HbA1c confused

[kellie lees]

Hello,

Wondering if anybody could clarify this (whilst we away to hear from the DSN). My husband was diagnosed type 1 in January of this year. He had his first hbA1c in April and got 46 (pre-diabetic) which we put down to the honeymoon period. He's coping with his diabetes and using the freestyle libre to help with control but still has tricky days of highs and lows (due to us still learning). He's just had another hbA1c done in September and it came back at 42. This has confused us - any ideas?

 

[TheBigNewt]

Sounds like he's pretty borderline if you ask me. Was he in full blown DKA when he was diagnosed? Because and A1C of 46 doesn't sound like his blood sugars were way high before he was diagnosed. I remember some person here post they were diagnosed Type 1 in a hospital and sent home on metformin and a little Lantus or something. And I don't think he'd even seen the diabetic nurse yet.

 

[catapillar]

What exactly are you confused about @kellie lees ?

Your husband has type 1 diabetes. The hba1c "labels" of pre-diabetic, non diabetic etc don't apply to someone with type 1. It doesn't matter where your husbands hba1c sits within that, he will continue to be diabetic whatever his hba1c is.

The target for type 1s is to have hba1c under 48.

A hba1c of 42 suggests very good diabetic control, provided you aren't having lots of hypos.

 

[kellie lees]

What exactly are you confused about @kellie lees ?

Your husband has type 1 diabetes. The hba1c "labels" of pre-diabetic, non diabetic etc don't apply to someone with type 1. It doesn't matter where your husbands hba1c sits within that, he will continue to be diabetic whatever his hba1c is.

The target for type 1s is to have hba1c under 48.

A hba1c of 42 suggests very good diabetic control, provided you aren't having lots of hypos.

We were just thinking that the 42 was a little low considering we know he hasn't had great control because he's still learning how his body reacts to certain things. I just wanted to know if he 42 was a bit too low and a concern?

 

[Juicyj]

Hi @kellie lees - 42 is a really good result so on the basis you think he doesn't have great control he is in fact doing alot better than he thinks, as long as he's not suffering lots of hypos as a result as Catapillar has pointed out then it's absolutely fine - keep doing what you are doing. He may well be in the honeymoon phase which will help his control too

 

[TheBigNewt]

She said his A1C was 46 at the onset of the disease, which to me means BEFORE HE EVER TOOK ANY INSULIN. If that's wrong please correct me @kellie lees. I think that's what she's confused about. My initial question was this: was he in full blown DKA when diagnosed? If not what criteria were used to diagnose Type 1 diabetes in his case?

 

[db89]

She said his A1C was 46 at the onset of the disease, which to me means BEFORE HE EVER TOOK ANY INSULIN. If that's wrong please correct me @kellie lees. I think that's what she's confused about. My initial question was this: was he in full blown DKA when diagnosed? If not what criteria were used to diagnose Type 1 diabetes in his case?

Check again; the original post says they were diagnosed in January and the 46 result wss in April.

 

[TheBigNewt]

Check again; the original post says they were diagnosed in January and the 46 result wss in April.

Oh yeah I missed that. I guess I was wondering what his A1C was before he took insulin, and what specific criteria were used to establish the diagnosis of Type 1 diabetes in his case. I seem to come across people who are labeled as Type 1's with different/various ways their diagnosis was made. This is a pretty serious disease to label someone with after all.

 

[kellie lees]

She said his A1C was 46 at the onset of the disease, which to me means BEFORE HE EVER TOOK ANY INSULIN. If that's wrong please correct me @kellie lees. I think that's what she's confused about. My initial question was this: was he in full blown DKA when diagnosed? If not what criteria were used to diagnose Type 1 diabetes in his case?

Sorry I'm new to this board. I don't know what his hbA1c was when he was diagnosed. The 46 was 4 months into his diagnosis. He was running on very high sugars when he was diagnosed and had ketones present. Sorry if I've annoyed anyone with my lack of understanding. We were confused with his recent hbA1c of 42 because we'd been told that his level for good control should be between 48 and 53. So as this was below the 48 we were concerned it was too low and meant too many hypos (he's had a few but not too many that we'd worried!) I know he could still be honeymooning but the last few months he's had to up his carb:insulin ratio so we thought he was coming out of the honeymoon so questioned the 42. I just wondered if it was too low if the DSN monitored his hypos and lows and contrast of highs if this makes sense.

 

[Diabeticliberty]

Sorry I'm new to this board. I don't know what his hbA1c was when he was diagnosed. The 46 was 4 months into his diagnosis. He was running on very high sugars when he was diagnosed and had ketones present. Sorry if I've annoyed anyone with my lack of understanding. We were confused with his recent hbA1c of 42 because we'd been told that his level for good control should be between 48 and 53. So as this was below the 48 we were concerned it was too low and meant too many hypos (he's had a few but not too many that we'd worried!) I know he could still be honeymooning but the last few months he's had to up his carb:insulin ratio so we thought he was coming out of the honeymoon so questioned the 42. I just wondered if it was too low if the DSN monitored his hypos and lows and contrast of highs if this makes sense.

You will absolutely not annoy anyone with a lack of understanding. It is only by asking questions that any of us get to understand anything. Ask away

 

[TheBigNewt]

How much insulin did they put him on?

 

[kellie lees]

How much insulin did they put him on?

He's on 14 units for his long lasting and his carb:insulin ratio is now 1:10

 

[TheBigNewt]

He's on 14 units for his long lasting and his carb:insulin ratio is now 1:10

Sounds pretty reasonable. Well it's good that he's under good control right? As long as he's not getting low a lot (we all do) sounds like he's doing better than most. Remember the A1C results have an error margin, maybe 5% up or down if you sent the same blood sample through the lab a second time. So 45 might be 50.