HbA1c: It’s just a number

Quotes of Type-1 Diabetes: “I feel ashamed of my HbA1c.”

Show of hands from my diabetes community, who else has felt this?

I have.

There was a time in my life where I feared going to the endocrinologist or diabetes clinics because of what that number would show.

I feared judgment.

I feared self-criticism.

I felt if my number wasn’t perfect that meant that I wasn’t doing enough of the “right” things.

And now, as a registered dietitian working with the type-1 diabetes population, I’m in a position where others fear sharing that number with me.

And it pains me.

Our HbA1c is a number – just a number.

It does not define our worth. It does not define how hard we work in managing this disease. It does not even define the overall health of our disease.

It is a 2-3 month average of blood sugars. It is a potential indicator of things to investigate, for both above target and below target values, but it is not an outright indicator.

An A1c above the target range does not indicate poor health; just as an A1c below the target range does not indicate perfection.

Both are just indicators for further investigation.

For so long, the healthcare system has been so focused on HbA1c values with regards to diabetes management. People with diabetes are regularly lectured to strive for A1c’s below 7 per cent, and some below 6.5 per cent.

For some, it can be a huge burden!

Promoting HbA1c perfection can lead to seriously negative outcomes

Did you know that the HbA1c of someone without diabetes, of a person with a fully functioning pancreas, is less than 6 per cent?

Did you know that a pancreas not only turns insulin and glucagon on and off in the presence or absence of food, but also anticipates and reacts towards other elements that can affect blood sugars like stress, hormones, medications, coffee, sleep, exercise etc.

In those of us with type-1 diabetes, we do not have those on-off mechanisms.

We cannot be perfect with this disease – ever!

Full stop.


So let’s stop encouraging perfectionism.

Perfectionism can lead to seriously negative outcomes, including eating disorders and diabulimia, which is a form of caloric purging via insulin restriction, as well diabetes apathy and diabetes burnout.

No one wants that.

We need to stop putting so much power into this one number, and instead start looking more at the whole picture.

Because we are more than just a number – so much more!

People with type-1 diabetes are more than just a blood sugar or HbA1c reading

2 thoughts on “HbA1c: It’s just a number”

  1. I absolutely LOVE this post and you are so right. I have had Type-1 Diabetes for 38 years and as a child, my A1C is all my doctor ever focused on. It actually isn’t until the past ten years that I’ve turned my focus towards “time in range” as opposed to hbA1C, especially in light of the fact that one can easily manipulate their hbA1C through extreme high’s and low’s. one needs ot look at the bigger, overall picture. I think there’s incredible value in the point you made about the outside elements of life, such as stress, that our pancreases can’t compensate for as a normal person’s would. I love your posts and I’m sure you’re busy as hell in recent times with completing some of your studies and everything else you have on the go. But I’m glad to see you posting. Keep that positive information coming!

    1. Thanks so much Shawn! It has been a busy time recently with getting my practice up and running, but I am aiming to bring back the blog posts regularly again 🙂

      I also love your comments and feedback – your experiential knowledge adds to the conversation as a whole as well!

      I totally agree that time in range is a much better focus to have. Sometimes we won’t be in that target range, and that’s okay because we can’t be 100% perfect. Time in range allows a bit more flexibility 🙂

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