What is a dangerous HbA1c level

[Roggg]

For what it;'s worth, this is a pretty good meta-analysis quantifying the effects of metformin:
https://care.diabetesjournals.org/content/diacare/35/2/446.full.pdf

Short story: Metformin as a monotherapy lowers HBA1c by about 1.12%. This does NOT mean dropping the HBA1c by 1.12% of what it was prior. HBA1c is already measured as a percent (in many places..there are other measures), so this is like going from 8.12% to 7.0%. Metformin combined with other treatments had less effect. I would call 1.12% pretty modest given that my A1C has been as high as 10% before. It's enough to treat borderline diabetics or pre-diabetics into normal readings but wont be enough alone for even intermediate cases.

1.12% A1c is about equivalent to a drop in average glucose levels of about 1.7mmol/l or in the neighbourhood of 35mg/dl.

Hope this helps.

 

[lucylocket61]

For what it;'s worth, this is a pretty good meta-analysis quantifying the effects of metformin:
https://care.diabetesjournals.org/content/diacare/35/2/446.full.pdf

Short story: Metformin as a monotherapy lowers HBA1c by about 1.12%. This does NOT mean dropping the HBA1c by 1.12% of what it was prior. HBA1c is already measured as a percent (in many places..there are other measures), so this is like going from 8.12% to 7.0%. Metformin combined with other treatments had less effect. I would call 1.12% pretty modest given that my A1C has been as high as 10% before. It's enough to treat borderline diabetics or pre-diabetics into normal readings but wont be enough alone for even intermediate cases.

1.12% A1c is about equivalent to a drop in average glucose levels of about 1.7mmol/l or in the neighbourhood of 35mg/dl.

Hope this helps.

Interesting article, thanks. If appears that different amounts of Metformin gave different results.

 

[Daibell]

There are drugs like metformin that lower blood sugar just as much as a low carb diet without all the deprivation of your favourite foods that a low carb diet causes, and you have described as being a problem. If you have bad side effects from them you could ask your GP for a different version (eg slow release) of different drug.

I think you will find that for most people, Metformin only ever reduces BS a little whereas a low-carb diet can and does have a big effect

 

[Bluetit1802]

There are drugs like metformin that lower blood sugar just as much as a low carb diet without all the deprivation of your favourite foods that a low carb diet causes, and you have described as being a problem. If you have bad side effects from them you could ask your GP for a different version (eg slow release) of different drug.

Yes, there are drugs that lower blood sugar levels as much as a low carb diet will, but Metformin is not one of them. It helps to a limited extent by reducing the amount of glucose the liver shoots out and to a limited extent with insulin resistance, but it does not lower blood sugar levels sufficiently to allow patients to eat what they please without seeing increased BS levels. If it did help as you suggest, why do so many T2s initially on Metformin, eating as they please, end up on very strong drugs and even insulin?

 

[MrsA2]

Can we come back to the thread title of what is a dangerous level of Hba1c please?

 

[bulkbiker]

Can we come back to the thread title of what is a dangerous level of Hba1c please?

Was that a self nomination to be a mod? I'll second you if you like!

 

[lucylocket61]

I have only heard medical people talk of under 42 to be non- diabetic and 42-48 being pre-diabetic.

Anything above that is all described as unsafe, with no further divisions of levels of safety.

 

[MrsA2]

Was that a self nomination to be a mod? I'll second you if you like!

No! I'm just really wanting to know the answer
(And not being on metformin myself get very bored with all the circular discussions on it )

 

[bulkbiker]

No! I'm just really wanting to know the answer
(And not being on metformin myself get very bored with all the circular discussions on it )

Anything into the pre diabetic or diabetic level is "dangerous".. the degree of danger probably depends on how much over it is.
For me anything over 40 mmol/m should be classed as "dangerous" .

 

[VashtiB]

Hello @davd

It is an interesting question but I don't think there is a straight forward answer. Many people smoke and don't get lung cancer others don't smoke and get it. Human bodies are very complicated.

My take on it is that many people live well into their 80s or even older. I would like to avoid those complications caused by diabetes. The best way to achieve that is to keep my levels as low as possible. It may be that I could take after my mother who does not look after her diet and has been diagnosed with diabetes and is in her 80s with no complications or I could be like may younger brothers who already have ulcers on their legs. I love carbs. I miss them but I want to be as healthy as possible. While the thought of losing a limb would be horrible- I could just about cope with that. My father lost an arm in an accident before I was born and it never stopped him doing anything. I fear particularly the loss of my sight. As a lawyer I could not practise without my sight but in life my big love is reading and I dread being old and infirm but not being able to read.

The decision is yours- you need to make a decision that you can live with. I hope you make an active decision rather than just drift letting the levels just gradually rise. I don't think you are that old. All that said my decision may be different if I am diagnosed with a terminal illness- a number of my clients have had terminal illnesses and died so it is something I do speculate on from time to time.

 

[davd]

Hello @davd

It is an interesting question but I don't think there is a straight forward answer. Many people smoke and don't get lung cancer others don't smoke and get it. Human bodies are very complicated.

My take on it is that many people live well into their 80s or even older. I would like to avoid those complications caused by diabetes. The best way to achieve that is to keep my levels as low as possible. It may be that I could take after my mother who does not look after her diet and has been diagnosed with diabetes and is in her 80s with no complications or I could be like may younger brothers who already have ulcers on their legs. I love carbs. I miss them but I want to be as healthy as possible. While the thought of losing a limb would be horrible- I could just about cope with that. My father lost an arm in an accident before I was born and it never stopped him doing anything. I fear particularly the loss of my sight. As a lawyer I could not practise without my sight but in life my big love is reading and I dread being old and infirm but not being able to read.

The decision is yours- you need to make a decision that you can live with. I hope you make an active decision rather than just drift letting the levels just gradually rise. I don't think you are that old. All that said my decision may be different if I am diagnosed with a terminal illness- a number of my clients have had terminal illnesses and died so it is something I do speculate on from time to time.

Thanks for that great answer.
I think now I understand how everybody is different on how they react to carbs and high blood sugar.
I managed to get down from 90 to 40 in three months and have kept it there for the last 9 months just with moderately low carbing 60 to 80 per day ,it was after increasing just slightly my carbs my readings started to rise and I was worried that if it stabelised at about 50mmol/mol it would cause me damage.
Yes it could but also maybe not so to be on safe side I’ll try and keep doing what I’ve done for last year.
It seems some people can have 100+ carbs a day and be ok and others have to keep below 50 keto , I am one of those in between so I have a little bit to be thankful for .