Appropriate A1C for my age and condition

Patient: I’m 65yr male 6’4′ 178 lb, body fat % 14.2, cholesterol 88,Hdl 38, LDL36 ,Triglycerides 71, active exerciser, been on Eliquis for 3 months for afib. noticed my A1C is up to 6, glucose after fast is 85, insulin is

Symptoms: No symptons

Doctor: Hello,Thank you for your medical query at AskTheDoctor.comI understand your concern.Let me start by saying I am re ally impressed on how you have maintained yourself. Your BMI is impressive, body fat is on the lower side, most other people at your age have body fat more than 30 %. Your cholesterol levels are fine too, I would have preferred HDL over 40. But the values do come down with age, the only way to improve is through regular exercise, which I am sure you do already.Now regarding your HBA1c range, a normal is below 5.6. A value between 5.7-6.4 just indicates increased risk of diabetes. Considering your body weight and fat %, lifestyle wise, there is nothing much you can do more to ensure no development of T2DM. As you know, it is also genetically determined, and in some cases, very thin people end up developing T2DM even with proper precautions. Your values still suggest you do not have T2DM, just a slightly increased risk. I will advise you to continue exercising, and try to avoid sweets or sugar as far as possible. Worst case scenario, even if you do develop T2DM, it will never be very progressive, as you have very low body fat %, and you are not overweight.One isolated value also does not indicate anything. So a repeat HBA1c along with FBS/PPBS will be required to see if you are developing T2DM. As of now, even your fasting is fine, so do not worry.Please feel free to follow-up.Wish you all the best!Regards.