The question that someone raised earlier is an interesting one. It was whether tighter control led to more hypos.
I think there are a couple of ways to look at it. One is that a lower Hba1c number statistically would suggest more hypos.
The second is that a tighter level of control doesn't have to, however it is a tighter level of control at all levels and therefore suggests significant lifestyle impacts.
Yes, that's the million-dollar one. It's always stated that a lower HbA1c must increase hypos.
So let's have a look at it. If that statement is true, then it's because either (a) a low A1c necessarily lessens hypo awareness, or (b) you can't have a low A1c without hypos, or both.
But (b) isn't true. As Smidge pointed out, A1c numbers aren't a mean, they're incremental: we acquire the glycosylated hemoglobin when we have lots of glucose bumping about in the blood, and only then. And we don't lose glycosylated cells/whatever after a hypo: we don't lose them at all till they die off. You could have as many hypos as you like (as it were), and it wouldn't knock a point off your A1c score. So hypos wouldn't show up in A1c at all, and you can't read hypos off an A1c measurement.
As to (a), it's true that people who have had lots of hypos lose hypo awareness. And that's very serious.
But that's because their adrenalin warning system has been desensitised by the hypos. Their bodies no longer respond to the cues.
So that doesn't make (a) true either. Why should people who haven't had lots of hypos lose hypo awareness? What other reasons would there be?
It actually looks as if hypos and A1cs have nothing to do with one another.
So we're left with the key Q: can very low BS leading to hypos be avoided, like high BS, by careful management including low and consistent carbs?
Regardless of whether that would be horrible in lifestyle terms - a separate question that each of us makes up our mind about at any given time.