Type 1: A good HbA1C without hypos?

ann34+

Well-Known Member
Messages
393
Type of diabetes
Type 1
Treatment type
Pump
I have been told that Metformin reduces insulin resistance, suppresses appetite (so aids weight loss in heavier people) and helps reduce the glucose produced by the liver, but all to a limited extent. So unless you are heavy and need to eat less, are insulin resistant, or suffer too much by way of liver dumps, I can't see it being of much use to either T1s or T2s.

Yes, i think you are correct , it does do the above. Also, research last year, and research reported recently re type ones, shows a cardioprotective effect (i think this was found for type 2s earlier), i am not sure how this effect happens or whether it is just due to reduction of insulin resistance. maybe these studies are what Dillinger is referring to. At the moment, at least in the NHS, i have been told that only type ones in certain categories are prescribed it - i am not being prescribed it, despite asking about it, even though i am older and in a risk group, i am just too insulin sensitive.
Insulin sensitivity, as the original OP has found, is not always easy, and dealing with it can be quite challenging.
 
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Jurga66

Member
Messages
11
Type of diabetes
Type 1
Hello,everyone,yesterday my son had a hb1ac test done,i am really happy with the result,same as 3 months ago it came up to average level of 35, so happy we r doing a good job looking after him ;)
 
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Hoping4Cure

BANNED
Messages
204
Type of diabetes
Type 1
a hba1c of 5.3 translates to average blood sugar levels of 5.9, so quite safely away from hypos really.

The target for type 1 is a hba1c of 6.5, individual targets are adjusted if there is some concern over hypo awareness etc.

To get an average of 5.9, in the presence of spikes in the teens, requires there to be hypos, including some very bad ones, to balance it out. There is just no way around that. So very low A1Cs can be quite dangerous. The mean doesn't tell the whole story, one has to look at sugar variance as well. Ergo, the law of small numbers / aka Bernstein to the rescue, plus drugs like GLP-1 can help lower sugar variance drastically too. It cut mine in half, literally overnight.

I've successfully kept my A1C in the low 6s most of my adult life, but only recently decided this wasn't optimal after reading the "Golden Years" study, showing that longest lived type 1 diabetics have an A1C on average of 7.6.

Glucotoxicity isn't the only thing that matters, there is also insulin toxicity. Hypos can cause heart failure, sudden death, car accidents, comas.

The best goal to my mind is keeping A1C reasonable, whilst minimizing insulin TDD as the primary objective.

To do that, the best way is calorie restriction and LCHF, IMO, but also retreating from the obsession that you have to keep sugars in the perfect range via insulin shots, rather than via urination (and ideally diet to avoid spiking sugars in the first place).

So I'd suggest that prioritizing low TDD over extremely low A1C is the smart move, for both short-term safety and longevity's sake. And lowering TDD while maintaining a decent, middling A1C, is typically achieved through diet and exercise (lean muscle requires less insulin since it's more sensitive).
 

Hoping4Cure

BANNED
Messages
204
Type of diabetes
Type 1
Hello,everyone,yesterday my son had a hb1ac test done,i am really happy with the result,same as 3 months ago it came up to average level of 35, so happy we r doing a good job looking after him ;)

Low A1C is only one number. Hypo frequency and severity is potentially far more important, especially over the short-term. Lowering A1C by increasing hypos is not a good tradeoff, IMO.
 

Jurga66

Member
Messages
11
Type of diabetes
Type 1
Lowering A1C by increasing hypos??? We dont do that!!! He's not having hypos frequency...i do know hypos are not good and trying to avoid it by checking him very often..
 

Jurga66

Member
Messages
11
Type of diabetes
Type 1
Low A1C is only one number. Hypo frequency and severity is potentially far more important, especially over the short-term. Lowering A1C by increasing hypos is not a good tradeoff, IMO.

We r trying to avoid hypos by checking him often,we r using libra sensors