HbA1c concern

[kellie lees]

I’m wondering if anyone could offer any advice (non-medical) about a recent HbA1c reading - my husband has been diabetic for 18 months now at first he suffered a lot of hypos but pretty much has them under control. He wears the freestyle LibreLinkUp so checks his levels with that but also does finger prick. His levels are in range with probably about one hypo still a month (I know this is a lot but it’s early days!) he ranges from about 5-14 but when he gets a 14 he tends to act on it and give himself some insulin. The nurses have offered advice along the way and said he’s doing well.

His recent hba1c however came back at 41??? My husband rang the nurse as he said he hasn’t been low or had loads of hypos so couldn’t understand this reading. The nurse said it was concerning and that she thought his body had too much insulin but now we don’t know what to do? He can’t just stop giving himself insulin??

 

[Juicyj]

Hi @kellie lees - one hypo a month is not a lot at all in fact it’s amazing considering his HbA1c is 41, I average 2-3 a week and my last HbA1c was 54, judging by what you've written his results are great so unsure what point the nurse is attempting to make, did you tell them he only has 1 hypo a month as they might of had a concern that he was suffering more hypos to achieve this ?

 

[kellie lees]

Oh no sorry I meant one hypo A WEEK probably we can’t be exact sorry! But still it’s a very low HbA1c for him having generally ok control. The nurse said she was concerned his HbA1c was 41 and said he had too much insulin in his body! Apart from reducing his long lasting she didn’t say what else to do but I’m worried he’s doing damage? I hope we don’t sound too silly

 

[EllieM]

Those results sound awesome and wonderful to me. However, when you say 1 hypo a week, does that include any reading that is 3.9 or less or just ones that make him "feel funny". The nurse is possibly worried that he is getting too used to low readings, and may lose hypo awareness. She may also not be used to the fact that people with a cgm (continuous glucose monitor) can fend off highs before they really happen by giving small doses of insulin. (Though given some people have pumps I don't really see why not.)
Has he had any serious hypos? (ie ones where he's had to be rescued by other people) If not, I don't really see the issue, (unless he starts to lose hypo awareness....)
Keep up the good work.

 

[kellie lees]

But we are slightly concerned that a HbA1c of 41 is not in range for a diabetic and we are questioning why it is so low when he does have good control? His hypos (touch wood) have never been serious and he has good hypo awareness but a HbA1c is 41 is not right is it and is it s worry to have it that low?

 

[Diakat]

Hi, mine is lower than that and my team are happy. If your husband feels the hypos when they come then keep doing what is working.

 

[Freema]

But we are slightly concerned that a HbA1c of 41 is not in range for a diabetic and we are questioning why it is so low when he does have good control? His hypos (touch wood) have never been serious and he has good hypo awareness but a HbA1c is 41 is not right is it and is it s worry to have it that low?

An HcA1c of 41 is fine , mine was 36 last time , your husbond would he be able to manage without insuline and only keep blood glucose Down by eating very few carbs ?
He is type 2 diabetic isnt he ?

 

[EllieM]

He is type 2 diabetic isnt he ?

T1, I assume, both from the subforum and the T1 on the OP's name. (I'm guessing you're using a phone so you can't see that. ).
Hypos are a big concern for insulin dependant T1s (and T2s???), as some people do actually die from them (luckily very very few).

 

[kellie lees]

An HcA1c of 41 is fine , mine was 36 last time , your husbond would he be able to manage without insuline and only keep blood glucose Down by eating very few carbs ?
He is type 2 diabetic isnt he ?

No he is type One??

 

[kellie lees]

T1, I assume, both from the subforum and the T1 on the OP's name. (I'm guessing you're using a phone so you can't see that. ).
Hypos are a big concern for insulin dependant T1s (and T2s???), as some people do actually die from them (luckily very very few).

Yes type one - do you think the HbA1c of 41 has concerned the nurse in the sense that she thinks it’s too low due to too many hypos? It isn’t that at all I’m hoping it’s low simply due to good control and a quick reaction to highs because of the freestyle LibreLinkUp?? I was worried because the nurse said he had too much insulin in his body but obviously he can’t stop taking his insulin so I worried he is actually slowing killing himself because he’s using too much insulin? This sounds dramatic but I’m not sure how to word it sorry

 

[becca59]

If he had too much insulin in his body he would be hypo surely. Very strange remark!! Fantastic results, be proud.

 

[Circuspony]

I was told to aim for around 50 as a T1. Much lower and the chances are you are having hypos that you don't recognise and that is potentially causing brain damage.

My last one was 48, which they were fine with, but I exercise daily and struggle to keep my BG levels up so I know I'm falling to around 4 regularly each day. Because i know this is happening I don't always test - I just eat. I get through a lot of cereal bars.

41 would suggest to me unrecognised hypos which I think is what the nurse is concerned about.

 

[slip]

If he's not having lots of little hypos then well done him on a great hba1c score. However you say he ranges from 5 to 14, obviously it depends on how long the highs are (short by the sound of it) but was wondering if his red blood cell life span is shorter than most so give a slightly flawed low result - what does the libre software suggest his hba1c is? if they pretty well match then great. And also assuming the accuracy of the libre has been checked appropriately against a BG finger prick test now and again.

Is he killing himself by having a low hba1c........no.