Hba1c of 145 - can blood transfusion bring this down?

[NoopNoop]

Hi, I was diagnosed with type 1 this week, so still reeling from the shock and trying to understand everything. I just got my hba1c results back and it's 145. So apparently that's really high and it's going to take a while to bring that down. My BG was 29 on Monday, now it's hovering around the teens. Am I at high risk while my hba1c is so high? Do I need to do or not do anything to try and mitigate those risks? I have an identical twin. Would it be possible to have a blood transfusion to try to bring down my hba1c quicker? Would that help reduce some risk? I should be hooked up with community DB nurse from Monday, but wanted to ask some questions before then. Thanks in advance. Jim

 

[Zhnyaka]

No, a blood transfusion won't help. But in fact, if your hba1 is high for a while, nothing terrible will happen to you, it takes years of bad bg to develop complications. Just do what the doctors tell you, take insulin and everything will get better. hba1 shows what your bg was like in an average of 3 months, so when bg become normal, it will take another 3 months for hba1 to become normal. And... if you have an identical twin, then his risk of developing t1 is quite high

 

[EllieM]

Hi, I was diagnosed with type 1 this week, so still reeling from the shock and trying to understand everything. I just got my hba1c results back and it's 145. So apparently that's really high and it's going to take a while to bring that down. My BG was 29 on Monday, now it's hovering around the teens. Am I at high risk while my hba1c is so high? Do I need to do or not do anything to try and mitigate those risks? I have an identical twin. Would it be possible to have a blood transfusion to try to bring down my hba1c quicker? Would that help reduce some risk? I should be hooked up with community DB nurse from Monday, but wanted to ask some questions before then. Thanks in advance. Jim

Hi @NoopNoop and welcome to the DCUK forums.

Your biggest risk with undiagnosed T1 and a very high blood sugar is diabetic ketoacidosis, which is caused by lack of insulin in your body leading to high blood sugar and high ketone levels in your blood
https://www.nhs.uk/conditions/diabetic-ketoacidosis/

As your blood sugar has started to come down then I assume you have already started insulin and therefore that risk is mitigated.
Other problems to do with high blood sugars are long term and not something to worry about at this stage. (Disclaimer, I'm not a doctor just a long term T1 diabetic).

Your team may want to bring your levels down slowly because too fast a drop can cause short term complications. (Plus insulin doses very drastically between different people and have to be increased slowly because too much insulin can lead to hypoglycemia.)

My advice would be to try not to panic. The treatment for T1 diabetes has improved drastically over the years and there is no reason why you can't live a long and healthy life. But it takes time to learn how to manage it. The phrase, diabetes is a marathon not s sprint comes to mind.

I'm sure you will have many many questions. Please feel free to post here for support and advice.

Once more, welcome.

ps and yes unfortunately @Zhnyaka is right , your identical twin is at risk of developing T1 (but only about 6% I believe https://academic.oup.com/jcem/article/91/5/1654/2874215 it would be a lot higher if you had developed T1 when younger.)

 

[becca59]

Hi @NoopNoop and welcome. Yes the HbA1c is very high as it often is when people are newly diagnosed with Type 1. Your individual readings will also be high to start with until you are on regular carb counting and two types of insulin. Known as basal (usually once a day) and bolus (taken to match the food you eat). What is very important is that those levels are brought back into a more consistent range without doing it too rapidly. Rapid reductions in very high glucose can affect the eyes. You may be having difficulty with sight at this moment, but slowly that will settle and return to normal. So patience is the key.
From Monday your new life with Type 1 will start in earnest. There is lots to learn. It is not easy or predictable as you will find out. But you will learn, manage and be successful. It is a journey, not a race. You will still be able to live your life as you wish doing all you want to do albeit with daily management of food and insulin in tow. Good luck, and feel free to ask anything no matter how inconsequential it seems. There will be people to help.

 

[TheSecretCarbAddict]

Think of HbA1c as a rough historical record of your average blood glucose levels over the last three months. It shows what your daily levels were like, and you can't go back and change those. What you can do is focus on here and now and what you do going forward. The way you 'fix' your HbA1c is by getting your daily readings down and then re-testing in 2-3 months.

 

[NoopNoop]

That's really helped put my mind at rest. Thank you so much for your replies!

 

[becca59]

Think of HbA1c as a rough historical record of your average blood glucose levels over the last three months. It shows what your daily levels were like, and you can't go back and change those. What you can do is focus on here and now and what you do going forward. The way you 'fix' your HbA1c is by getting your daily readings down and then re-testing in 2-3 months.

Unlikely they will retest a type 1 in that short space of time. There is a lot to learn and take on board. The most important results will be Time in Range from his CGM How the insulin is being managed to avoid hypos and hypers. HbA1c will eventually go down but it will take time and is an unrealistic criteria for a newly diagnosed Type 1 with a steep learning curve. In my opinion.

 

[TheSecretCarbAddict]

Unlikely they will retest a type 1 in that short space of time. There is a lot to learn and take on board. The most important results will be Time in Range from his CGM How the insulin is being managed to avoid hypos and hypers. HbA1c will eventually go down but it will take time and is an unrealistic criteria for a newly diagnosed Type 1 with a steep learning curve. In my opinion.

What I really meant to say was that you generally leave at least 2-3 months between the tests to see the impact of your interventions that HbA1c is not a metric that changes drastically from hour to hour. It might well be that for different reasons, you test less frequently.

 

[searley]

Hi, I was diagnosed with type 1 this week, so still reeling from the shock and trying to understand everything. I just got my hba1c results back and it's 145. So apparently that's really high and it's going to take a while to bring that down. My BG was 29 on Monday, now it's hovering around the teens. Am I at high risk while my hba1c is so high? Do I need to do or not do anything to try and mitigate those risks? I have an identical twin. Would it be possible to have a blood transfusion to try to bring down my hba1c quicker? Would that help reduce some risk? I should be hooked up with community DB nurse from Monday, but wanted to ask some questions before then. Thanks in advance. Jim

If you had a hba1c immediately after a transfusion then yes you may see a reduction in hba1c as not all the blood in the test is yours.. but there is no benefit if you have not fixed the cause.. you’d simply be masking the truth

In reality all you can do is work on your bg control

Short term high hba1c won’t harm you it’s long term that causes all the nasty stuff to happen

 

[NoopNoop]

If you had a hba1c immediately after a transfusion then yes you may see a reduction in hba1c as not all the blood in the test is yours.. but there is no benefit if you have not fixed the cause.. you’d simply be masking the truth

In reality all you can do is work on your bg control

Short term high hba1c won’t harm you it’s long term that causes all the nasty stuff to happen

I understand that now, thanks for clarifying.

 

[hyponilla]

Hi @NoopNoop I just wanted to add that there is a rare complication called treatment-induced neuropathy that happens from a rapid drop in HbA1c. I got it after my diagnosis by dropping my HbA1c from 91 to 42 within three months and I was in so much pain I could barely walk some days. So like everyone already mentioned, don't stress too much about having high blood glucose for a while and try to decrease your levels slowly over time rather than abruptly because your body will have adjusted to the higher levels. Knowing what I know now, I would never have dropped my levels as quickly as I did.