Hba1c too low!

Over the past year I have reduced my level from 54 to 42 which now agrees to my Dr's ideal target, however my end has set a level of 53 is 7% rather than 6% as he feels I am having too many hypos whilst trying to maintain strict control. My motivation to reduce it was to reduce some neuropathy I was feeling. I have never had any problems with the hypos and have always acted on them swiftly. I was also advised that hypos can damage the heart. What do you think I should do?

helensaramay said:

Hba1C is an average.
If you are having quite a few hypos, it is likely you are achieving this Hba1C with quite a few highs too.
I believe, the best target is to aim for a more level BG. If you have a Libre, it would be useful to understand what is causing the highs and lows and try to level them out.

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Hi there, yes correct, I'm just using normal testing strips at the most using the mysugr app to record, on a cluster graph I'm in range ie 4.1 to 7.7 about 50% of the time 20% hypo, 30% hyper but not spiking more than 12. I worked out my carb factor ratio at 1unit to 6 g of carb and I only consume about 100g of carbs per day on average, including no more than 2 slices of brown bread which can spike it. The way I achieved the drop was by increasing my basal to 50 units per day from about 10 units before, I've now dropped the basal to 35. Also note I have graves disease hyperthyroid but that's it remission and I am now actually on thyroxine as I have gone hypothyroid. I have increased the amount to 8 g per unit of insulin but if I have a carb load it will spike it to 14!

tim2000s said:

I guess the simple question in this case @johnboy326 is:

Did the Endo say that he believed you were having too many hypos or did the data support the point that you are having too many hypos?

If it's the latter, then, as @helensaramay says, you need to reduce them, as otherwise, hypo unawareness may be on the cards, and that's really not something you want. Systems which provide continuous data really do help with this kind of thing.

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Hi after I provided him with the data, however the results can be skewed rather as I will test more if I feel odd or there have been extremes of range. Very much trying to keep a strict range but I can be prone to over correcting one way or the other

My data readings are slightly distorted I record on average 6 times a day just using test strips not yet convinced about libre yet and am ocd about recording, always when first wake up and before meals and then when I dont feel right hence being 20% below 4 is probably higher than actual time spent in hypo as I jump all over extremes of range, this seems to work for me and I am a trained biochemistry graduate so data recording is important to me. What I need to do is be even more regimental with my recording ie before a meal then 2 hrs after and recalculate my insulin carb factor, and my correction factor based on the 450/500 rule,with basal being approx 50-60% of the total insulin taken and then adjust for the glycemic index of certain foods eg need to take more for bread. Since being advised by my end and dietician that I'm taking too much insulin I have reduced my hypos to just 2 a week rather than 10 actual recordings below 4 but my range has increased and a few times have woken up at 14 which wasn't happening before was more like 8 Max first thing, and surely a wider range is less good in the matter of cardio disease I am 50 13 stone and with a cholesterol of 3.9 on stations but also have graves hyperthyroidism but am actually on thyroxine as I am now subclinical hypo thyroid so as u can see there are lots of variances affecting the overall position, and I am also prone to burn out so I have to reduce my over thinking of the matter and so if I feel fine in a day when I fast my blood sugar will be flat lining all day at about 5-6 which shows that my basal dosage must be about right