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Can Your A1c be too low? - Article

The conclusion of this article seems to be if you have a low A1C, there is a risk this may be due to many hypos.
If you have a CGM and can prove the low A1C is not due to hypos, then it is ok.
However, if you have no CGM, there are too many unknowns so the risk of hypos should be considered high.
 
Which is why if you do not have a cgm then regular testing and recording of readings is most important to spot peaks and troughs as well as trends.
 
helensaramay said:
The conclusion of this article seems to be if you have a low A1C, there is a risk this may be due to many hypos.
If you have a CGM and can prove the low A1C is not due to hypos, then it is ok.
However, if you have no CGM, there are too many unknowns so the risk of hypos should be considered high.
Click to expand...
I think the risk of hypos applies mostly to T1s, who are more likely to be using some form of CGM?
 
Mel dCP said:
Perfect timing, just printing off a copy to take to my telling off appointment this afternoon, as they think my last HbA1c of 43 is too low :mad:

Along with 90 days of Libre data... An average BG of 6.6mmol with a standard deviation of ±1.7 - not as low an SD as in the article, but not bad, I don’t think!
Click to expand...
You could also try quoting Dr Bernstein, "Diabetics have a right to normal blood sugars", but they probably / almost certainly haven't heard of him.
 
I expect a lot of disagreements on this but I think A1c is a load of cobblers that shouldn't be taken too seriously, at least if you have CGM/FGM that will show you exactly when your levels are where you want them to be and when they're not. Averages are unreliable and can easily be tweaked to suit your argument despite not actually reflecting it if you look at the raw numbers that you can see with your CGM/FGM. This whole obsession over A1c will probably looked back on as a headscratcher once CGM/FGM is the norm and there is proper analysis over how our levels are affected by what we eat and inject and so on rather than just saying you're doing well because your average falls within an agreed upon range with no concern for how that actually happened.
 
jlarsson said:
I expect a lot of disagreements on this but I think A1c is a load of cobblers that shouldn't be taken too seriously, at least if you have CGM/FGM that will show you exactly when your levels are where you want them to be and when they're not. Averages are unreliable and can easily be tweaked to suit your argument despite not actually reflecting it if you look at the raw numbers that you can see with your CGM/FGM. This whole obsession over A1c will probably looked back on as a headscratcher once CGM/FGM is the norm and there is proper analysis over how our levels are affected by what we eat and inject and so on rather than just saying you're doing well because your average falls within an agreed upon range with no concern for how that actually happened.
Click to expand...

I don't think there is anything to disagree with there.
 
Mel dCP said:
Perfect timing, just printing off a copy to take to my telling off appointment this afternoon, as they think my last HbA1c of 43 is too low :mad:

Along with 90 days of Libre data... An average BG of 6.6mmol with a standard deviation of ±1.7 - not as low an SD as in the article, but not bad, I don’t think!
Click to expand...
As the article says time in range should be the key metric not HBa1c. Your results are awesome but probably deeply confusing to your consultants. See how many times you can say nutritional ketosis to cause maximum peturbation..
 
helensaramay said:
The conclusion of this article seems to be if you have a low A1C, there is a risk this may be due to many hypos.
If you have a CGM and can prove the low A1C is not due to hypos, then it is ok.
However, if you have no CGM, there are too many unknowns so the risk of hypos should be considered high.
Click to expand...
Hmm, Helen, that may be true within the diabetes parameters but an extremely low A1c can surely be a cause of other issues, not necessarily associated with hypo's or diabetes. I was reading about it recently and an A1c lower than 4 (it specifically stated in the 2s or 3s) can be a sign of something serious.
 
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