HbA1c reading and hypos

[Jon-Manchester]

Hello
I had my first HbA1c reading since October when I first got diagnosed. At that time it was 78.
The nurse called me this morning and said it was quite low with a reading of 36. She asked me if I get a lot of hypos and the truthful answer is before I got the Libre I use to hypo a LOT (pretty much every day) but since the libra I feel like I have almost eliminated most of the hypos (well I have only got 2.5 months of experience of the libra but so far so good). With the Libre I seem to be able to catch it most of the times before it goes too low (and the miaomiao certainly helps) so over the almost 3 months I perhaps go down to 3.6-3.8 once every week or so (not gone any lower since the libre). I havent actually properly checked if that is how often I go low but I scanned through the logs to see and that seemed about right.
To me that is a massive improvement in hypos but perhaps that is still too many and it is just my point of reference that makes me think I am doing well as I guess I am only comparing it to how it was previously.
How often is 'normal' (if there is such a thing with T1) in terms of number of hypos?

 

[Bruce Stephens]

I havent actually properly checked if that is how often I go low but I scanned through the logs to see and that seemed about right.

The software can tell you. There's a low glucose events chart and the ever popular time in range information.

If you set the range to 3.9-10.0 (the widest it'll let you) there's a guideline that we should spend less than 5% of the time below 3.9 (and over 70% of the time in range, with less than 25% over 10.0 with less than 5% over 13.3 though the Reader doesn't show that (and I'm not sure how much I'd believe the accuracy of that distinction anyway)).

 

[Kaylz]

How often is 'normal' (if there is such a thing with T1)

You've hit the nail on the head yourself there, it varies widely from person to person and even in one person, I can go a month maybe more without then have 1 every day for a few days, they worry about low hba1c's 1 - because you may be experiencing too many hypo's and 2 - you might be spending a lot if time a bit on the low side increasing the chances of losing your hypo awareness xx

 

[trophywench]

Jon - hear hear to the part about watch out that you don't lose the symptoms BUT the important thing about hypos is their educational ability.

If you only have one hypo and do not/cannot learn anything from it, then ONE hypo is too many!

I honestly do not believe there is a number - think the medical reply would be 'As few as humanly possible' - so I generally go for that! 😉

 

[Jon-Manchester]

The software can tell you. There's a low glucose events chart and the ever popular time in range information.

If you set the range to 3.9-10.0 (the widest it'll let you) there's a guideline that we should spend less than 5% of the time below 3.9 (and over 70% of the time in range, with less than 25% over 10.0 with less than 5% over 13.3 though the Reader doesn't show that (and I'm not sure how much I'd believe the accuracy of that distinction anyway)).

Thank you Bruce, I had completely forgotten about Libreview, so I have just logged in and the data looks OK to me.
According to libreview I have spent 1% in the 3.0-3.9 category and 0% in the below 3.0 (for the last 90 days). Though I take the point from you all that I should aim for as few as possible and less hypos is always better..
I might give my diabetes nurse team a call and discuss it with them to see if I need to make any change

Being T1 is like walking a tightrope over volcano, on both side you all manner of bad stuff...

 

[Bruce Stephens]

Thank you Bruce, I had completely forgotten about Libreview, so I have just logged in and the data looks OK to me.

Not just Libreview. The FreeStyle Reader can show this information, as can the phone apps. (They vary a bit in exactly what they show, but all of them can show the basic information.)

So that 1% ought to reassure your DSN. An HbA1c of 36 is surprisingly low, so the worry is that it's explained by hypos. But in your case it doesn't look like that.

 

[Jon-Manchester]

Not just Libreview. The FreeStyle Reader can show this information, as can the phone apps. (They vary a bit in exactly what they show, but all of them can show the basic information.)

So that 1% ought to reassure your DSN. An HbA1c of 36 is surprisingly low, so the worry is that it's explained by hypos. But in your case it doesn't look like that.

Thanks Bruce. I guess i will keep on working on it and we will see if it was just temporary blip. The nurse seemed OK to wait and see