Hba1c too low

[searley]

My girlfriend had her consultants appointment today her hba1c was 6.5 she was told this was too low for a T2 on insulin

What's your thoughts, as I think I may be in the same for my appointment next month

I calculate I will be sound the 6.7 mark


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[mo1905]

The only time 6.5 is too low is if it means your girlfriend hypo's regularly to achieve it. If her diabetes is well controlled and her BG levels fairly steady then I think it's a great result. Her consultant should be congratulating her rather than being negative. Why would he encourage her to maintain higher levels ? seems crazy. Good luck with yours

 

[searley]

I know I will be much lower than I have been in the past as I'm now on degludec/tresiba

My calculations which are normally quite good say I should be in the 6.7 mark, this time last year I was 10.9

Six months ago 8.9 and 3 months ago 8.3

So I'm quite happy, but I have to see a DVLA consultant in 5 weeks, I've only had 1 self treated hypo in the last 3 months, but am worried I may fail the meeting for lower than required hba1c as the DVLA consultant is the same consultant that my GF saw today


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[CollieBoy]

Your girlfriend is T2 on insulin.
What is her control like? Does she have a lot of hypos?
If she is not having a lot of hypos, then IMHO 6.5 is not too low.
edit:
You had 1 hypo which was self treated so I would emphasize that you self treated and were aware of the hypo, hence in control of your BG.

 

[searley]

She's had no daytime hypos, however I personally think she maybe having night time lows she is not aware of so I'm going to wake her over night a bit so she can test to see

My concern is the statement 6.5 is too low


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[mo1905]

I know I will be much lower than I have been in the past as I'm now on degludec/tresiba

My calculations which are normally quite good say I should be in the 6.7 mark, this time last year I was 10.9

Six months ago 8.9 and 3 months ago 8.3

So I'm quite happy, but I have to see a DVLA consultant in 5 weeks, I've only had 1 self treated hypo in the last 3 months, but am worried I may fail the meeting for lower than required hba1c as the DVLA consultant is the same consultant that my GF saw today


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My last HbA1c was 41 ( 5.9mmol ). I hold LGV license no problem. When on insulin, occasional low BG readings are common. You self treated, which is fine. The DVLA are only concerned with repeated hypo's and losing hypo awareness.

 

[Daibell]

HI. I think the consultant could do with some re-training! If the girlfriend isn't having hypos and monitors her blood sugar regularly for driving etc then there is no lowest HBa1C figure. My last one was also 6.5% and I'm planning to move it down a bit. Diabetes 'experts' can tend to assume that patients haven't a clue and don't manage themselves well so set a high HBa1C target to avoid problems and this becomes the norm

 

[Beachbag]

My girlfriend had her consultants appointment today her hba1c was 6.5 she was told this was too low for a T2 on insulin

What's your thoughts, as I think I may be in the same for my appointment next month

I calculate I will be sound the 6.7 mark


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I'm type2 ID and was told exactly the same thing last week when my result came in at 6.4. Apparently any lower is not considered "safe". I asked what was meant by safe and was told 6.4 could indicate I was having frequent hypos and there was a strong possibility I might have one when driving .......well, that's what I was told but.......

 

[alaska]

It's not a good assumption to make for those of us who are able to control blood glucose levels better with a low HbA1c.

A few years ago, when my HbA1c was over 6.5%, my blood sugars varied haphazardly and my hypo awareness was at its worst. Since I brought my HbA1c in the mid 5s, I don't have the rapid swings in blood glucose and have reliable early hypo symptoms back.

In my own case, I've found that standard deviation in test results is a better predictor of hypo awareness than Hba1c.

 

[CollieBoy]

In my own case, I've found that standard deviation in test results is a better predictor of hypo awareness than Hba1c.

What SD values do you consider to be an appropriate predictor?

 

[Indy51]

Jenny Ruhl has a great article on this very subject - it reveals how uneducated doctors really are which is frankly scary:

http://www.phlaunt.com/diabetes/35169265.php

 

[alaska]

What SD values do you consider to be an appropriate predictor?

I wish I still had my old figures to hand as it would be interesting to see how things have differed as an actual figure.

All I can say is that rather than regularly varying widely between 2 and 17 (as I used to be at my least hypo aware), my figures now vary in a closer window between 3.5 and 11.

I should add that I'm type 1 so as not to mislead anyone with type 2.

 

[lovinglife]

My dad is a T2 on insulin (although from what I have learnt over the years I suspect he is T1.5 or LADA) and he holds a HbA1c of 5.9% and he has tight control without hypos. His HC team is happy with this. And so is he

 

[donnellysdogs]

I have a combo pump and that gives SD levels. My SD is now normally around 1.9- 2.2. If it reads under 3.0 I am happy.

I firmly believe that it is swings in bloods that do the damage...I've never been an angel with my T1, but after 30 years without complications so far, then I havent done bad. (Better now being able to control with a pump though).


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[dawnmc]

Jenny Ruhl has a great article on this very subject - it reveals how uneducated doctors really are which is frankly scary:

http://www.phlaunt.com/diabetes/35169265.php

That is so scary, that doctors only read half a study.

 

[monkeynuts]

My most recent HbA1c was 6.5. My GP called me and advised that it is on the low side and to increase my testing at night (3am). I've not had a hypo in over 10 years so was astonished by the call. I've never hit my lifetime target of 6 but i will continue to aim for it. 28years and counting


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[donnellysdogs]

Medics assume that ant level under 6.7 causes hypo's. They. Wil also assume that you do not recognise ANY hypo. Same as dvla. The lower you hba1c the more risk of you going hypo and not recognising then... According to medics and those that license you...


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[mo1905]

My last was 41, 5.9 avg. I was also told that I must ne hypoing on a regular basis, but I wasn't. #annoying


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[donnellysdogs]

Well they may well go on worst scenarios.... And I don't blame them.

If on the accuchek pump they can download all your data, and I for one can honestly say that I do not recognise 100% of my hypo's. The lower my hba the worse I get. Having almost lost my license has made me take stringent steps to raise my hba1c's....


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[IanD]

I've never had a hypo, but the only diabetes drug I have taken has been metformin.

Once I got control after diagnosis at 11% my HbA1c has been below 7%. Even when I developed debilitating complications on the high carb, low fat DUK diet, it was 6.7%. I've been on the low carb, increased fat diet for 6 years with complications.

I now believe that while the high carb, low fat DUK diet may produce an HbA1c below 7%, it is the result of fluctuations between say 4 & 15, causing the need for a snack before the next meal. OTOH, the low carb, increased fat diet gives a much closer range, with a low after-meal rise & a slow fall until the next meal. I never feel hungry - I eat at meal times

I suggest you do nothing to increase your HbA1c unless you or GF get hypos. You appear to be doing everything right. KUTGW.