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disfor · **Joined:** Tue Feb 17, 2009 9:47 pm **Posts:** 27

What is the ideal A1c number for a non diabetic. Mine just came back at 5.4% (out of a range of 4.5-6.0) and I thought that was a little high considering the following studies:

Association of Hemoglobin A1c with Cardiovascular Disease and Mortality in Adults: The European Prospective Investigation into Cancer in Norfolk. Kay-Tee Khaw, MBBChir FRCP; Nicholas Wareham, MBBS, FRCP; Sheila Bingham, PhD; Robert Luben, BSc; Ailsa Welch, BSc; and Nicholas Day, PhD. Annals of Internal Medicine, 9/21/2004, Vol 141, no 6, 413-420

http://annals.org/article.aspx?volume=141&issue=6&page=413
Here's the summary from that paper's conclusions:
In men and women, the relationship between hemoglobin A1c and cardiovascular disease (806 events) and between hemoglobin A1c and all-cause mortality (521 deaths) was continuous and significant throughout the whole distribution. The relationship was apparent in persons without known diabetes. Persons with hemoglobin A1c concentrations less than 5% had the lowest rates of cardiovascular disease and mortality. An increase in hemoglobin A1c of 1 percentage point was associated with a relative risk for death from any cause of 1.24 (95% CI, 1.14 to 1.34; P < 0.001) in men and with a relative risk of 1.28 (CI, 1.06 to 1.32; P < 0.001) in women. These relative risks were independent of age, body mass index, waist-to-hip ratio, systolic blood pressure, serum cholesterol concentration, cigarette smoking, and history of cardiovascular disease.

Another study which drew similar conclusions discovered an even tighter correlation between A1c and heart disease risk that began as A1c rose above 4.6%, a level that corresponds to a blood sugar level of 86 mg/dl (4.8 mmol/l).

Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes. The Atherosclerosis Risk in Communities Study. Elizabeth Selvin,et. al. Arch Intern Med. 2005;165:1910-1916.

http://www.ncbi.nlm.nih.gov/pubmed/16157837?dopt=Abstract
To quote what that study found:
In nondiabetic adults, HbA1c level was not related to CHD risk below a level of 4.6% but was significantly related to risk above that level (P<.001). In diabetic adults, the risk of CHD increased throughout the range of HbA1c levels. In the adjusted model, the Risk Ratio of CHD for a 1 percentage point increase in HbA1c level was 2.36 (95% CI, 1.43-3.90) in persons without diabetes but with an HbA1c level greater than 4.6%. In diabetic adults, the Risk Ratio was 1.14 (95% CI, 1.07-1.21) per 1 percentage point increase in HbA1c across the full range of HbA1c values.

With a BMI of 18.5 and exercising regularly, I'm not sure what else to do. I successfully gave up sugar about 8 weeks ago, so maybe I just need to have it tested again at a later date since I probably ate too many Mcdougall friendly sweet treats that first month and it is a test of three month values.

Any insight would be helpful!

Thanks!

Den32 · **Posted:** Mon Jun 18, 2012 10:36 am

I have 5.1 HbA1C too. It was the same even when I was on 100% sweet fruit diet for 6 months, and on junk food diet for all my life earlier.

GeoffreyLevens · **Posted:** Mon Jun 18, 2012 11:05 am

No mention of A1c in this study but it may indicate that one hour postprandial sugar reading is the most significant number to pay attention to. At least, more important than the traditional 2 hour and/or fasting blood sugars
http://care.diabetesjournals.org/content/33/3/557.abstract

Quote:

Minimal Contribution of Fasting Hyperglycemia to the Incidence of Type 2 Diabetes in Subjects With Normal 2-h Plasma Glucose
Muhammad A. Abdul-Ghani, MD, PHD1, Michael P. Stern, MD2, Valeriya Lyssenko, MD, PHD3, Tiinamaija Tuomi, MD, PHD3, Leif Groop, MD3 and Ralph A. DeFronzo, MD3
+ Author Affiliations

1Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, Texas;
2Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas;
3Department of Clinical Sciences, Diabetes and Endocrinology and Lund University Diabetes Center, Lund University, Malmö, Sweden.
Corresponding author: Muhammad A. Abdul-Ghani, abdulghani@uthscsa.edu.
Abstract

OBJECTIVE To assess the relative contribution of increased fasting and postload plasma glucose concentrations to the incidence of type 2 diabetes in subjects with a normal 2-h plasma glucose concentration.

RESEARCH DESIGN AND METHODS A total of 3,450 subjects with 2-h plasma glucose concentration <140 mg/dl at baseline were followed up in the San Antonio Heart Study (SAHS) and the Botnia Study for 7–8 years. The incidence of type 2 diabetes at follow-up was related to the fasting, 1-h, and 2-h plasma glucose concentrations.

RESULTS In subjects with 2-h plasma glucose <140 mg/dl, the incidence of type 2 diabetes increased with increasing fasting plasma glucose (FPG) and 1-h and 2-h plasma glucose concentrations. In a multivariate logistic analysis, after adjustment for all diabetes risk factors, the FPG concentration was a strong predictor of type 2 diabetes in both the SAHS and the Botnia Study (P < 0.0001). However, when the 1-h plasma glucose, but not 2-h plasma glucose, concentration was added to the model, FPG concentration was no longer a significant predictor of type 2 diabetes in both studies (NS). When subjects were matched for the level of 1-h plasma glucose concentration, the incidence of type 2 diabetes markedly increased with the increase in 1-h plasma glucose, but the increase in FPG was not associated with a significant increase in the incidence of type 2 diabetes.

CONCLUSIONS An increase in postload glycemia in the normal range is associated with an increase in the incidence of type 2 diabetes. After controlling for 1-h plasma glucose concentration, the increase in FPG concentration is not associated with an increase in the incidence of type 2 diabetes.

disfor · **Joined:** Tue Feb 17, 2009 9:47 pm **Posts:** 27

Thanks so much for the info. I appreciate it.

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