Low A1C?

fluteduet9

Member
Messages
11
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
Hi, all,
I have RH, just newly discovered. I've had hypos for many years. Recently they've gotten worse. Last May my doctor recommended getting a glucose monitor. I've recorded numbers as low as 39 (USA), but the problem with the monitor was I wasn't seeing the whole picture. I'd miss the initial spike and just see the lows. But 2 weeks ago my NEW doctor got me a Freestyle Libre and it was a lightbulb moment. I could see the high GI carb meals spiking my sugars up to nearly 200, then plummeting to extreme lows. Wow. Ain't technology wonderful?
Anyway, the reason for my post..... do any of you with RH have low A1C numbers? I keep reading that RH is potentially pre-diabetes. My A1C is 4.8. Obviously it's not dangerously low, but it's certainly lower than what I've seen as "normal". Anyone else have numbers in the sub-5 percent range?
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi, all,
I have RH, just newly discovered. I've had hypos for many years. Recently they've gotten worse. Last May my doctor recommended getting a glucose monitor. I've recorded numbers as low as 39 (USA), but the problem with the monitor was I wasn't seeing the whole picture. I'd miss the initial spike and just see the lows. But 2 weeks ago my NEW doctor got me a Freestyle Libre and it was a lightbulb moment. I could see the high GI carb meals spiking my sugars up to nearly 200, then plummeting to extreme lows. Wow. Ain't technology wonderful?
Anyway, the reason for my post..... do any of you with RH have low A1C numbers? I keep reading that RH is potentially pre-diabetes. My A1C is 4.8. Obviously it's not dangerously low, but it's certainly lower than what I've seen as "normal". Anyone else have numbers in the sub-5 percent range?

Hi And welcome to our forum.
I'm so glad you have found a doctor that has got a clue and use the technology to track what happens to blood sugar after eating, it is as you say a light bulb moment to see the results.
4.8 is perfectly normal, it is not a low hba1c number. I usually hover between 4-5 with my Hba1c or my fasting levels. Being in that range, is healthy and helps with symptoms. The more time you spend in normal levels, the high circulating insulin will lower, and you won't trigger the insulin overshoot.
The trick is to eat food that won't spike you, no spike, no hypo!
But finding those foods is the best way to control the condition.

Keep asking questions, knowledge is key in how to control. I have not had a hypo in nearly four years!

Best wishes, and again welcome.
 

fluteduet9

Member
Messages
11
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
Thanks, Lamont! I've enjoyed reading many of your posts here. You are definitely on top of this subject. Good to know that 4.8 isn't weird or Abby Normal.
I have to say I am so relieved to have figured this RH thing out, and to find such a big online community with similar issues. I thought I was all alone!
 
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kokhongw

Well-Known Member
Messages
2,394
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
But 2 weeks ago my NEW doctor got me a Freestyle Libre and it was a lightbulb moment. I could see the high GI carb meals spiking my sugars up to nearly 200, then plummeting to extreme lows. Wow. Ain't technology wonderful?

Yes. To see the effects of the high carbs spike and the sharp drop really drives home the point. I suspect this is more common than the medical community is prepared to acknowledge...
upload_2018-3-22_9-17-58.png
 
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fluteduet9

Member
Messages
11
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
Yup, that looks familiar. Big spike, big drop. The two subsequent smaller spikes... were they meals or rebounding? I noticed that after I drop I rebound back up without eating anything, then it comes back down to normal range. The rebound isn't nearly as high as the initial spike, but still it goes up without me doing anything. I suspect it's my body trying to fix the low, then overshooting high again. What a rollercoaster.
 
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Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Hi and welcome! :)

I get the double spike. The second is always lower.

I speculate that one of three things is happening:
1 my insulin releases in bursts
2 my insulin resistance hikes in bursts
3 my glucagon releases in bursts

Of course, I can’t test any of these. And there may be another explanation... :D
 

fluteduet9

Member
Messages
11
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
Hi, Brunneria -- I was hoping you'd chime in on this. From reading some of your other posts, I suspect we are very similar. I've been gluten free for 9 years now after going through he-double-hockey-sticks trying to figure out what was wrong with me. Bad digestive issues plus ever-worsening peripheral neuropathy. Then found some medical papers online linking gluten sensitivity and neuro symptoms. Went gluten free and resolved the digestive issues. The neuropathy has improved noticeably over the years but is still with me a bit. I did a gluten challenge for 2 months back then and the neuropathy was excruciating. No coeliac, thankfully, but definitely sensitive. To this day, I know when I've been "glutened", usually by a restaurant, by the digestive reaction and the neuropathy pain increase. Weird, huh?

I wanted to ask about your Freestyle Libre. Do you still test your blood glucose? If so, do you find the Libre to be accurate? Mine seems to be consistently low as compared with my Bayer Contour meter, even accounting for the 5-15 minute lag time between blood and insterstitial fluid. It seems to be especially inaccurate in the lower ranges. Does yours do that?
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Hi and welcome! :)

I get the double spike. The second is always lower.

I speculate that one of three things is happening:
1 my insulin releases in bursts
2 my insulin resistance hikes in bursts
3 my glucagon releases in bursts

Of course, I can’t test any of these. And there may be another explanation... :D

Or all three!

The Initial insulin response is too weak to cope with the glucose.
Without the first spike and low, the second smaller spike would be considered normal.
I do believe that after so many years, the rebound would be worse because of awareness. The simple fact that no hyper, no hypo has been clearly shown in the graph, for control to be maintained.
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Hi, Brunneria -- I was hoping you'd chime in on this. From reading some of your other posts, I suspect we are very similar. I've been gluten free for 9 years now after going through he-double-hockey-sticks trying to figure out what was wrong with me. Bad digestive issues plus ever-worsening peripheral neuropathy. Then found some medical papers online linking gluten sensitivity and neuro symptoms. Went gluten free and resolved the digestive issues. The neuropathy has improved noticeably over the years but is still with me a bit. I did a gluten challenge for 2 months back then and the neuropathy was excruciating. No coeliac, thankfully, but definitely sensitive. To this day, I know when I've been "glutened", usually by a restaurant, by the digestive reaction and the neuropathy pain increase. Weird, huh?

I wanted to ask about your Freestyle Libre. Do you still test your blood glucose? If so, do you find the Libre to be accurate? Mine seems to be consistently low as compared with my Bayer Contour meter, even accounting for the 5-15 minute lag time between blood and insterstitial fluid. It seems to be especially inaccurate in the lower ranges. Does yours do that?

Oh yeah.
Being ‘glutened’ is unmistakeable! With you there. For me it is my knees, a psoriasis flare up, and my guts.

Yes, I still use the Libre - every few months.
I don’t find it accurate on the highs, lows, and specific numbers. My sensors usually show numbers 0.5-1.0 mmol/l lower than my prick tests (assuming they are accurate).
However, once I know how low a sensor reads, i just allow for it.
And it is MARVELLOUS for showing detail on the graph line. The dip at 2.30 am that explains why i wake up sweating. The impact that 2 squares of dark choc has (none) as opposed to 4 squares (less than 1mmol/l) as opposed to 6 squares (2-3mmol/l).
Knowing that, makes portion control soooo much easier! Lol

I don’t prick test often now. Just when i feel wobbly. And then use the Libre sensors when ill or away from home and my food is less under my control. :D I usually run a few tests per sensor. Just to prove that milk choc buttons are still a really dumb idea ;)
 
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fluteduet9

Member
Messages
11
Type of diabetes
Reactive hypoglycemia
Treatment type
Diet only
I don’t find it accurate on the highs, lows, and specific numbers. My sensors usually show numbers 0.5-1.0 mmol/l lower than my prick tests (assuming they are accurate).
However, once I know how low a sensor reads, i just allow for it.

For my readings in the US, that would be about 9 to 18 off, which is about right when I'm in the mid ranges. In the extreme lows, mine can be upwards of 25-30 off, and extreme highs seem to be pretty much spot on. So I find I can't go by the numbers, just the trends. But the trends and the little arrows pointing straight up and down are great helps to know when to prick test. And as you said, who's to say if the prick tests are accurate, too? My Bayer Contour is a full 10-15 points off the Libre's built-in blood meter, with the Libre again being lower. I think I trust the Contour more.

And it is MARVELLOUS for showing detail on the graph line. The dip at 2.30 am that explains why i wake up sweating. The impact that 2 squares of dark choc has (none) as opposed to 4 squares (less than 1mmol/l) as opposed to 6 squares (2-3mmol/l).
Knowing that, makes portion control soooo much easier! Lol

Absolutely! Knowing what's going on at night is SOOOO useful! I've started eating tiny protein/fat/low carb snacks just before bed and I'm not getting those lows overnight anymore. Fantastic!