Hba1c question.

[Steff]

Following on from something someone said in another thread, i just was curious as to anyone knows the answer to this question.

Is it just as dangerous to have a sudden drop in your hbA then it is to have a rise?
My GP said to me this morning she would of been worried if it my hbA was any lower then what it was as a drop of significant levels may have been bad for me

 

[novorapidboi26]

I would be curious to find an aswer to this as well.............to me a low HbA1c means more hypos, not actual damage to micro/macro vascular veins and organs etc that comes with long term high HbA1c...........

 

[Northerner]

I would be curious to find an aswer to this as well.............to me a low HbA1c means more hypos, not actual damage to micro/macro vascular veins and organs etc that comes with long term high HbA1c...........

There can be transient (temporary) side effects from a rapid fall in HbA1c - most often transient neuropathy and retinopathy. It's not always bound to happen and is something that would generally repair itself. Any such problem should be picked up at your normal checks, or if you get neuropathy pains then these can be treated with medication until they (hopefully) disappear when levels have stabilised.

 

[Andy HB]

I would be curious to find an aswer to this as well.............to me a low HbA1c means more hypos, not actual damage to micro/macro vascular veins and organs etc that comes with long term high HbA1c...........

I don't know the answer.

However, I would say that a large fall in HbA1c could indicate a large number of hypos as nrb suggests.

My HbA1c plummeted from 13.3 at diagnosis down to 6.9, 3 months after. In that case there were practically no hypos involved, it was just better control.

Andy 🙂

 

[Steff]

Thanks.... I'll have a more indepth chat with my GP when i see her at the end of the month about this

 

[novorapidboi26]

for someone not on insulin I think it would be a struggle if not impossible to get down lower than normal levels............the speed at which you drop though I believe doesnt or shouldnt have any adverse effects..........

 

[getcarter76]

Following on from something someone said in another thread, i just was curious as to anyone knows the answer to this question.

Is it just as dangerous to have a sudden drop in your hbA then it is to have a rise?
My GP said to me this morning she would of been worried if it my hbA was any lower then what it was as a drop of significant levels may have been bad for me

Hi Steffie,

I understand that a significant drop can have an effect on on the eyes with retinopathy with Diabetes. I never knew this until i was pregnant and my HBA1C went down to 4.8% from about 6.5% (over a few months). There i was thinking this was the best thing ever but alas, it can be as bad. As a result i have background retinopathy (joy of joys) which i understand was caused by this as a result (doesn't seem particularly fair) but i should think the principle is the same.

I would like to add though, i am sure if it drops too much in one sitting then it may be that your Doc is worried purely about you having too many hypos I should think. What i have referred to was due to it being over a period of several months....don't want to panic ya!

Bernie xx

 

[novorapidboi26]

Hi Steffie,

I understand that a significant drop can have an effect on on the eyes with retinopathy with Diabetes. I never knew this until i was pregnant and my HBA1C went down to 4.8% from about 6.5% (over a few months). There i was thinking this was the best thing ever but alas, it can be as bad. As a result i have background retinopathy (joy of joys) which i understand was caused by this as a result (doesn't seem particularly fair) but i should think the principle is the same.

I would like to add though, i am sure if it drops too much in one sitting then it may be that your Doc is worried purely about you having too many hypos I should think. What i have referred to was due to it being over a period of several months....don't want to panic ya!

Bernie xx

Hey bernie, so your saying that a lack of sugar in the blood can cause leaks in the eye blood vessels, please say no..........I know blood pressure is connected.......is there a connection between low long term blood sugar and blood pressure

 

[Northerner]

for someone not on insulin I think it would be a struggle if not impossible to get down lower than normal levels............the speed at which you drop though I believe doesnt or shouldnt have any adverse effects..........

It's not about getting lower than normal levels, it's precisely all about the speed at which it falls as the body can become confused as to what normal levels are. I'm sure there are better, more medical explanations, but it is the rate of fall that can cause the problems.

 

[Lizzie53]

Hmm I hadn't thought about it Steffie. I've just had a massive drop from 10.5 in January to 6 now. I did have some odd sensations in my feet a month or so ago but now I have pretty good feeling in both and haven't noticed any eye probs. I'm having an eye test soon though so I'll quizz the optician.
When I spoke to the nurse at the docs she was pleased with the drop but I'm starting to wonder how much they actually know there. They only have one other Byetta Babe there and he's a bloke lol. So they don't have much clue when I ask questions about it. I'm back at the hossie next week so I can quizz them too.

 

[novorapidboi26]

It's not about getting lower than normal levels, it's precisely all about the speed at which it falls as the body can become confused as to what normal levels are. I'm sure there are better, more medical explanations, but it is the rate of fall that can cause the problems.

Do you know what effects a rapid drop in long term sugar would be?

 

[Northerner]

Do you know what effects a rapid drop in long term sugar would be?

I just did! 😉

There can be transient (temporary) side effects from a rapid fall in HbA1c - most often transient neuropathy and retinopathy. It's not always bound to happen and is something that would generally repair itself. Any such problem should be picked up at your normal checks, or if you get neuropathy pains then these can be treated with medication until they (hopefully) disappear when levels have stabilised.

 

[novorapidboi26]

I just did! 😉

Cheers mate.......I am just trying to find out wether my retinopathy could be worsened by a quick drop, not that that will happen.........

I cant get my head round that can happen as its an increase in pressure in the vessels from high sugars and blood pressure (so I believe) that contributes to retinopathy...........

 

[Steff]

Thank you Bernie, seems like ive asked a good questions for once lol.

 

[Northerner]

Cheers mate.......I am just trying to find out wether my retinopathy could be worsened by a quick drop, not that that will happen.........

I cant get my head round that can happen as its an increase in pressure in the vessels from high sugars and blood pressure (so I believe) that contributes to retinopathy...........

I suspect it may be more to do with the variability of pressure which might weaken the blood vessels, rather than a steadier adaptation - so a quicker drop from high to low might not allow the vessels to adapt normally.

 

[getcarter76]

Hey bernie, so your saying that a lack of sugar in the blood can cause leaks in the eye blood vessels, please say no..........I know blood pressure is connected.......is there a connection between low long term blood sugar and blood pressure

Hello novorapidboi.....I am no scientist on this front but the sudden drop in levels can increase the worsening of certain complications and Retinopathy is one of them...hence pregnancy can be a large reason for this worrying onset.

I have attached a link but don't want everyone to panic....i scare myself senseless and 'read too much'!

http://medweb.bham.ac.uk/easdec/retinopathyprogression.htm#typ

and re the sudden improvement:

http://medweb.bham.ac.uk/easdec/prevention/hba1c_and_retinopathy.htm#sudden

In answer to your question though, i cannot fully understand this quote but may answer your question??

"The hyper-perfused retina develops microvascular damage and becomes slightly ischaemic..but as soon as the glucose levels drops, perfusion drops, and the retina becomes even more ischaemic. This induces a rapid growth of new vessels"

Where's Tom when you need him??

Bernie xx

 

[getcarter76]

Thank you Bernie, seems like ive asked a good questions for once lol.

Lol...there's no such thing as a silly question 😉

In addition, i hope that i have tried to find you an answer Novo and that the long term effects of looking after yourself outweigh the consequences of not doing so. I also understand that a sudden drop in BG levels, whilst can be bad, can also be put right in the long run should you not be looking after yourself in the first place.

Bernie xx 🙂

 

[Lizzie53]

Oh flipping heck this is doing my head in. Well I cant do much about it now, I've had the sudden dramatic drop and s'pose the best thing to do will be to keep it there. I did have worsening pains and numbness in my feet about a month into the Byetta and several folk said it could be that the nerves were being repaired. During the last week or so I must say my feet have been much less numb, infact hardly numb at all. I cant say I noticed any difference to my eyes either way really.

 

[getcarter76]

Oh flipping heck this is doing my head in. Well I cant do much about it now, I've had the sudden dramatic drop and s'pose the best thing to do will be to keep it there. I did have worsening pains and numbness in my feet about a month into the Byetta and several folk said it could be that the nerves were being repaired. During the last week or so I must say my feet have been much less numb, infact hardly numb at all. I cant say I noticed any difference to my eyes either way really.

As i said...try not to read too much into it all, it is frightening and worrying all at the same time. The examples are worst case scenarios given. A sudden drop in the long run will be better than keeping it high forever. Just so you know though, Retinopathy is a slow progression and rarely does anyone know that they have it until a check up. Keep em tested and all will be fine. Also, if it is caught early, it can be treated.

Bernie x

 

[Lizzie53]

Decided not to read it at all lol. When my eyes were screened in April the operator said from looking at my eyes she would not know I had diabetes but of course that was before the drop. I shall have my annual eye test with the optician soon so can talk to him about it.