c due to alarms notifying me earlier than my manual scanning with the Libre.
Although I am a little disappointed, the author of the Crick, Tech, Munch blog gave me some encouraging words that put the result in context: Only 7% of Type 1 diabetics in the UK reach an HbA1c result of 6.0% or better.
The HbA1c test is also limited in that it can potentially reward poor glucose control, by being lowered through periods of hypoglycaemia. A supplementary test —1,5 Anhydroglucitol — is a historical indicator of hyperglycaemia only.
Coupling the HbA1c result with this GlycoMark 1,5AG test gives a far better picture of glycemic control than HbA1c alone. Together, they can show whether an HbA1c result is being artificially lowered by hypoglycaemia and give an accurate indicator of glycemic variability.
I hope to have another HbA1c test in about two months. I have also found Australian laboratories that can perform the GlycoMark 1,5AG test and hope to have that conducted around then too. I am looking forward to seeing these results.