HbA1c levels

[Humminglime]

Hi all, I've been on my diabetes journey for a few years now and I'm getting the hang of it slowly.

I've accepted that I need medication. I think the stigma and the feeling that I'd failed was putting me off. I felt like I wasn't doing "well enough" and medication was admittance of that. I now see it was for the best and I truly needed it.

I find where there is stigma around diabetes being the "fat" disease and the person's own fault where by its type 2. There is always the pressure to be "the best diabetic" that has it all under control and eats perfectly all the time. Exercises all the time. Has their stuff together really and thats not me! I'd always been active with a relatively healthy lifestyle and found I gained a lot of weight after the diagnosis, not before.

Anyways, I'm on medication and my HbA1c is on the decline finally. While my gp is happy with my latest result of 58, I'm not really sure where I should be aiming for realistically. What is a level where I'm not damaging myself? Or going to see the affects in several years. To note I'm only 28, diabetes runs in my family and we didn't know until I was tested. We were expecting it to likely happen much later in my life but here we are.

So any help would be appreciated and thanks in advance!

 

[Mrs HJG]

Glycosylated haemoglobin & diabetes. HbA1c facts, units, diagnosis, testing frequency, limitations, control & conversion. How blood glucose levels link to A1c.

Glycosylated haemoglobin & diabetes. HbA1c facts, units, diagnosis, test frequency, limitations, control, conversion. How blood glucose levels link to A1c.

www.diabetes.co.uk

The link above gives you all the relevant levels, hope it helps I'm not T2, so can't really comment, but I am a low carber, trying to hang on to my insulin production for as long as possible, and know lots of T2s go this route too - lots on the forum to help on this.

 

[Brunneria]

An HbA1c of below 42 is considered normal in the UK (that is, below prediabetic), and anything above 47 is considered fully diabetic, for type 2s.

In America, the cut off for prediabetes is lower, so they have a larger chunk of the population classified as 'not normal'.

There is a school of thought that says truly 'normal' people rarely ever had a blood glucose higher than 6.6 mmol/l (which roughly equates to the bright green area in the image below). Of course, there is a difference between current (snapshot) blood glucose levels, and HbA1c (average) blood glucose levels, so this comparison is rather inaccurate.

The reason for the idea that 6.6 is the max safe level, is that there have been studies (you can find the references to them on the https://www.bloodsugar101.com/ website) that show damage is done to the insulin producing cells in the pancreas (the cells are being effectively bathed in too much glucose which causes the damage, if you spend much time above 6.6mmol/l. The effect of this is that, in the long run, you progressively damage your capacity to produce insulin, and over time, will become unable to produce your own insulin in sufficient quantities, leading to progressively worsening blood glucose control.

The damage may take years to emerge, but it is what leads to eye, nerve, circulation and kidney damage. Diabetes is the largest cause of blindness, dialysis and amputation for the elderly.



Congrats on your acceptance. I don't say that lightly. It is a huge step. No matter where we are on our journey with D, accepting where we are, without beating ourselves up for things not being 'perfect' is a massive help, because it allows us to work from where we are, rather than making things worse for ourselves before we start.

If you choose to nudge your HbA1c downwards, there are a number of ways you can do that, from dietary changes such as lowering carb intake, more activity and exercise, changing eating times and frequency, and even more medication. The NHS is supposed to keep tweaking medication and offering assistance until we have HbA1cs of at least below 53.

 

[Humminglime]

An HbA1c of below 42 is considered normal in the UK (that is, below prediabetic), and anything above 47 is considered fully diabetic, for type 2s.

In America, the cut off for prediabetes is lower, so they have a larger chunk of the population classified as 'not normal'.

There is a school of thought that says truly 'normal' people rarely ever had a blood glucose higher than 6.6 mmol/l (which roughly equates to the bright green area in the image below). Of course, there is a difference between current (snapshot) blood glucose levels, and HbA1c (average) blood glucose levels, so this comparison is rather inaccurate.

The reason for the idea that 6.6 is the max safe level, is that there have been studies (you can find the references to them on the https://www.bloodsugar101.com/ website) that show damage is done to the insulin producing cells in the pancreas (the cells are being effectively bathed in too much glucose which causes the damage, if you spend much time above 6.6mmol/l. The effect of this is that, in the long run, you progressively damage your capacity to produce insulin, and over time, will become unable to produce your own insulin in sufficient quantities, leading to progressively worsening blood glucose control.

The damage may take years to emerge, but it is what leads to eye, nerve, circulation and kidney damage. Diabetes is the largest cause of blindness, dialysis and amputation for the elderly.

View attachment 59245

Congrats on your acceptance. I don't say that lightly. It is a huge step. No matter where we are on our journey with D, accepting where we are, without beating ourselves up for things not being 'perfect' is a massive help, because it allows us to work from where we are, rather than making things worse for ourselves before we start.

If you choose to nudge your HbA1c downwards, there are a number of ways you can do that, from dietary changes such as lowering carb intake, more activity and exercise, changing eating times and frequency, and even more medication. The NHS is supposed to keep tweaking medication and offering assistance until we have HbA1cs of at least below 53.

Thank you for taking the time to come back to me on this with such a detailed reply. I’ll definitely check that website out.

It’s a difficult journey for all of us and such a big lifestyle change. I think after accepting the diagnosis it’s really a rediscovering yourself journey that incredibly difficult and emotionally taxing but when you start to see the other side it’s worth it!

i want to get my HbA1c as low as it needs to get but I’m not getting a lot of direction just ‘your doing good’ or ‘we’re happy with your levels’. Keep getting offered slimming world and it’s driving me crazy! Though that’s more my dislike for the programme

I will aim for 53 and below going forward then I think!

Again, thank you

 

[Humminglime]

Glycosylated haemoglobin & diabetes. HbA1c facts, units, diagnosis, testing frequency, limitations, control & conversion. How blood glucose levels link to A1c.

Glycosylated haemoglobin & diabetes. HbA1c facts, units, diagnosis, test frequency, limitations, control, conversion. How blood glucose levels link to A1c.

www.diabetes.co.uk

The link above gives you all the relevant levels, hope it helps I'm not T2, so can't really comment, but I am a low carber, trying to hang on to my insulin production for as long as possible, and know lots of T2s go this route too - lots on the forum to help on this.

thank you for you input I’ll check the website out!