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Is there something like too low HbA1C?

lucas12

lucas12

Well-Known Member
Read something about hba1c U shape and increased mortality for those with a1c lower than 5%. Is that actual thing? or some internet
rubbish.
 
@lucas12, can you cite the article where you read about this please? Since gaining control my HbA1c has been between 33 - 36 (5.2 - 5.5%). My GP once said when confronted with yet another of my non diabetic HbA1cs “you don’t want to let it go any lower”, but didn’t say why. I’ve never seen any info about low HbA1cs being detrimental so I’d be interested to read anything you’ve seen.
 
Just a thought, here. Non Diabetics seem to do OK on non Diabetic A1c's.

There has been a bit of a push in the US for those with T1 to have slightly higher values but the cynics say this is due to the fear of litigation against doctors/endocrinologists rather than the risks of hypo/DKA or worse.
 
There was a Mayo Clinic study on T1s which sowed that those with middling a1cs lived longer. However that cohort would not have had all the tech that T1s do today so may not be so relevant to a modern T1.
 
Ugh, this is massive bone of contention between me and my GP practice as a t1. Mine is 37-40c so mid five % and they think it’s too low and assume I’m having hypos when I’m not. They’re not used to seeing what can be acheived levels wise by the combination of CGM, pump, (and a low carb diet) yet so are going by what they do know - huge hypos to balance out the huge highs.
 
I first heard about this when the Libre was launched. There were about three video's for marketing purposes. In one of them the lecturer implied that a low Hba1c was not good for diabetics. Since the Hba1c is an average it means that the low peaks are more likely to be in hypoland when the Hba1c itself is low. It made sense to me.
 
I will need to book my funeral? For the last four years I have been 30 and under.. Ironically I have been wondering if my carb intake has been too low and possibly raise it a little.
 
It's certainly something which gets studied, for example, this meta-analysis of other studies in 2014 suggests a J shaped curve in T2s, and it seems that what they mean by that is very high a1c poses a very high risk, and very low a1c poses a risk but not as high a risk as high a1c.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310064/

I've no particular view on it either way; a1c is getting kinda irrelevant for cgm users: I think our aim is to spend each day within a decent range with modest standard deviation and let the a1c fall where it may.

Gut instinct does make me feel, though, that there are diminishing returns and increased risks in chasing an ever lower a1c just for the sake of it - there's bound to be an "ok-ish" a1c range and getting any lower seems not to bring any added physiological benefits.

I have no view on what that range is.
 
I've never heard anyone here with an HbA1c sub 4.0 % (20.2 mmol/m)
My last few have been 27 mmol/m (4.6%) give or take seem to be fine so far.
Well not dead yet so far as I can tell.
 
Most likely this is in relation to HbA1c being achieved through means of oral hypoglycaemics and exogenous insulin. Hey presto...clean blood, glucotoxicity everywhere else.
 
I just got my latest HbA1c results back and its 26. Now I have patient access where you can view all your results it says the result is abnormal along with a few others. Have a non urgent telephone consultation with GP next Thursday so will ask about this.
 
rainbow79 said:
I just got my latest HbA1c results back and its 26. Now I have patient access where you can view all your results it says the result is abnormal along with a few others. Have a non urgent telephone consultation with GP next Thursday so will ask about this.
Click to expand...
Thats quite interesting.... when I was diagnosed in 2015 the range was 29-51
But in 2013 it appears to have been 20-42

Screenshot 2019-05-02 at 20.11.04.png Screenshot 2019-05-02 at 20.11.36.png

Most recent one has 30-48Screenshot 2019-05-02 at 20.14.26.png
 
EF17777E-483B-4E65-910D-B15FF1E966CF.jpeg
rainbow79 said:
I just got my latest HbA1c results back and its 26. Now I have patient access where you can view all your results it says the result is abnormal along with a few others. Have a non urgent telephone consultation with GP next Thursday so will ask about this.
Click to expand...
My recent HbA1c shows normal as 20 - 41 on Patient Access!
 
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