HbA1c levels and heart problems

[Dave Wyldes]

I have had type 2 diabetes for a number of years being controlled by diet and medication (metformin)
On a recent review my hba1c level was 43 at which I was very pleased. I was then told by my diabetic nurse that this was to low.
My dose of metformin was changed to slow release and halved. I had a further blood test 3 months later and my hba1c had risen to 50 which she thought was ok. I also stated that since the change of medication I have been a lot more fatigued and constantly hungry. In reference to the hunger I was told that this is a good thing has it shows my body's insulin is working!
On searching the internet and doing some reading I cannot find any reference to this, in fact the opposite.
After working hard to get the balance of my diet and medication working ok I now feel totally confused.
Has anybody else had this problem

 

[Dave Wyldes]

The above heading should probably be hba1c levels and heart problems and not metforfin and heart problems

 

[Ljc]

Hi Dave, welcome to the forum. Sorry I am not aware of any problems with Metformin re heart problems, ohers here may know.
Personally I would not be happy with an Hb1ac of 50. Please bear in mind I am no medic, I do not understand why she was concerned about 43 being too low, like you I would have been delighted with that result.
Have a look at this chart, you will see it states 50 is good control.
http://baspath.co.uk/Hba1c_table.pdf

 

[Ljc]

Hi me again. If you wish to change the title of your thread , you can.
To the far right of the page and slightly below the title, click on thread tools, alter the title and save it.

 

[Robin]

On that chart, 43 is 'excellent'. I don't know why your nurse thinks that having excellent control is too low!

 

[Northerner]

The above heading should probably be hba1c levels and heart problems and not metforfin and heart problems

Hi me again. If you wish to change the title of your thread , you can.
To the far right of the page and slightly below the title, click on thread tools, alter the title and save it.

I've changed the title for you Dave 🙂

Personally, I do not consider 43 'too low', particularly as you are only on metformin which is very unlikely to cause hypos.50 isn't bad either, but does represent quite a rise on the 43 and would suggest that you are getting possibly much higher levels at certain times e.g. after eating,which could be what is making you feel tired - are you able to test when you feel tired? I'd also question the hunger aspect - our brains don't 'know' that with diabetes our levels may not be in the perfect range and if you are not able to get enough energy from your food then it thinks you need more food, hence the humger. So it is not the fact that your insulin is working well, it's more likely that you have become more insulin-resistant due to the reduction in meds and not able to process the food as efficiently!

I'm not a doctor either, but that would be my explanation - hope it makes sense! 🙂

 

[the blue wildebeest]

This appears to me to be a misapprehension of a DSN. I have wondered what training they receive, and whether they are aware of updates. (And whether some exceed their authority.) I made the mistake in January of having a "43", with Metformin and a small amount of Gliclazide, which appeared to prevent rising overnight bgs. And so I got a telephone call instructing me to stop taking the Gliclazide which was "not needed".
I asked to speak to the person responsible several times without response. When we did eventually meet, there was an unproductive "discussion", in which the DSN contradicted the advice of other DSNs, and had the Gliclazide removed from repeat prescriptions. This is an ongoing situation. The next HbA1cs were 47 and 46. I have reduced carbs even further, and it is certainly more difficult to maintain a regimen which does not result in undesirable weight loss.
May I suggest asking for further advice either from a GP with a special interest in diabetes, a recently trained dietitian, or that elusive species, an endocrinologist? (Rumour has is that they do exist.)
So strange isn't it? Do well, make good progress and take responsibility, and someone will interfere...