• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

How low is too low for an HbA1c?

I did see your post after I had made my reply Grazer and you made the point I was trying to make so much better than I did.

Scaremongering should have no place on a help forum. IMHO the mods should stop sitting on the fence and deal with rubbish like this so that no new members take it as sound advice.
 
Once again, can i say that we are all different and therefore some of us may have other contributing factors that need considering when setting HbA1c targets.

I agree scaremongering is not helpful and has no place here.

I would suggest your consult your HCPs about your own HbA1c.
 
So pleased you posted Sid- see how you are missed!

I sometimes wonder if people who claim to have achieved these wonderful results are in fact diabetic. I occasionally seems almost as if people actually want to have the disease ..

I can hink of a few reasons why this migh be bu its sad and doesn't do anyone any favours.
 
ClaireG 06 said:
Once again, can i say that we are all different and therefore some of us may have other contributing factors that need considering when setting HbA1c targets.
Click to expand...

This is exactly true. There are very good reasons why lots of people cannot achieve aggressive HbA1c targets (as lots of us have agreed above and in different threads). "Type 2 Diabetes" is just an umbrella diagnosis for lots of different complaints that share a common set of symptoms.

I think the quote from BloodSugar101 has been taken out of context. The whole point of the book is that there is very little scientific data on long-term complications for people HbA1cs of less than 7% . She suggests that you take your HbA1c as low as you can, but also admits that she (like all of us) has found a level that she is comfortable with (without having to "low-carb" to Bernstein levels).

ClaireG 06 said:
I agree scaremongering is not helpful and has no place here.
Click to expand...

I agree too. I agree with Sid, and I agree with Grazer.

However, I don't think that we should be afraid of demonstrating that some T2s (not all) can get near non-diabetic HbA1c with a bit of time and effort. When I was diagnosed all that I needed to know was that it was possible to control my T2 diabetes. I took strength from those people in the "5%" club. Once I knew that it was possible, the actual sacrafice needed join the club was easy.

ClaireG 06 said:
I would suggest your consult your HCPs about your own HbA1c.
Click to expand...

Obviously you should discuss everything with your HCP, but unless you have an unusually well informed GP, you're quite likely to be told that HbA1c of below 7% is good enough.

It's your body and ultimately you need to work out for yourself the HbA1c level that you can safely and sustainably achieve.

Stephen
 
"An unusually well-informed GP". Personally I would jus setle for a Gp . Not only do the GPs in my practice shy away from any hing to do with diabetes but one now has to fight even to find out what ther HBAIC results are - let alone the rest of them .
Patients are now expected to be satisfied wih a "Normal" result. Apparently only if it falls outside he targe
of 7'5 :I think} does the DSN contact the patient.

The last ime I asked to speak to the DSN about my results{because I knew he figure I had been given by the receptionis was wrong} I was told that she would try to ring me between *.30 and %.30 4days later.

A figure of 7 is good enough because it meets the target comfortably. A sign of the imes I'm afraid.
 
In my own post, I didn't mean to suggest that people should be unhappy with their A1c's if their A1c's are coming down, but we shouldn't be complacent. I've had a remarkable experience since I started insulin. For about 4 months I was doing not so well in controlling my carbs (about 200 grams per day), and then I had 2 months in which I really lost control (230 to 240 grams per day on average). (My goal has always been 150 grams per day.) Obviously, I have issues with food. However, I ended up with an A1c of 6 because I covered my slips with injections of insulin. If I can get an A1c of 6 on such a poor diet, then certainly other people can. Part of the problem, in my opinion, is that a lot of diabetics haven't found the right treatment regimen. Also, some diabetics may be happy with a high A1c in lieu of starting insulin injections. What I'm saying is: Don't be satisfied with an A1c that is too high, as it could be harming you in ways that you don't realize.

Now, I don't mean to be bawdy, but there was an Oprah Winfrey show in which experts fit (fitted?) a whole bunch of female audience members with properly sized brassieres. It seems that many women settle on a brassiere size that isn't right for them, and they will wear the wrong size all their lives. In the same way, I think that a lot of people settle on a treatment regimen that isn't right for them. I personally think that many more of us could have low A1c's if we educated ourselves more thoroughly and experimented with our treatment regimens more aggressively. No diabetic should feel that an A1c of 5.5 is hopelessly out of reach.
 
Caleb Murdock said:
properly sized braziers. It seems that many women settle on a brazier
Click to expand...

Isn't that something you burn things in? Have to be careful they don't set their Brassieres on fire! :lol:
 
From Caleb's post:

. . . properly sized braziers.
Click to expand...

That must have kept them really warm! :lol:

Sorry - the picture it conjured up was too wonderful to let it pass without comment! You mean "brassieres", of course - and you are quite right, a frightening number of women wear the wrong size. Shoes too!

I agree with you about finding which treatment suits you best, for diabetes. I low-carb because it keeps my figures stable and is the best way for me to lose weight. I expect to be eating more (healthy) carbs, with stable blood sugars and an HbA1c still in the 5s, once Ive got the weight off. I may be wrong, but I shall give it a try.

Viv 8)

PS - great minds, Grazer!
 
It was the settling on the brazier that got me! :lol: :lol: Just the thing for the cold weather!

No offence taken here, Caleb, just in case you were worried :wink:

Viv 8)
 
Sid Bonkers said:
IMHO the above statement is absolute garbage and the fact that these days on this forum rubbish like this is posted so often now is the reason I do not post much any more.

You should be ashamed of yourself for posting stuff like this that just scares the hell out of people who are newly diagnosed and dont know any better.
Click to expand...

Thank you for your informed and rational response to my supplying information that I feel to be useful. From the tenor of your reply, I think "Bonkers" is a reasonable term to apply to your response.

I see no reason to be ashamed of posting a link to one of the well-respected diabetes information sites on the net. On the contrary, I feel *you* do members a disservice by effectively encouraging any individual to be satisfied with anything less than the best they can achieve.

I've not just cherry-picked info from BS101; there are plenty of papers showing how a lot of risks to health increase in line with a1c (I have a feeeling thet Bernstein goes as low as 4.3 for 'normal' which does seem pretty extreme).

Sid Bonkers said:
Scaremongering should have no place on a help forum. IMHO the mods should stop sitting on the fence and deal with rubbish like this so that no new members take it as sound advice.
Click to expand...

Well Sid, the only rubbish I see in this thread is from your two posts! What would you prefer, a cozy, complacent little social gathering devoid of any real encouragement to tackle diabetes head on, all driven by what Sid thinks isn't rubbish??

I've just looked back at what I wrote and it isn't scaremongering at all (and I apologise to anyone except Sid if it came out that way at all); I certainly take Caleb's and Grazer's points about risk, and that a total increase of a couple of % isn't that much.

It is all about risk and our attitude to it; one problem is that all of these small risks (a1c a little high, a bit too much around the middle, not enough exercise, a bit too much booze, only a few fags per week...) all tend to aggregate into a bigger value, so suddenly the 'only a couple of percents' add up to a 10, 20 or even 30% increased risk of mortality. Some combinations increase risk far faster than simple addition would indicate.

I'm happy for you to hold your Bonkers views, and if a forum majority feels that the Word of Sid is law, then I'll stop posting. BTW, Sid, maybe you should think about removing the 'H' from the IMHO you mention - inferring one of the better known diabetes authorities on the net to be 'rubbish' and 'garbage' isn't really humble... foolish (or something stronger) might be appropriate.
 
Please just discuss the issue and not get personal.
 
daisy1 said:
Please just discuss the issue and not get personal.
Click to expand...

I'm sorry, you are correct - but I wasn't doing any other than reply in the same vein as Sid.

I'll stick to being on topic in future, on the assumption that I don't get banned!

mark
 
I can vouch for the fact that complications of eyes and nerves can begin at pre-diabetic levels. I've temporarily "reversed" mine with a low carb <50g diet. But it doesn't take long off the diet to bring those symptoms back.
I agree that T2's should be encouraged to get their numbers as close to normal as they can and not be fobbed off with "if your happy..." etc. It makes it even more confusing if some people are telling you that high a1c's are ok.
 
We need all viewpoints and I hope neither of you stop posting but let's keep it polite please. This forum is far to helpful and vital for anybody to feel intimidated from asking a question or putting forward a point of view.

Read twice (preferably after a calming gap or overnight) and post once.
 
markd said:
It is all about risk and our attitude to it; one problem is that all of these small risks (a1c a little high, a bit too much around the middle, not enough exercise, a bit too much booze, only a few fags per week...) all tend to aggregate into a bigger value, so suddenly the 'only a couple of percents' add up to a 10, 20 or even 30% increased risk of mortality. Some combinations increase risk far faster than simple addition would indicate.
Click to expand...

Well, the risk of mortality for all of us is 100%.

It's all about balance. Some people have the self-control and temperament to control their diabetes to near perfection, but many of us don't. We do the best we can. However, we mustn't fool ourselves into believing that a high A1c is okay just because our misinformed health provider says it is.
 
I have 5.5 but i only check everything every 3 months after a 12 hour fast. I don't know what the other numbers below are - before, after, fasting etc. I do not check every day before/after meals , it would drive me mad. So I keep my nose clean, only eat low glicemic and with a little bit of help from my good friend Mr. Metaformin, I get a good number!
 
9.0 on Diagnosis, nurse said an okay reading would have been 6.0 or under, ditto on the cholesterol which in my case was fine, I've no idea as to what a 'too low' reading would be.
 
Caleb Murdock said:
markd said:
It is all about risk and our attitude to it; one problem is that all of these small risks (a1c a little high, a bit too much around the middle, not enough exercise, a bit too much booze, only a few fags per week...) all tend to aggregate into a bigger value, so suddenly the 'only a couple of percents' add up to a 10, 20 or even 30% increased risk of mortality. Some combinations increase risk far faster than simple addition would indicate.
Click to expand...

Well, the risk of mortality for all of us is 100%.

It's all about balance. Some people have the self-control and temperament to control their diabetes to near perfection, but many of us don't. We do the best we can. However, we mustn't fool ourselves into believing that a high A1c is okay just because our misinformed health provider says it is.
Click to expand...
You're new here, Caleb, and welcome. I resonnate with a lot of what you're saying. Though I'm never comfortable with the term 'carboholic' (when carbs are some of the most 'vitamin rich' 'energy powerful' nutrients on that planet) - certainly many modern carbs because of their refined nature 'jolt' our system with such a high octane energy blast that we can tend to only want 'high test' fuel - not to mention the flavors. But let me not get sidetracked.

The Jenny Ruhl site is enigmatic. It has both good and horrible advice on it at the same time. For example the data showing diabetic complications for heart and neuropathies starting with A1c's as low as 5.5 are just so poorly backed and yet they're among the most widely distributed mythson diabetic forums. In that way -- I echo Sid Bonker's concerns. BUT -- in stark contrast to that statement of mine - let me also state - there IS lots of evidence that the 'beginnings' of retinopathy, IN PEOPLE, so disposed to complications (a genetic part of the equation) DO show up as early as A1c 5.2 and 5.3.. Now THAT's scary.. It's not SCAREMONGERING -- it's just plain 'SCARY' that the data exists. NEURopathy - doesn't show up anywhere near that low in A1c level in the studies I've read. Nor does the risk for heart problems. It's up near the 7's and above where you see the early signs of CVD and neuropathies setting in - again for those predisposed to problems. No all get complications even at higher A1c's - which is just weird.

So there's a mixed bag here. And some people with A1c's in the 6's and low 7's -- have NO complications of any kind for decades. Look at the T1's.. They rarely ever get into the 5's and yet they have very low complication rates. There's SOMETHING there we T2's don't really get about this disease. My personal belief is that 'insulin' IS the therapy for diabetes. It gets RIGHT at the cause of the sugar staying in our blood. Like L-Dopa is the medication for Parkinson's - and the triple cocktail helps HIV -- insulin is the only therapy that truly helps the pancreas rest and do its job more efficiently. Not even super low carbing can rest the pacreas in the same way. But people are afraid of needles or many times of 'admitting' they have a disease that 'needs a therapy' like insulin. Doing it all by 'diet only' - makes us feel powerful. And I like that feeling too. But most of us will end up on insulin one day. And the newest studies are showing that 'insulin early' gives us LONGER periods of time without 'loads of it'. So it's no longer considered a LAST RESORT. It's a "FIRST LINE" of defense. This is what the blood sugar 101 site doesn't tell you -- because it's rarely updated with the newest science and, sadly too, it's because Jenny's opinions taint the site too much. She's an 'alarmist'.

But Caleb -- I too found a wonderful blend between using fast acting insulin to let me eat a little more freely with the carbs which totally increases the quality of my life. And my A1c and all numbers are as good and better than most people who do the diet/ex only thing. So why deprive myself.. :) Not that other who've learned to eat extreme LC are deprvinging themselves necessarily. But I tried eating that way - and it was NO LIFE AT ALL for me.

I would only warn you of one thing, Caleb - since you're new to this all and new to insulin. You can gain a LOT of weight from using insulin to cover for the carbs you eat if you 'go nuts'. And that creates another who host of problems. So learn the concept of 'everything in moderation' and life can be very full as a diabetic. It's worked for me and WORKING still. My weight is still coming down - very slowly. And I've never felt better and I still eat a little of ALL the foods I grew up loving. No deprivation here. If I want some pumpkin pie this time of year -- I enjoy it! If I want potatoes at every other meal - no problem. It's all about portion size - which is the real issue in obesity anyway. Insulin just 'makes us honest' again -- since it's so effective at its job of taking the sugar out of our blood.

Good luck!!! You're on the right track in my view. I've found that you need to be between 90-150 grams of carbs, when using insulin to assure you don't gain too much weight while using it. If you stay up over 200 grams a day - you may start gaining weight quickly on the insulin. So be careful.
 
Grant, you and I seem to agree on everything. Diabetics should start insulin early (why wait until you have permanent nerve damage?), and it should be fast-acting insulin. In your case, you are using a very fast-acting engineered insulin; in my case, I am using regular insulin (I don't have insurance here in the U.S., and regular is cheapest). All this means is that you can eat one large meal on your shot, whereas I can eat two smaller meals on my shot. It's really the same thing. A lot of people take Lantus because they are in love with the idea of taking one shot a day, but Lantus is designed to cover your body's fasting needs, not your meals. Most type-2 diabetics have enough pancreatic function to cover their fasting needs; it is their meals that their pancreases can't handle. (When I took Lantus, I discovered that I would have to take a daily shot of 90 units to cover my meals adequately.)

I agree also about carbs. What the fast-acting insulin does is it turns our bodies back into more-or-less normal bodies. A middle-aged non-diabetic can't eat 250 grams of carbs a day without gaining weight. On insulin, we have to watch what we eat just as we did when we were younger. And I agree about the numbers you quote also. My experience is this: If I average more than 200 carbs a day, I gain weight. If I eat about 180 carbs a day, I plateau (but then, I need to lose weight). If I eat about 150 carbs a day, I lose weight very, very gradually. 150 carbs a day is my goal. My problem is that I'm an emotional eater, and sweets are my best friend. I've just gone through 3 months of eating over 200 carbs a day, and I gained 5 lbs. I am trying to get my carbs under 200 now.

I've had some thoughts about the original topic of the thread. How low is too low for an A1c? Someone said that Bernstein recommends 4.3%, but in my opinion, Bernstein is an extremist. A normal person's BS may be 90 (5.0) with peaks of 125 (6.9) after meals, but Bernstein wants his patients to be at 83-90 at all times (4.6-5.0). Thus, the A1c that he considers to be optimal is lower than even a normal non-diabetic would have. So my view is that 4.5% is low enough for anyone. (Just a reminder: The A1c test measures a different blood factor than a glucose test measures, so the numbers are not equivalent -- an A1c of 4.5% is equivalent to an average blood glucose of 4.6. An A1c of 6% is equivalent to an average blood glucose of 7.)
 
Back
Top