• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Can Your A1c be too low? - Article

My father was T1 diagnosed in the early 40s. My brother T1, diagnosed in the late 50s

My father certainly followed a prescribed diet, can’t remember precise details, but food was Reds, Greens and Blacks.

Could be wrong, but greens were things he could eat freely, I think and blacks were measured, so maybe reds were don’t eat at all.

We never had desserts in the house, my father was diagnosed before I was born, my brother when I was a little girl. Sweets, for me, we’re like a ‘dirty little secret’ - I could only eat them out of sight of my brother. Meals were fairly standard, I remember my father having 2 boiled potatoes, no more, no less, with his dinner every night. And there was always meat and there was always greens.

I remember being intrigued by his urine testing chemistry set, his aim was to be ‘green precip’.

I remember the advice changing to ‘base the meals on carbs’ - by then I was a ‘Paramedical Professional’ a Radiographer actually, and believed everything new - and trying to explain it to my father - and him having none of it! He never did change, he lived to be 86. He did have the odd hypo - usually when he got delayed or his routine was disrupted. He had a serious hypo in his very late 70s, when he fell asleep on a long coach journey and slept through lunch. Had I known he was making the journey alone I would not have allowed it, but, fiercely independent, he allowed me to believe that he was accompanied by his younger brother, when I dropped him at the Coach Station. He was treated by the paramedics, presumably with Glucagon, and when he recovered consciousness, refused to be admitted (typical) but then set off running because he was late to meet his brother, and had a Cardiac Arrest. But he had a good and a full life, the last few years were a bit of a challenge because the anoxia resulting from the Cardiac Arrest robbed him of his memory. We could not have insulin in the house because he could never remember he had already injected himself and would do it again and again. And he could hunt it down! I arrived home one day to find the district nurse trying to ‘teach him how to do his own injections so he could be independent’. I exploded in a fury!

So no, in my experience and recollection, diabetics throughout the 60s, 70s and much earlier (but I was too little to remember) did follow well structured, restricted diets that actually made sense.
 
Not everyone can afford pumps, let alone CGM long-term. In Oz you are subsidized for CGM costs up til the end of your 18th year of age.( assuming you have have waited on the Oz Govt pump list for long enough, or paid up by private insurance for a suitable pump). Pregnant diabetics are not subsidised for CGM in Oz. (go figure!)
So we are stuck with regular BSL monitoring and HBA1C. And let us remember that some of us developed diabetes before home glucose monitoring and HBA1C were available.
As you know home blood glucose monitoring of T2D is controversial in UK because of NHS restraints and policy.
Not so in Oz.
Whilst insulin pumps and GGM systems can produce great stability, let us not forget that CGM readings are sometimes inaccurate, that pumps, and needle inserts in particular, can cause problems which may overwhelm CGM correction systems. Add stress, the general decrease in stability of diabetes with consequent need for increase medication and intensity of management over time, and illness to any level of diabetes management and readings can go haywire.
Given all that, we are left with an imperfect measurement , HBA1C, which is the best overall measure we have to date for ALL diabetics.
 
Back
Top