Drastically reducing hba1c and side effects

It is known that for some people reducing blood glucose very quickly can cause damage to eye capillaries. Bilous and Donnelly (Handbook of Diabetes ch 15 pg 115) say that a worsening (my emphasis) of retinopathy can occur with too rapid correction of [hyper]glycaemia in patients.

Unfortunately they don't say how often this occurs or what "too rapid" might look like. I suspect that as usual with B&D this is written to explain to the doctor what is being looked at rather than with the intention of helping patients avoid complications.

My own experience is that in early 2020 when my BGs were falling sharply I often had blurry vision (I assume because of the refractive index of the liquids in my eye changing) but that cleared up once my HbA1c stabilised. My lens prescription altered quite a bit at the time, but hasn't changed much since.

I’ve heard that reducing your HbA1c by more than 3% too quickly can cause retinopathy to worsen. I’m actually part of a Facebook group that extensively talks about this and how it has affected a fair amount of people. When I went onto hybrid closed loop I went from a HbA1c of 78 to 38 in less than 3 months. The consequence of that is developing maculopathy, thankfully I haven’t required treatment but 2 years down the line it still has not fully resolved.

Sorry to hear that @Nicola M .

ElenaP said:

What pump are you on?

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Medtronic 780g with Guardian 4 CGM