How low can you go?

[rob2465]

Hi,All I am wondering how low can your hba1c go? I have lowered mine from 92 in August to 35 in November and wonder if it can be lowered further still. I have lost 22 kilos and now exercise 15 hours a week. Any advice welcome. Rob

 

[TorqPenderloin]

If you're looking for the scientific answer, after you reached ~25 mmol/mol you'd probably run the risk of it having a negative physiological impact on your life.

However, that's not to say that it can't have a psychological impact on your life well before that. Think of it similar to anorexia. There is a healthy range to stay within, but after a certain point people can begin to become obsessive and develop disorders.

You're at 35 which is an awesome number to be at (that's what my last two a1c results were as well). Personally, I want to stay around that number, and I'm even okay with it being a bit higher since I'm well within the range of minimizing the chances of complications later on in life.

 

[MikeTurin]

From what I can see under 4.0% aka 20 mmol/mol is considered out of range. I suppose that is the limit for people not using hypoglicemizants.

 

[AndBreathe]

Nobody knows if your body and lifestyle can achieve a lower HbA1c. Mine seems to run at 31-33, and I'm content with that. It is some margin from a pre-diabetic level and I am enjoying my diet and overall lifestyle. For me, it feels like a lifestyle I can sustain.

Who knows how my body will physiologically hold up as I age. I may be lucky or not, but I'll take my chances.

My hypothesis is that we all have a bit of a range where we routinely run, in a healthy state. That's not governed by any particular number. There are thousands of people out there running around, happily, healthily with blood markers like ours, and margins worse, who don't give it a moment's thought.

Only you can decide where and when you accept you're in "your place". "Your place" is about the scores youo achieve, balanced with the effort required to achieve it, and how you can cope with doing that day-in/day-out for the very longer term. To my way of thinking, there's little point in me half killing myself to shave another couple of points off my HbA1c score next time around if I can't live on like that. This condition truly is a marathon, not a series of sprints; although in the early days it may feel that way.

Very well done on your achievement thus far, and good luck with whatever goals you set yourself, moving forward.

 

[kokhongw]

I am wondering how low can your hba1c go? I have lowered mine from 92 in August to 35 in November and wonder if it can be lowered further stil

Congratulations on your remarkable success in lowering your HbA1c. And to answer your question...Yes it can be lowered further. Many on the TypeOneGrit community are able to achieve and maintain HbA1c < 5.0% range (around 31).
https://www.facebook.com/Type1Grit/

Also seen on other forums
https://www.reddit.com/r/type2diabe...14_to_46_in_5_months/?st=iwph8wdr&sh=298917b8

And from Jenny Ruhl's blog, there is at least one study that noted this
http://www.phlaunt.com/diabetes/15945839.php

Another study which drew similar conclusions discovered an even tighter correlation between A1c and heart disease risk that began as A1c rose above 4.6%, a level that corresponds to a blood sugar level of 86 mg/dl (4.8 mmol/l)!

Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes. The Atherosclerosis Risk in Communities Study. Elizabeth Selvin,et. al. Arch Intern Med. 2005;165:1910-1916.

To quote what that study found:In nondiabetic adults, HbA1c level was not related to CHD risk below a level of 4.6% but was significantly related to risk above that level (P<.001). In diabetic adults, the risk of CHD increased throughout the range of HbA1c levels. In the adjusted model, the Risk Ratio of CHD for a 1 percentage point increase in HbA1c level was 2.36 (95% CI, 1.43-3.90) in persons without diabetes but with an HbA1c level greater than 4.6%. In diabetic adults, the Risk Ratio was 1.14 (95% CI, 1.07-1.21) per 1 percentage point increase in HbA1c across the full range of HbA1c values.

But the fact that it has been done and can be done doesn't really mean that we have to do it. It is a matter of personal decision. Each of us may have different circumstances and prioritize differently.