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Too good hba1c!?!??

M

Miss90

Well-Known Member
Messages
223
Location
UK
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Diabetes
So I had my latest hba1v today, which was 6.1. I've worked very hard to get this and I'm pleased!!! However, the consultant said it's 'too good' and is the result of 1 or 2 hypos a week, mild hypos I can treat myself without a problem. He says to aim for a figure of 6.5 but I was always under the impression that the lower the hba1c the better!?!?
 
My last HbA1C was 41 (5.9%) and I got exactly the same advice. Annoying when you expect a well done and got a lecture lol ! Ignore them, it's your body. I aim for non-diabetic levels. Don't always achieve it but why lower your targets to please someone else ? I say well done


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I get exactly the same advice/lecture. I maintain my HbA1c at 5.4% with on or two mild 'hypos' a week. I don't even consider them hypos actually as they are not often below 3.4 mmol which is normal BG!

@Miss90 - well done! Don't let anyone tell you 6.1% is too low!

Smidge
 
I get more hypos than that at 8.3 so is my HBa1c too low?! silly drs :-/
 
Miss90 said:
It's an average, do you have a lot of highs too?
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Not as many as I used to. Believe it or not that is down from 10.0 just about a year ago. Making massive improvements now. I find it almost impossible matching insulin to food atm even with a pump. I cannot get the insulin to work quick enough which leads to a spike before coming down very quickly normally a very pronounced 'peak' using a CGM now so I'm woken at night if bloods go above 12 so I can correct.
 
My last HbA1c was 5.9 - doctor seemed very pleased, no mention of it being too low
 
You were told a 6.1 was too low? You've got some interesting health standards in the UK...
 
That is completely absurd, how can 6.1 be classified as too low. At my last endo appointment I was told 4.4 mmol was too low for a fasting blood sugar and I laughed in the doctors face.
 
I beep getting told so many different things by different people!! To be honest my DSN is amazing and I trust get judgement more than the actual consultant!!! The way I see it, the lower the better!


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Miss90 said:
I beep getting told so many different things by different people!! To be honest my DSN is amazing and I trust get judgement more than the actual consultant!!! The way I see it, the lower the better!


Sent from the Diabetes Forum App
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It's not a matter of judgement or opinion, even small increases in HbA1c have been shown to dramatically raise the chances of heart disease and other complications.

http://www.cardiab.com/content/10/1/58
("Overall, risk of CVD was significantly 2.4 times higher in individuals with HbA1c ≥6.5% versus <6.0%.")
http://www.ncbi.nlm.nih.gov/pubmed/15381514
("An increase in hemoglobin A1c of 1 percentage point was associated with a relative risk for death from any cause of 1.24 (95% CI, 1.14 to 1.34; P < 0.001) in men and with a relative risk of 1.28 (CI, 1.06 to 1.32; P < 0.001) in women. These relative risks were independent of age, body mass index, waist-to-hip ratio, systolic blood pressure, serum cholesterol concentration, cigarette smoking, and history of cardiovascular disease.")
http://diabetes.diabetesjournals.org/content/41/2/202.full.pdf
("The relative odds of CVD increased 1.39 fold for increases in HBA1c of 1% (eg 5 to 6%)")

It's good to see you're aiming for a lower number though.
 
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My past three readings have been 27mmol/mol - aka 4.6%. (That's a non-diabetic normal, incidentally.)

And what no critic ever asks me is this: "How do you manage not to have hypos?"

Nor this: "What do you eat, exactly?"

I find this marked absence of enquiry to be very telling.
 
HI. As others have said there isn't a limit to how low you should aim for, but do avoid anything but rare hypos as there is no point in being low enough to start having them?
 
The food that you eat can make an enormous difference to the safety - or otherwise - of maintaining a near-normal HbA1C.

Some do it with one kind of diet: http://www.diabetes.co.uk/forum/threads/low-blood-sugar-without-problems-anyone.38667/ But this method necessitates 'carb counting'.

The closest I come to having to 'count carbs' is simply making sure that I steadily eat around 220g of rye bread each day. (I don't eat any rye after 4.00pm. or my blood sugar would tend to rise in the evening and overnight.)

I also don't take any significant amount of slow-acting insulin. In this way, I go to bed at night with the bare minimum of insulin active within me. (The last fast-acting insulin I take is at 4.00pm.) So I sleep safely.

Rather than take insulin in a fairly hopeless attempt to anticipate my likely insulin requirements, I simply take the same insulin each day, and I 'feed' that insulin. (That's why I don't have to 'count carbs'.) This necessitates a fair bit of blood sugar testing: on average, around once per waking hour.

My readings are almost always near normal. And that makes the simple and highly economical visually read testing strips ideal for most of the readings I take. (http://www.betachek.com/uk/) For the lower the blood sugar, the more precise are the readings they give.
 
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It may sound absurd that a doctor says that a HbA1c 6.1 is too low. But the reason behind this statement is that if you are achieving this value running your blood sugars too low for too long you are taking serious risks. It's true it is your body.... but a doctor must warn you around the dangerous risks of strong hypos ( which in the worse scenarios can kill and it happens! ). Twelve years ago, when I was living in manchester, I received a letter from my consultant saying that my hba1c was too low (it was exactly 6.1). That letter made no sense to me. Less than a month after I woke up in a hospital due to a hypo so strong I couldn't manage. Now February 2014 my hba1c was 6.1 again but I was not told it was too low as I don't have hypos. Clearly I'm not saying keep your blood sugar high and you should be proud of your result. I'm 34 years diabetic and I know how hard it is to achieve 6.1. The point I am making is make sure your sugars don't drop too much too often because that, in the long term, can become dangerous.


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Same here with a registrar. Last HbAic was 6.1. I was interrogated (it felt like an interrogation) in detail about how much carb I ate; how much insulin I injected; how long a pen lasted; when did I last have a hypo? Scrutinised my log book and was trying to identify a hypo from the brief snapshot shown in logbook entries? Completely ignored the fact that there were no entries above 10. I was told 6.5 was better because there was less risk of a hypo.

I also had the usual statin discussion but that's another story.
 

yep I see what your saying! I've had one serious hypo in my diabetic life, woke up with 4 paramedics round my bed, needed glucogon and IV glucose before i regained consciousness and that was bloody scary to think I have no recollection of that what so ever, so now i am super paranoid about hypos and try my very hardest to avoid them! it just annoyed me that i'm always made to feel as though that trying my best is never good enough!!! how many consultants ACTUALLY have diabetes?! knowing about it from a textbook and actually having it are two very different things!!!
 
Just passing through guys, heres a worthwhile read:
 
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