HbA1c

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Yes, kind of, I was 87 mmol/mol when diagnosed for comparison.
Reversed it in 4 months with an ultra low carb diet and time restricted eating.
 
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Yes. It’s high, but can be brought down.
 
IanR76 said:
Is 92mmol/l high?
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Those units are used for blood glucose levels and would be considered astonishingly high. Perhaps it was 9.2 - which you could live with?
Hba1c is expressed as mmol/mol, and I was diagnosed after a result of 91 mmol/mol, which I reduced to 47 at the first retest 80 days later and was at 41 in 6 months, so if that is a Hba1c level it is not the end of the world.
 
harbottle said:
I was never given that advice.
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That depends on who you get it off I guess.
A build up of glucose can cause you to have issues with eyes, A bit like an over pressure, where the eye ball swells, and alters your vision.
If you race to the bottom, you may cause some bleeds in the eye, as it contracts again.
But it does seem to recover, but I wasn't going to chance that.
I went slow and steady.
I looked at all the options, all the issues, and I decided I'd take the meds, get a space so I could step back, take a look at everything that I wanted to work on, and that worked for me.
I wasn't purely trying set a record for how fast to just crash the BG down.
 
@IanR76 Just make sure there is no confusion, can you confirm that the 92 was an HbA1c result and should have been in units of mmol/mol?
 
IanR76 said:
Is 92mmol/l high?
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Pretty high but not off the charts. I was 89 - reversed over ~6 months via weight loss. Doing it very much faster than that can cause (usually temporary) vision probs.
 
travellor said:
That depends on who you get it off I guess.
A build up of glucose can cause you to have issues with eyes, A bit like an over pressure, where the eye ball swells, and alters your vision.
If you race to the bottom, you may cause some bleeds in the eye, as it contracts again.
But it does seem to recover, but I wasn't going to chance that.
I went slow and steady.
I looked at all the options, all the issues, and I decided I'd take the meds, get a space so I could step back, take a look at everything that I wanted to work on, and that worked for me.
I wasn't purely trying set a record for how fast to just crash the BG down.
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Blurred vision is caused by the lens swelling, not the eyeball. This can happen when levels are low or high and will go back to normal when levels are OK. (As they did with me, about a week after diagnosis - I have terrible eyesight anyway and just assumed the blur was because I was due an eye test).

There are other problems linked to high glucose levels such as bleeding and swollen blood vessels and diabetes may induce glaucoma - I'm not sure why lowering blood sugar levels would cause any of these, as they are problems of high blood sugar and if they've already happened it's not going to make it worse.

Have you got a link to any research or guidelines on how lowering blood sugar levels quickly can cause eye problems? I can't find any and it's never been mentioned during any calls with a GP or visits to the DN. I was just told to change lifestyle to bring it down and we'll check again in three months.
 
harbottle said:
Have you got a link to any research or guidelines on how lowering blood sugar levels quickly can cause eye problems?
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It's probably only an issue where there is existing retinopathy, but I guess better to be safe than sorry etc etc, particularly as the chances of having retinopathy if you're diabetic are so high.

Some specifics:


Roy Taylor's notes suggest that it's only an issue where there is pre-existing moderate or worse background retinopathy:


6. Diabetes complications

It is most important to consider the individual’s microvascular complications before embarking upon major dietary change. If there is no retinopathy, or only early changes (scattered micro aneurysms with few blot haemorrhages) then no additional precaution is required other than an annual screening. However, if moderate or more severe retinopathy is present then arrangements should be made to re-screen the eyes within six months of achieving a substantial improvement in blood glucose control. The reason for this is that the sudden normalisation (reduction) in retinal blood flow associated with the return of normal blood glucose control can disadvantage areas of the retina in areas of marginal circulation with resulting deterioration in retinopathy. This effect is entirely restricted to individuals with pre-existing moderate or worse retinopathy. (Arun CS, Pandit R, Taylor R. Diabetologia 2004; 47:1380-84. PMID: 15309288). For those individuals who achieve reversal of their type 2 diabetes, retinal screening should be continued long term pending further data upon this matter.

And see eg https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587545/ for a detailed discussion.

The majority of evidence supports an association of large and rapid reductions in blood‐glucose levels with early worsening of DR.
 
Docb said:
@IanR76 Just make sure there is no confusion, can you confirm that the 92 was an HbA1c result and should have been in units of mmol/mol?
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ooking it up on the MyDiabetes Scotland website
Drummer said:
Those units are used for blood glucose levels and would be considered astonishingly high. Perhaps it was 9.2 - which you could live with?
Hba1c is expressed as mmol/mol, and I was diagnosed after a result of 91 mmol/mol, which I reduced to 47 at the first retest 80 days later and was at 41 in 6 months, so if that is a Hba1c level it is not the end of the world.
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It was 92 mmol/mol. Dieting and taking metformin so hopefully will be down for next reading at the end of June.
 
Thanks @IanR76 for confirming that. I was being a bit pedantic I know, but we have had real confusion in the past over numbers!
 
IanR76 said:
Not at all. I find the nomenclature and units very confusing as a bit dyslexic.
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I'm a bit dyslexic myself which is why I have tried to train myself to pay really close attention for over 60 years now - still catches me out once in a while though.
Being blithely self confident I went back to eating 50gm of carbs a day - bit of a shock as I'd been encouraged to do a low fat diet with high carb content by my GP and felt dreadful - and I was almost spherical by the time I was diagnosed.
I was told that a Hba1c of 91 was very bad - but did not take it to heart. I used a test meter to check I was getting normal numbers after eating, and after a few wobbles and getting rid of the tablets - I reacted dreadfully to them and it took quite a while to recover from the worst side effects it showed in my Hba1c being at the top of the normal range.
I had some retinopathy at the first eye check, but it was gone by the second one and my eyes have been normal at all subsequent checks.
I had settled on eating twice a day after a few months, but now I tend to eat only once.
 
IanR76 said:
Is 92mmol/l high?
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Just had my results and mine is 120 it’s a bit depressing to be honest but at least I am aware and can do something about it I have not been managing my diet well over the last 4/5 months and I am changing medication- I want to avoid insulin at all costs!!
 
Blackwellmatt said:
Just had my results and mine is 120 it’s a bit depressing to be honest but at least I am aware and can do something about it I have not been managing my diet well over the last 4/5 months and I am changing medication- I want to avoid insulin at all costs!!
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That is very high considering you have already been on medication and presumably watching your carbohydrate intake.
Oral medication can only do so much and if your carb intake is more than your body even with the help of the meds can cope with then your blood glucose will still be high.
What dietary measures you take may depend on which meds you have now been given but reducing the carbs should be a priority.
Do you have a blood glucose monitor so you can check out meals and foods so you can cut out or reduce portions size of those which are big hitters in pushing up your blood glucose.
 
I have been T2 since 2014 and I am on large doses of metformin/ gliclazide and small dose of alogliptin I know I can sort my levels if I behave myself

I had to deal with a bereavement earlier this year and ran off the rails in many ways Getting this high count us a wake up call just need to get my act together now
 
Blackwellmatt said:
I have been T2 since 2014 and I am on large doses of metformin/ gliclazide and small dose of alogliptin I know I can sort my levels if I behave myself

I had to deal with a bereavement earlier this year and ran off the rails in many ways Getting this high count us a wake up call just need to get my act together now
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If the meds and your dietary changes are not effective you may be misdiagnosed and actually be Type 1 or LADA so keep that in mind.
With levels as high as you are do you have ketone urine test sticks just to check if you are feeling unwell. If you haven't got then a home testing monitor should be prescribed by your GP because of the medication you are on.
 
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