A1C reduction - realistic outlook

[Red_Fox22]

Hi All

I previously posted the good news about the rapid and significant drop in my initial reading of A1C at diagnosis of 109 to 60 after three months of low carb including one month on metformin..

Thank you all for your kind comments.

I cannot be complacent of course but all things being equal it seems as though my BS levels should soon be normalish - I am aiming for a level of 48.

Once (if) I get there I understand that my risk of developing complications is "drastically reduced". Does anyone know what that means in % terms?

I am only 38 years old and have ideal BMI so my Dr does not think I have common or garden T2.

If it was the case that my chances of getting complications were reduced by say over 70% that would be pretty reassuring but its not clear to me from the literature I have read what my outlook is as I will have this condition for the rest of my (hopefully long) life.

Many thanks

 

[Brunneria]

Hi,

Well done! that is a brilliant achievement!

You question about the % risks is a very complicated one, because so many different factors come into play.

Have you come across the www.bloodsugar101.com website yet? It is a brilliant source of info on type 2 (so if you eventually get a diagnosis of a different type, some of the info and advice may be less relevant to you). But it is also a good source of info on the hows and whys, the studies used to inform medical opinion, their limitations and gives a good understanding of the risks. I believe there is even a section explaining how the risks are calculated.

My best advice would be to go to the site and read it all - you will be amazed how informative it is.

 

[AM1874]

Hi @Red_Fox22 ..
Well done and many congrats on your excellent numbers ..

 

[Bluetit1802]

Well done on reducing your numbers so much. That is excellent. Keep going and you should reach your target.

 

[Resurgam]

My take on it is that if I don't have any of the underlying causes - as indicated by high blood glucose levels, then I am keeping the best course possible - as we can't know what might have been our non diabetic future, I'm now getting on with the diabetic one.

 

[librarising]

Once (if) I get there I understand that my risk of developing complications is "drastically reduced". Does anyone know what that means in % terms?

Hi, @Red_Fox22. I found this, which offers an incremental value to a lowered HbA1c. Please note how all HbA1cs are NOT 'equal' e.g.
"although HbA1c is currently the principal tool for assessing glycemic status, one must continue to measure fasting and, particularly, postprandial glucose levels, in the determination of individual glycemic risk."
http://www.diabetesincontrol.com/reduction-in-risk-of-diabetic-complications-per-1-decrease-in/
Geoff

 

[Art Of Flowers]

See http://www.diabetes.co.uk/what-is-hba1c.html

What are the benefits of lowering HbA1c?

Two large-scale studies - the UK Prospective Diabetes Study (UKPDS) and the Diabetes Control and Complications Trial (DCCT) - demonstrated that improving HbA1c by 1% (or 11 mmol/mol) for people with type 1 diabetes or type 2 diabetes cuts the risk of microvascular complications by 25%.

Microvascular complications include:

• Retinopathy
• Neuropathy
• Diabetic nephropathy (kidney disease)

Research has also shown that people with type 2 diabetes who reduce their HbA1c level by 1% are: [1]

• 19% less likely to suffer cataracts
• 16% less likely to suffer heart failure
• 43% less likely to suffer amputation or death due to peripheral vascular disease

 

[NatJS]

Although everyone's talking a lot about blood sugar levels, it seems insulin levels come into play a lot too as high insulin levels can also be very damaging in the long term! In type 2 diabetics this seems to be a significant issue because we tend to have very high insulin levels in our blood. Some interesting reading here: http://insulinresistance.org/index.php/jir/article/view/18/25

 

[Bluetit1802]

I would also urge caution when using the HbA1c results alone. The way they are calculated does not take account of swings from high to low. They are just a sort of average, but as we spend the majority of our time at lower levels, and a shorter time at higher levels after eating, the lows outweigh the highs and the average is therefore not a true measure. It is the spikes and the frequency of the spikes that cause the damage.

Then of course, there are those whose red blood cells live a lot longer than the 2 to 3 months standard, and there are those whose red blood cells die off before the 2 to 3 months. The 2 to 3 months is a "one size fits all" but of course, it doesn't fit all.

The best method of measuring control, in my opinion, is by regular testing post meal and keeping those spikes down as low as you can.

 

[Brunneria]

Yes, I agree with @Bluetit1802
- the standard deviation between highs and lows, also plays a big part and cannot be seen on an HbA1c test.

There are also some very interesting YouTube vids by Ivor Cummins on the links between hyperinsulinemia and long term health
https://www.youtube.com/channel/UCPn4FsiQP15nudug9FDhluA

 

[Art Of Flowers]

Although everyone's talking a lot about blood sugar levels, it seems insulin levels come into play a lot too as high insulin levels can also be very damaging in the long term! In type 2 diabetics this seems to be a significant issue because we tend to have very high insulin levels in our blood. Some interesting reading here: http://insulinresistance.org/index.php/jir/article/view/18/25

Which would suggest that treating type 2 diabetes with insulin should be a last resort and a low carb diet based treatment is much preferred. Insulin resistance seems to be partly connected with the modern habit of constantly snacking and not leaving the body time to reset and repair itself between meals. I presume as the article is authored by Jason Fung that he would see fasting as a key remedy to insulin resistance. Fasting does seem to reduce levels of IGF-1 in the blood which is associated with a variety of diseases such as cancer and Alzheimer's.

 

[Art Of Flowers]

I am just watching "That Sugar Film" where a documentary maker in Australia subjected himself to 40 teaspoons of sugar a day for a few weeks to see the effect on his health. The result was Insulin Resistance, fatty liver and a lot of poor health markers. The equivalent of 40 teaspoons of sugar is the average consumed daily by a Australian. This amount of sugar is easily consumed as sugar is hidden in many everyday foods such as "low fat yoghurt", baked beans and "healthy" snack bars. It looks like reducing carbs and sugar will dramatically improve the health of the average person as well as those with diabetes.

 

[Red_Fox22]

Thanks for the notes.

I need to learn more about these spikes, like most T2 I was advised by my Dr not to get a monitor and in truth I was not unhappy about that since the finger pricking and paranoia caused by the constant checking seemed like a pain. I was happy to rely on just A1C if the numbers were coming down. It sounds like this is inadequate.

Geoff - the link you sent me is very encouraging. I have dropped 5% points so according to that it is a mathematical impossibility for me to get the complications! I suspect that is a little too optimistic but thanks all for the information.

 

[Bluetit1802]

Thanks for the notes.

I need to learn more about these spikes, like most T2 I was advised by my Dr not to get a monitor and in truth I was not unhappy about that since the finger pricking and paranoia caused by the constant checking seemed like a pain. I was happy to rely on just A1C if the numbers were coming down. It sounds like this is inadequate.

Geoff - the link you sent me is very encouraging. I have dropped 5% points so according to that it is a mathematical impossibility for me to get the complications! I suspect that is a little too optimistic but thanks all for the information.

A meter and finger pricking are essential if you want full control otherwise you are working blind and just relying on the HbA1c every so often. It can be a pain, but it is something we have to do and soon becomes part of life.

 

[Allessandra]

I am just watching "That Sugar Film" where a documentary maker in Australia subjected himself to 40 teaspoons of sugar a day for a few weeks to see the effect on his health. The result was Insulin Resistance, fatty liver and a lot of poor health markers. The equivalent of 40 teaspoons of sugar is the average consumed daily by a Australian. This amount of sugar is easily consumed as sugar is hidden in many everyday foods such as "low fat yoghurt", baked beans and "healthy" snack bars. It looks like reducing carbs and sugar will dramatically improve the health of the average person as well as those with diabetes.

Thanks for putting that up! Great stuff. How amazing that he put on so much weight and so many inches of fat around his belly from just eating 'healthy' - big business has a lot to answer for.