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HbA1c = 35

pshawfocus

Active Member
Messages
26
Location
Croydon, South London, UK
Type of diabetes
Type 1
Treatment type
Insulin
Hi All

I'm a 44 yo, 30+ year type 1, male, consider myself very well controlled, I cycle 80+ miles most weeks (my job is mostly office based so I cycle to / from work), I've always eaten LC with Moderate Fat to avoid cholesterol complications. Sensitivity to hypo's still very good. Recent HbA1c test came back with 35 which my doctor was concerned about.

Does anyone know of any health issues (side effects) which might arise with a consistent low long term blood sugar level for T1s? As long as sensitivity to low sugar (hypo) remains (and i doubt it's an on / off switch), I can't see any problems? I'm on Novomix 30/70 twice a day - same regime as when I was diagnosed.

Gary
 
Providing your HbA1c of 35mmol/mol isn't a reflection of regular hypos then it's not a problem. If you're having 3 or less mild hypos per week and recognise the symptoms at 4mmol/l or just below then you're all good.

I had this discussion with my diabetologist at the last appointment, and their concern was that low HbA1c's can often come about from frequent hypos, which is quite true. She also advised that there is little difference between Having an HbA1c in the 30's vs that of an HbA1c somewhere around 40-50mmol/l. She did say the evidence showed that someone with an HbA1c is the 30's was 3x more likely to suffer regular bouts of hypoglycemia which can severely impact hypo awareness.

I'm quite sure what I've said is an accurate paraphrase of what the doctor said, but you how clinic visits are - a little overwhelming at times. It's hard to remember everything and everything accurately...

Keep doing what you're doing if you're not having frequent hypos and certainly not disabling ones. If you can demonstrate your level of control to your Dr from some sort of Flash Monitoring/CGM graph, then that will probably put his mind at rest.

An HbA1c of 35mmol/mol isn't low by the way, when compared to that of a non-diabetic. So you're very unlikely to suffer any health problems from that. Certainly none that I can think of. There is correlation between rapidly reduced HbA1c's and eye problems, but that's not applicable to your situation.
 
Last edited by a moderator:
As @GrantGam has said GPs will expect an HbA1c of 35 to be accompanied by frequent lows. Since going onto insulin 15 months ago my HbA1cs have been 38 and 35. In all that time I've had one hypo of 3.9 (after 14 months of control), which I know I caused. I knew I didn't feel right, tested, and headed it off with jelly babies. If you're well controlled, there is no problem. I compare low HbA1cs to driving fast. Some are unsafe at 70mph, others quite safe at 80 mph.
Geoff
 

This guy is T1 I think and recorded how he ended up with exactly the same Hba1C using two different diets , one low carb with little hypo, one high carb with more variation, more drugs and more hypos. Might be worth investing in a two week CGM so that you can see for yourself that your lows are not very low commensurate with your highs not being high and you low overall hba1C ?

https://diatribe.org/low-carb-vs-high-carb-my-surprising-24-day-diabetes-diet-battle
 

Thanks all.

What's a CGM?
 
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