What your A1C should be after 60

Dr. Martin does not want your A1C merely inside the lab's normal band. He wants it low, and he wants two other numbers read beside it, because on their own none of the three tells him much.

So you want your A1C, you want your triglycerides and your HDL, okay?

Dr. Martin, The Doctor Is In, Episode 1562

He adds the practical bit straight after. They usually run those, but you have to ask for them. If you do not ask you do not get, and you go home with a pile of numbers and no reading of them.

What A1C measures over three months

This is why he trusts A1C more than a fasting glucose. A fasting number answers for one morning, and one morning can be arranged. A1C is sugar attached to your hemoglobin, averaged across the life of the red blood cell, so it answers for about three months of ordinary eating.

You cannot be good for a week and fix it, which is exactly why he likes it. It is the number that tells the truth about a normal month rather than a careful one.

The study he points to

He has a poster he kept on his office wall for years, and behind it sits a study he has told the audience about more than once. As he tells it, 200 patients were followed for six years and sorted into three groups by insulin resistance.

Dr. Martin on the markers they measured:

A couple of these markers, they had high A1C, high triglycerides, high blood pressure, low HDL cholesterol, okay?

Dr. Martin, The Doctor Is In, Episode 1562

The worst group, the ones carrying those markers, had the most chronic disease at the end of the six years. The middle group had some but not much. Then the part he slows down for.

The lowest group, the ones that had an A1C under 5.4, listen to this.

Dr. Martin, The Doctor Is In, Episode 1562

Not one of them, he says, got sick from a chronic disease in those six years. He then adds his own complaint about it: the study is old, and in his view it got buried, because insulin resistance means talking about food and medicine would rather talk about detection than prevention.

Take that for what it is. One study he cites, reported the way he reports it, not a promise about anybody's next six years. What it does explain is why 5.4 is the number in his head when he looks at an A1C rather than whatever the lab prints as the top of normal.

The three numbers to ask for together

A listener asked him how to raise her HDL, and his answer was a question. Compared to what? He says he needs two numbers before that one means anything.

Triglycerides, which he calls fat balls, should sit below your HDL. At a minimum he wants HDL at least as high as triglycerides, and he would rather see it up to two and a half times higher.

If your triglycerides are high and your HDL is lower than that, you got insulin resistance.

Dr. Martin, The Doctor Is In, Episode 1562

His phrase for how confident he is about that reading is that you can go to the bank with it. It is also why he is far less interested in total cholesterol and LDL than most people expect. He has never been convinced those numbers answer the question being asked of them. More on that in the cholesterol hoax.

The check engine light symptoms

The poster on his wall was headed check engine light, and he is careful about what he means by it.

If you have any of these symptoms, I'm not saying it's only insulin resistance, but it's a check engine light.

Dr. Martin, The Doctor Is In, Episode 1562

His own example is the time the light came on in his car and it turned out to be a gas cap he had not tightened. It could be the transmission. It could be a leak. It could be nothing much. The light does not tell you which, it tells you to look.

• Low energy, which he puts first on the list
• Weight gain that does not match what you are eating
• Poor sleep
• Leg cramps
• Chronic tendonitis and other stubborn inflammation, what he calls any itis
• Adult acne, which he ties back to hormones as well

Then the separate list he calls strong indicators, where he is far less tentative: belly fat, high blood pressure, high triglycerides, low HDL, inflammation, and a fatty liver, which he says insulin resistance is the number one reason for.

What moves A1C, and how fast

Because A1C is a three month average, it moves when three months of eating move. That is slow enough to be honest and fast enough to be worth starting.

The lever is the rapid carbohydrate. Not fat, in his reading, and not how much you are exercising. The bread, the cereal, the juice, the crackers and the things that turn to sugar before they get anywhere.

And the reason he cares beyond the number itself is this.

When you lower your insulin resistance, you are lowering your inflammation.

Dr. Martin, The Doctor Is In, Episode 1562

That is why he treats insulin as a major pathway rather than as a diabetes topic. None of this replaces your own doctor, and none of it is a reason to change a medication. It is a case for asking for three numbers instead of one, and for reading them together.

Common questions

Read next: What Is A Normal Blood Sugar For A Woman Over 60? and Prediabetes At 60: What Dr. Martin Would Do First.

Where Blood Sugar Support Formula fits

Martin Clinic's Blood Sugar Support Formula is the one he points at alongside the food changes, because the food is what moves a three month average.

Shop Blood Sugar Support Formula

60-day money-back guarantee. Cortisol sits in the same conversation, and that is Cortisol Control Formula.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.