Aim: The aim of this study to evaluate the role of HbA1C as a predictor for the development of diabetic nephropathy in type 1 diabetic patients. Methods: This prospective observational study was carried out by involving 120patients. The ‘‘fluctuations” in HbA1C over time was assessed. HbA1C fluctuation was defined as an increase in HbA1C of more than 2% between two consecutive measurements, or an increase of more than 1% at 2 points in time. Results: There was no association between gender and the development of diabetic nephropathy (p = 0.95). There were no significant group differences in the ‘‘age at onset of diabetes” or ‘‘time period from the onset of diabetes till admission to the chronic care center” (p = 0.48 and p = 0.81, respectively). The association between fluctuations in HbA1C and diabetic nephropathy is shown in Table 1. Among those who developed nephropathy, 10 of 20(60%) had fluctuations in HbA1C; compared to those who do not develop nephropathy 54 of 100 (54%) had fluctuations in HbA1C (p = 0.05). The mean HbA1C per individual was 8.65 ± 1.3 in the whole sample. As shown in Table 1, mean HbA1C was 9.5 ± 1.7% among those who developed nephropathy compared to a mean of 8.6 ± 1.2% for those who did not develop nephropathy, and was statistically significant between the two groups (p = 0.004). Conclusion: we concluded that the T1D patients who have a similar mean HbA1C may progressively behave differently in terms of developing nephropathy, depending on the fluctuations in HbA1C.