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HbA1c result 4.7 good or bad?

I

ilcittadinoale

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Hello everybody! I am type 1 since 2004 and my last HbA1c was 4.7. My previous ones were 4.9 and 5.1. I try to take care of myself and I do sports and I eat healthy food. But my doctor wasn't happy with my last result, She started telling me about the consequences and complications (amputations, retinopathy...) of high sugar levels (not my case) and low levels (heart attacks). She also asked me about my sugar levels, and I said that my sugar levels are moving all the time. I've always believed that the sugar levels in type 1 were moving always and it's been always like that in my personal experience. She said that the sugar levels in type 1 patients shouldn't move and I was wrong about that. Am I doing anything wrong? is she right???? because it doesn't matter how hard I'm trying, my sugar levels are always going up and down.
I've also mentioned that I should be more naughty and start eating more unhealthy food in order to rise my HbA1c, but my doctor never said anything about it.
What is in my mind is: Trying to do the right thing is wrong then????? or basically I should change doctor???
Thanks for reading!!!
 
Was she an endocrinologist?

I would expect a consultant endocrinologist to be a bit concerned that a hba1c of 4.7 might suggests problems with hypos and to ask questions about whether you have a lot of hypos and whether you have good hypo awareness. If you can answer no (no, you aren't spending a lot of time hypo) and yes (yes, you do have good hypo awareness) to those questions then 4.7 is a flipping excellent hba1c and you should be really exceptionally pleased with it.

Unless she was mentioning the risks of diabetic complications in passing in terms of the need to keep up the good work with yOur diaBetic control, I can't see any specific reason why your hba1c result in itself would have indicated a particular need to discuss the risks from high blood sugar levels. Do you have any signs or symptoms of complications? Do you keep up to date with annual retinopathy/foot checks/kidney bloods?

Blood sugar levels in everyone, type 1, type 2, non diabetic are indeed moving all the time. If you have a blood sugar level that is completely static, you are probably dead. So yes, she was wrong in saying that sugar level in type 1 patient shouldn't move. But perhaps she was just wrong in the way she presented it? Glycaemic variability (so how big the swings up and down are) is a factor that increases diabetic risks and carries its own risk of damage. The aim should be to try and minimise the swings so that your standard deviation is less than 3 (or possibly even tighter @tim2000s ?). That is easier said than done. I would expect that if a consultant endocrinologist was concerned about a patients glycaemic variation they would have a chat about ways to reduce the variation (that might include looking into the timing of your mealtime bolus to try to soften the peaks, looking into the causes of any hypos to try and avoid them, looking into a period of flash glucose monitoring or continuous glucose monitoring to investigate any patterns to the swings).

I don't know about changing doctor. But if your consultation has left you with queries, why don't you get in touch with your doctor and ask her for further help in explaining? They should copy you into the clinic letter and you could wait till you get that and then send her some follow up queries?

Why are you thinking of eating unhealthy food to raise your hba1c? The only reason you might want to think about raising your hba1c is if you are getting lots of hypos - and even then, the aim isn't to get a higher hba1c, the main goal would be to reduce the number/severity of hypos and you would be putting up with a consequential hba1c increase because of the benefits of avoiding the hypos. Eating more unhealthy food wouldn't help you to avoid hypos.
 
I personally would be looking for a new doctor or at least an explanation. Holy cow, most people whether type 1 or 2 or 56 would kill for those numbers. How on earth could anyone have a completely flat BS. It is not possible as catapillar has said. Even non diabetics sugars go up and down, just not crazy high and low. I do not know the ins and outs of insulin management and don't pretend to but if your control is that good why mess with it?
 
Hello, A HBA1C of4.7 is exceptional. As a type 1 , trying to get it lower is probably not worth it. It's fantastic. Not sure most non diabetics would be in that range. You do need to speak with an Endocrinologist, ideally one who has a lot of experience in diabetes,not a general one. I have found even GPs who 'specialise in diabetes are pretty ignorant. Everyone's bg varies within a range, for normal people it varies in a tight range range (4-7) apparently. I am sorry to hear that your Dr is so silly. If you have had a lot of hypos getting to 4.7, that would be more of a concern as catapillar mentions above. Best of luck.great results.
 
Thanks Catapillar and Chalup!
She is a Doctor Catapillar and I think that she was trying to scare me, but I don't know why. I agree with you with your comment ("I can't see any specific reason why your hba1c result in itself would have indicated a particular need to discuss the risks from high blood sugar levels").
Complications and my hypo awareness is total, and it's been like that since day one , I said that to the doctor, but she was talking to me as I was diagnosed yesterday . Furthermore, I work for the Diabetic Eye Screening and she knows that too.
And definitely, I won't start eating unhealthy food, but when I made that comment, my doctor never said anything about it, and that's is really wrong too.
Thanks again!!!
 
ilcittadinoale said:
She is a Doctor Catapillar and I think that she was trying to scare me, but I don't know why.
Click to expand...

But what kind of doctor? Was it your GP? If so, I would imagine the GP just went through the script for giving a type 1 their hba1c results (most of whom will be significantly higher) without any actual thought to what your results were.

Or was it a specialist endocrinologist in a diabetic clinic at hospital? If so, I would be asking for a bit more explaination of the comments from her.
 
ilcittadinoale said:
GP doctor
Click to expand...

That's forgivable then, they were just giving the standard bumpf they say to all type 1s getting hba1c results. A GP is very rarely going to see a type 1 with such a good result and she apparently didn't amend the standard script to take your good result into account. And they won't have any in depth understanding of how blood sugar behaves in real time in real life.

You could ask for a referral to the endocrinology clinic if you weren't satisfied with the GP. It sounds like you are doing great management wise, but you never know you might appreciate the oppotunity for a review by a doctor who has a bit more chance of knowing what they are talking about :)
 
Hi all, I've been type I brittle for over 25 years, I run a typical a1c of under 5 and have for a very long time. At first I had quite few episodes of hypo, but it was worth it (always have something to eat or drink) because I found my routine. true, I don't go out and run around at all and I'm about 60 pounds over-weight (6'2 260lbs) but it could be far, far worse.
 
a2zcdk said:
Hi all, I've been type I brittle for over 25 years, I run a typical a1c of under 5 and have for a very long time. At first I had quite few episodes of hypo, but it was worth it (always have something to eat or drink) because I found my routine. true, I don't go out and run around at all and I'm about 60 pounds over-weight (6'2 260lbs) but it could be far, far worse.
Click to expand...
Hi @a2zcdk , welcome to the forum.
You've posted on a very old thread so your post isn't likely to get noticed much.

You can always post a new thread on the forum, or react to a more recen thread if you like!
 
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