How low is too low for an HbA1c?

[Caleb Murdock]

That really doesn't sound very hospitable of you. On the home page, it says "the global diabetes community", so I think you need to be accommodating of Americans. There are far more diabetics in the U.S. than there are in England. When I was posting on an American forum, I didn't criticize people for using British BS measurements; I just did the conversion. Besides, I have been giving the conversion in my own posts since the moment I started posting, so there shouldn't be any problem.

Are you saying that there are two ways to measure the A1c test? I wasn't aware of that.

 

[jinstone]

I think it comes through from other posters but I was told 5-8 is the new norm and in some cases this is why diabetes numbers seem to have surged because if you use 4 as a base line then every one would look over.

There is still an element of the effects of your own body and once I begin to get below 5 I do start suffering mild hypo's typically feeling faint headed and dizzy. Do go careful about going to too low but sounds like you are on the right track.

Regards
Jeremy

 

[phoenix]

Wouldn't it be JUST SO American to 'require' a British forum to know a measuring system that's only use is 'ONE PLACE' in the WHOLE WORLD: America

Well you're not that unique.
( chart of units used in different countries) http://www.abbottdiabetescare.com.au/di ... -units.php )
But it's not that difficult to become 'bilingual'. I've had to become trilingual since the French actual use g/l so 180mg/l would be 1.8g/l . The big problem is when you use the wrong unit to the wrong audience. I once told my opthamologist that my fasting reading that morning had been 4.7, which for him meant 470mg/dl , I couldn't understand his horrified look :lol:

 

[NewdestinyX]

That really doesn't sound very hospitable of you. On the home page, it says "the global diabetes community", so I think you need to be accommodating of Americans. There are far more diabetics in the U.S. than there are in England. When I was posting on an American forum, I didn't criticize people for using British BS measurements; I just did the conversion. Besides, I have been giving the conversion in my own posts since the moment I started posting, so there shouldn't be any problem.

Are you saying that there are two ways to measure the A1c test? I wasn't aware of that.

I think this place is very accomodating, Caleb, and though I don't think we get anywhere by making the comparison of how 'many more diabetics' there are in a place as a means by which to strong arm a group of people into accommodating us -- I do however think I punched back a little too hard at you in my response. My apologies! The Americans here are guests of the Brits and have pretty much learned to just make a chart for themselves and refer to the numbers in mmol/l. It's really easy to do once you get used to it. And I don't think anyone here will run us out of town if we occasionally write a number in mg/dL - which as I think about again-- actually IS a 'metric' number... It's just not the metric measuring unit used in most of the world for blood glucose level.

Again - my apologies for my 'oaf-ish' first response to you on the issue.

 

[ClaireG 06]

Another reminder to keep it friendly please and respect each others differences.

 

[onemanandhiswife]

I've just seen my consultant and my HbA1c is 36 (5.4) and he says its to low, he wants it to be between 6 and 7, I am on insulin and have no hypo awareness so i guess that's the reason but i just feel like it's going backwards, i'd much rather test more often than strive for higher numbers but i guess with all the cut backs they don't want to prescribe the extra strips, can't win :?

 

[Meg2009Arm]

Not sure if anyone has a similar dilema but as a Type 2 I find it quite difficult to balance keeping my hba1c at a good level (6.2 at last test, 6.8 previously) and keep my weight at a good level too. My BMI is now 18.3 and my consultant told that was too low, how can I put some weight back on and not comprimise my hba1c? I realise alot of diabetics have the opposite problem and I am grateful that I don't but in trying to be careful with my diet and eat all the right things I keep loosing weight.

Also worried that after explaining to my doc that the normal Metformin I was on for 2 years had given me a bad stomach for all that time and was still no better, she has finally put me on the slow release version just twice a day rather than the 3 times a day previously, they said this was mainly due to my hba1c being so good. Is it likely that I'll have to work even harder to keep my hba1c down now that I'm on a lesser dose?

Thanks
Meg

 

[Sid Bonkers]

I've just seen my consultant and my HbA1c is 36 (5.4) and he says its to low, he wants it to be between 6 and 7, I am on insulin and have no hypo awareness so i guess that's the reason but i just feel like it's going backwards, i'd much rather test more often than strive for higher numbers but i guess with all the cut backs they don't want to prescribe the extra strips, can't win :?

I would think as you have lost your hypo awareness you need to run a little higher in order to get it back as without hypo awareness you could find yourself in real trouble, if you run a little higher for a couple of months and get your awareness back you can then gradually drop it down again if you so wish but by keeping such tight control without hypo awareness you are effectively playing Russian roulette with your health.

Just the ramblings of a T2 so perhaps another T1 would like to comment?

 

[Grazer]

Not sure if anyone has a similar dilema but as a Type 2 I find it quite difficult to balance keeping my hba1c at a good level (6.2 at last test, 6.8 previously) and keep my weight at a good level too. My BMI is now 18.3 and my consultant told that was too low, how can I put some weight back on and not comprimise my hba1c? I realise alot of diabetics have the opposite problem and I am grateful that I don't but in trying to be careful with my diet and eat all the right things I keep loosing weight.

Also worried that after explaining to my doc that the normal Metformin I was on for 2 years had given me a bad stomach for all that time and was still no better, she has finally put me on the slow release version just twice a day rather than the 3 times a day previously, they said this was mainly due to my hba1c being so good. Is it likely that I'll have to work even harder to keep my hba1c down now that I'm on a lesser dose?

Thanks
Meg

Hi meg, I have the same problem, although I'm not down to 18. I was heading down steadily, so starting eating LOADSA nuts! Few carbs, but very low GI, stacked with protein. I seem to have stabilised now at about 22.5. Don't go for cashews, they aren't nuts ( they are the end of the fruits of the cashew tree) but most others don't seem to affect my BG at all. I eat them like I used to eat sweets! Don't worry about the slow release Met, can't imagine that would be worse for weight loss than the normal.

 

[CollieBoy]

Sid,
You may indeed be a rambling T2 by your own admission, but onemanandhiswife is a t2 too :lol:

onemanandhiswife ,
You seem from your sig to have come down from 7.4 to 5.8 This may be part of your consultant's concern as too sharp a drop can cause complications.
Regarding your loss of hypo awareness, some insulin users claim that using animal insulins(pig/bovine) can result in better awareness.

 

[carty]

Hi Meg I also have a problem keeping my BGs under control and putting weight on I eat lots of cream and cheese also snacking on nuts is good .I make a yummy desert by melting a square of very dark choc in the microwave with a handful of almonds mix together and add a good helping of double cream (I use Jersey) then mix until the choc turns to a mousse.
CAROL

 

[Grazer]

Hi Meg I also have a problem keeping my BGs under control and putting weight on I eat lots of cream and cheese also snacking on nuts is good .I make a yummy desert by melting a square of very dark choc in the microwave with a handful of almonds mix together and add a good helping of double cream (I use Jersey) then mix until the choc turns to a mousse.
CAROL

If you add a glug of dark rum or brandy, they're even better!! :thumbup:

 

[carty]

That sounds a great idea but we havent got rum or brandy in at the moment we have whiskey red and white wine .I think I may try the whiskey I will report later :lol: By the way Meg when I went to see a dietician she said that a little alcohol may help to put weight on .She is my favourite HCP :lol:
CAROL

 

[Meg2009Arm]

Thanks Guys, I do like cheese and tend to pick at that but nuts is good too I also like them. Love the sound of the chocolate mouse, very nice, might give it a go over Xmas. As for alcohol, I'm confused about that, my doc seems to be oK with the units I drink per week around 6-8. It's usually red wine but Metformin (normal and slow release) advises to avoid alcohol and I have found that recently I'm enjoying it less and less and I used to love my wine. I often fancy a glass then give up half way through the first glass (which I only ever have with food now) because it feels like it's too rich for me. Oh well.

Thanks v much

 

[LittleGreyCat]

Coming to this late, but (apart from a lengthy and at times quite useful diversion overseas) it seems to be on topic for my current concerns.

I have been slowly improving my BG control and my HbA1c has been trending downwards, but I have been reading recently on the forum that the aim should be to keep BG below about 7.8 mmol/L at all time to avoid increased risk of tissue damage.

My HCPs seem to feel that an HbA1c anywhere below 7 is pretty good.
Then again I get the impression that below 7 is fairly rare in that particular practice because of the demographic.
However my last practice in a different part of the country held a similar view and they were very diabetic aware.

The main thing is when you convert HbA1c to average BG reading.
This gets kinda scary.
I am using the Diabetes.co.uk calculator, which also carries the recommendation of a target HbA1c of 6.5% (average BG of 8.6mmol/L) or below.

My recent HbA1c history (from the notes of my last review) going oldest to newest.

HbA1c average BG reading
7.6..........10.8
7.2..........10.0
7.7..........11.0
7.4..........10.4
6.6.......... 8.8
7.1.......... 9.8
6.4.......... 8.4

Now looking back this is pretty scary reading.
Have I really been AVERAGING this high?
I know that when I have been testing I have had plenty of reading well below the converted average and most of my readings since July 2011 have been below 8 mmol/L.
Although looking back to my immediate post diagnosis readings is very scary indeed!

According to the calculator a BG level of an average of 7.8 mmol/L equates to an HbA1c of 6.1.
This, note, is an average not a maximum.
So even with an HbA1c of 6.1 I would be regularly going over the 7.8 mmol/L mark.

So - and I know that this is not possible for everyone and that any gain is magnificent progress made - should we all be aiming for the 5.5% HbA1c?
This equates to 6.6 mmol/L (which I seem to be hitting some of the time).
I still go over the 7.8 mmol/L - highest in this latest short testing campaign so far is 9.1 with an 8.6 in there as well.

Oh, and my BMI today is 24.54 so I am just insided the 'normal' weight range.
Best BMI was 23.59 but winter seems to play hell with weight loss.
To get to mid range BMI I would have to go down to 11 stone 7 lbs which I last weighed as a teenager!

Cheers

LGC

 

[hanadr]

I would say that the HbA1c of a healthy non-diabetic is the right target to aim for. I've read various authorities on the subject and that figure seems to be in the range of a few percent above or below 4.6%. I'm trying to get down there, but I'm still in the 5s. I'm with Libby, I'd freak if I went up into the 6s.
Hana

 

[LittleGreyCat]

When do you take your Metformin?

 

[phoenix]

So what is a normal HbA1c?
According to the NGSP (National Glycohemoglobin Standardization Program”, but now part of an international programme), according to tests on non diabetic, non obese individual it is between 4.5 and 6 (plus or minus 3 standard deviations)
for explanation see.
http://www.mendosa.com/blog/?p=366

 

[weeezer]

blimey, i thought i was ok anywhere in the 6s, didn't realise this was the top end of acceptable. must try harder!

 

[clairy clutterbuck]

Yes it has scared me to death reading all the posts on this topic. I had been concerned as I had read an article that said getting much below an HBA1C of 7 could be dodgy and my last one was 6.2, only to read that this is actually far too high - or is it? I noticed some of the comments were based on American measurements - are ours the same?

I finally got my HBA1C below 7 two years ago and have been in the 6's ever since, and developed backround diabetic retinopathy for the first time last year. The optician said it can be triggered with a sudden drop in sugars! GREAT!! I am eating a low carb diet (I think) of 70 to 80 carbs a day and have left work three weeks ago to make sure I get more exercise and eat "spot on" as much as possible but am now concerned this is not enough to lower my numbers. I have quite a bit of weight to lose and this is now gradually coming down. Will my numbers come down as I lose weight as a matter of course? and therefore I just need to continue with my plan and be patient? HELP.......

Claire x