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Can a HbA1c of 4.3 (23 mmol/mol) be possible?

VictorVillalobos

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Other
Hi Guys,
Since many of you have a lot of experience on long-term, low carb diet: is it possible to achieve a HbA1c=4.3 (23mmol/mol)?

Average doctors do not know. The laboratory says the value is correct, but I have doubts.

It seems to be out of range, even for normal persons. But perhaps under low carb diet is possible?
 
The range seems to bottom out at 21 so I guess the answer is yes, but you wont have many other folk on the planet for company
 
I have to admit it is very unusual, and see from your signature you have struggled with an OGGT.
What sort of levels do you see self testing pre and post meal? Do they correlate with such a magnificent HbA1c?

There is an article here that you may or may not know about, and worth a read.

https://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker/

It is always possible you are a low glycator, meaning basically your red cells don't live as long as the standard (one size fits all) range and therefore don't accumulate as much glucose. (exactly the opposite from me!)

Well done though. Huge respect and a lot of envy!
 
The correlation between HbA1c and average blood glucose levels is not exact. For a given average blood glucose level, the HbA1c will be lower if the average red blood cell lifespan is shorter and the HbA1c will be higher if the average red blood cell lifespan is longer. Also, the glycation rate can vary from person to person. I look at HbA1c as useful to see how you're doing over time, but don't take the HbA1c conversion to average blood glucose level literally. In your case, 4.3% converts to an average blood glucose level of 4.2 mmol/L. If your daily glucometer readings are higher than this, then maybe your red blood cells are shorter lived than average or you're a low glycater.
 
The maths says yes, it is possible, but what is the maths based on? The standard chart goes down to HbA1C of 4%, which gives 20.2 mmol/mol. And if you continue, this gives an estimated eAG of 3.0 mmol/l. eAG is the estimated blood glucose level that, if maintained for 2-3 months, would produce the HbA1C referred to. Now, whether anyone can sustain a blood glucose level of 3mmol/l for 2-3 months to produce a HbA1C of 4% is very doubtful.
For information, a HbA1C of 4.3% would in theory be produced by an eAG of 4.3, which is my current average.
But I think these charts and tables are all approximations, estimates, interpolations and extrapolations, but work fairly well within normal ranges.
As to whether it can be achieved, I plan to get a lot lower than my current 31 (5%), so I will let you know!
 
Hi All

Hi all. I guess the mistery is solved. It happens that I moved from living at 400m above sea level to 2120 meters. Therefore my body is still creating more hemoglobin, new, fresh, not glycosilated. I guess i have to wait more than 3 months in order to see a reliable HbA1c value. Hopefully it will still be low. Thanks all !
 
Mr_Pot said:
If you are running close to hypo levels, is that a good idea?
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I'm not sure you understand how the HbA1c is calculated.

I've never had a "hypo" and I doubt I ever will.

Having a BG level running between 4 and 5 is quite normal for a human being.

I am not remotely worried, in fact I am glad that I have managed to get the disease under control and in some way normalise my symptoms
 
Because as far as I am aware if you are not taking anything to lower your blood sugar you cannot have a "hypo" although your blood sugar can go below 4 mmol/l .
 
bulkbiker said:
Because as far as I am aware if you are not taking anything to lower your blood sugar you cannot have a "hypo" although your blood sugar can go below 4 mmol/l .
Click to expand...
But why is a low BG from dieting different from a low BG from medication?
 
Hi, you wouldn't naturally hypo unless you had another illness that causes the individual to produce too much insulin naturally. Having too much of medication in your system (insulin) etc will cause a hypo. Hope this helps
 
bulkbiker said:
because hypo's can be fatal...
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I agree, but it is the lack glucose for the brain that can be fatal, I can't see that how you got that lack of glucose makes any difference. If the fuel pump is broken or I didn't put any petrol in the tank it is still the lack of fuel that will stop the engine.
 
Using medication to lower your BG is "unnatural" Diet and exercise is "natural"

With medication your body's natural defences against low BG do not work.

If you control your BG with diet your body's natural defence mechanism, the Liver can stop you having a Hypo.

Medication will likely neutralise this defence mechanism.

Even a relatively mild drug like Metformin would be dangerous to take if your HbA1c was in the 20's
 
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