by Harinathan.K
I am a senior citizen aged 68. For the past 30 years, I have had type 2 diabetes. All these years, I have maintained good food habits and I walk every day.
I also undergo an annual master health check-up. I take Amaryl, Galvus, and other medicines as prescribed by my doctor.
For over 10 years, my HbA1c has ranged between 7% and 8%.
I would like to know how I can become normal with an HbA1c below 7%, especially with food habits rather than tablets.
At age 68, with type 2 diabetes for 30 years, an HbA1c between 7% and 8% may be acceptable for many people, depending on overall health, kidney function, heart health, risk of low blood sugar, and other medical conditions.
Trying to push HbA1c below 7% is not always safer in older adults, especially when taking medicines such as Amaryl, which can cause low blood sugar.
Healthy food habits and walking are very important, but after many years of type 2 diabetes, diet and exercise alone may not be enough. Do not stop your tablets without discussing it with your doctor.
Answer by Dr. Albana Greca, MD, MMedSc
Hello Harinathan,
I read your message carefully. First, I want to say that you are already doing many important things correctly. You have lived with type 2 diabetes for 30 years, you walk every day, you follow good food habits, you attend regular health check-ups, and you take your medicines as prescribed. These are all very important for long-term diabetes care.
Not necessarily. For many younger or newly diagnosed adults, doctors often aim for an HbA1c close to or below 7%. But for older adults, especially those who have had diabetes for many years, the target may be different.
In a 68-year-old person with long-standing type 2 diabetes, an HbA1c between 7% and 8% may be a reasonable and safer target if it avoids low blood sugar and keeps you well day to day.
You can read more about HbA1c here: HbA1c explained.
It is natural to want a “normal” HbA1c, but diabetes treatment is not only about reaching the lowest possible number. The goal is to reduce complications while avoiding treatment harm.
When HbA1c is pushed too low in some older adults, the risk of low blood sugar may increase. Low blood sugar can cause sweating, shaking, confusion, falls, fainting, heart strain, and in severe cases, seizures or loss of consciousness.
This is especially important because Amaryl is a sulfonylurea medicine. Sulfonylureas help the pancreas release more insulin, but they can also increase the risk of low blood sugar, especially if meals are delayed, portions are reduced, kidney function is reduced, or exercise increases.
You can learn more here: sulfonylureas side effects.
Food habits can help a lot, but after 30 years of type 2 diabetes, diet and exercise alone may not be enough for many people. Over time, the pancreas may produce less insulin, and the body may become more insulin resistant. This means medicines may still be needed even when the patient eats well and walks regularly.
So, in your case, the best plan is usually not “food instead of tablets,” but rather:
You may find this useful: best foods and drinks for diabetes blood sugar control.
Since you already have good habits, focus on small improvements rather than extreme changes:
You can also compare your readings with this guide: blood sugar levels by time of day.
At your next visit, ask your doctor what HbA1c target is safest for you personally. Also discuss:
You can read more about treatment options here: diabetes medications benefits and side effects.
Harinathan, your HbA1c between 7% and 8% does not mean you are failing. For a 68-year-old person with 30 years of type 2 diabetes, this may be a reasonable target if you are avoiding low blood sugar and complications. Continue your healthy food habits and walking, but do not stop your medicines without your doctor. The safest HbA1c goal is the one personalized to your health, not only the lowest number.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical advice, diagnosis, or treatment. Do not stop, start, or change diabetes medication without speaking with your healthcare provider.
Click here to post comments or follow up
Ask the Doctor now? Simply click here to return to Type 2 diabetes information.