HbA1c reduction rate

cara147m

Well-Known Member
Messages
47
Type of diabetes
Type 1
Treatment type
Insulin
Hello all - I was wondering if anyone had any data/evidence for rate of reduction of HbA1c to prevent worsening of retinopathy in T1DM - I am struggling to find any info about how much and quickly it is safe to reduce HbA1c by? Had some maculopathy during pregnancy years ago - likely due to pregnancy and quick reduction in HbA1c. Thanks!
 
M

Member496333

Guest
I rapidly improved my diabetes control and it totally decimated my eyes. n=1
 

BibaBee

Well-Known Member
Messages
583
Type of diabetes
Family member
Treatment type
Tablets (oral)
I've not been on here for a while and apologies for hijacking this thread, but my query is similar to the OP. Apologies for the long post too!

My partner had a very similar experience to @Jim Lahey when they rapidly got their HBA1C down from over 100 to 41 in 6 months. Almost 4 years since T2 diagnosis and still receiving regular anti-vegf treatment for Macular Odema and two rounds of treatment laser in one eye. It's been tough ride and managing mental health has proved challenging. We've remained low carb but over the couple of years monitoring stopped and exercise came to a halt. I finally persuaded them to get their HBA1C checked (they kept ignoring the GP's reminders due to poor MH, much to my frustration) and it's crept back up just into diabetic levels (51). LDL and Triglycerides also up, so some pressure to consider statins, but we're resisting that for now (particularly as it was a non fasting test). We're laying off the cheese and upping healthy fats again.

We are planning to get things under control quickly with a plan be stricter keto (there has been a little carb creep I suspect), more exercise and trying to lose a little weight (they are top of healthy bmi, but put on half stone over past couple of years). My concern is about the impact of our plan on the DME and retinopathy. We will discuss with the consultant later on this month, but wondered if anyone could advise? Would bringing HBA1C down by 10 in a few months potentially make things worse or is it more a case of drastic changes like we had early on. @Dark Horse you were a great help previously, so interested to know your thoughts.
 

Dark Horse

Well-Known Member
Messages
1,840
I've not been on here for a while and apologies for hijacking this thread, but my query is similar to the OP. Apologies for the long post too!

My partner had a very similar experience to @Jim Lahey when they rapidly got their HBA1C down from over 100 to 41 in 6 months. Almost 4 years since T2 diagnosis and still receiving regular anti-vegf treatment for Macular Odema and two rounds of treatment laser in one eye. It's been tough ride and managing mental health has proved challenging. We've remained low carb but over the couple of years monitoring stopped and exercise came to a halt. I finally persuaded them to get their HBA1C checked (they kept ignoring the GP's reminders due to poor MH, much to my frustration) and it's crept back up just into diabetic levels (51). LDL and Triglycerides also up, so some pressure to consider statins, but we're resisting that for now (particularly as it was a non fasting test). We're laying off the cheese and upping healthy fats again.

We are planning to get things under control quickly with a plan be stricter keto (there has been a little carb creep I suspect), more exercise and trying to lose a little weight (they are top of healthy bmi, but put on half stone over past couple of years). My concern is about the impact of our plan on the DME and retinopathy. We will discuss with the consultant later on this month, but wondered if anyone could advise? Would bringing HBA1C down by 10 in a few months potentially make things worse or is it more a case of drastic changes like we had early on. @Dark Horse you were a great help previously, so interested to know your thoughts.
Apologies for delay in replying. I'm very sorry to hear that you and your partner are having such a tough time.

Regarding the advisability of bringing HbA1c down by 10 mmol/mol, there doesn't seem to be a lot of information out there. Research suggests that controlling lipids is important with regard to macular oedema (although some research is contradictory) and, given that your partner's levels are only just in the diabetic range, it might be better to focus on controlling lipids (and blood pressure, if applicable) for the time being. If you could manage to encourage your partner to do a walk every day, that would not only help with HbA1c, triglycerides and blood pressure, but may have the added bonus of improving mood.
 

markpj31

Well-Known Member
Messages
177
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Diabetes.
Hello all - I was wondering if anyone had any data/evidence for rate of reduction of HbA1c to prevent worsening of retinopathy in T1DM - I am struggling to find any info about how much and quickly it is safe to reduce HbA1c by? Had some maculopathy during pregnancy years ago - likely due to pregnancy and quick reduction in HbA1c. Thanks!

I read sometime ago, in stages of no more than 3% reduction.