How low is too low for an HbA1c?

clairy clutterbuck said:

Yes it has scared me to death reading all the posts on this topic. I had been concerned as I had read an article that said getting much below an HBA1C of 7 could be dodgy and my last one was 6.2, only to read that this is actually far too high - or is it? I noticed some of the comments were based on American measurements - are ours the same?

I finally got my HBA1C below 7 two years ago and have been in the 6's ever since, and developed backround diabetic retinopathy for the first time last year. The optician said it can be triggered with a sudden drop in sugars! GREAT!! I am eating a low carb diet (I think) of 70 to 80 carbs a day and have left work three weeks ago to make sure I get more exercise and eat "spot on" as much as possible but am now concerned this is not enough to lower my numbers. I have quite a bit of weight to lose and this is now gradually coming down. Will my numbers come down as I lose weight as a matter of course? and therefore I just need to continue with my plan and be patient? HELP.......

Claire x

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Hi Claire

Yes there was a 2009 study done by researchers in the UK that concluded that risks began to rise again below 7%. It was conclusively trashed by a later Swedish study published mid 2011. They pointed out the UK study misinterpreted the results effectively because the sample of diabetics they choose had loads of insulin using obese diabetics who died prematurely of CVD (what a surprise given the NHS drug escalator approach!). If you adjusted the UK survey so that the sample wasn't weighted in that way but included a wider range of healthier diabetics the less than 7% finding completely vanished. Based on that later research the Swedish health service now encourages its diabetics to aim for an HbA1c as low as they can get and also for its diabetics to adopt a low to moderate carb diet i.e what most of us on the forum would promote.

What of course continues to be proved by the UK study is that insulin using obese diabetics have a far higher risk of dying young from CVD which is pretty obvious really when you think about it and is what the Swedes pointed out by saying the link to CVD is because of being obese and overweight and has little or nothing to do with HbA1c

an addition to the brassiere analogy.
I went to M&S to buy a new one and was persuaded to allow the "advisor" to measure me for fit. I tried the size that she recommended and it was awful. Nowhere near a good fit. too long in the body band and nowhere near big enough on the cups. I could not have gone out in that undergarment.
That's almost exactly what I think is happening to many diabetics. The "experts " give wrong information.
For Example; how can anything other than Normal blood glucose be the global target?
That's not to say that everyone can achieve the normal sugars, but what's wrong with aimong at the target, even if you end up just getting to the outer ring? Does it actually make sense to aim beyond that? If you don't aim for the bull, you have zero chance of hitting it.

To add to xyzzy's comments, 90% of all the participants were insulin dependant; of the remaining 10%, there was no evidence that the lower HbA1c readings worsened mortality.

I would be happy if i could get my daughters in the 6"s

Saralovessal
How old is your daughter? Is she a juvenile T1? It's very difficult to get really good numbers for kids. It gets harder when they hit puberty.
Hana

SaraLovessal said:

I would be happy if i could get my daughters in the 6"s

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This is a question in the T2 forum. There would be entirely different answers from T1s and they'd be different still in a question about T1 children.
As Hana says it's much harder to get lower glucose levels with children.