How low can you go.(hbA1c)

[Steff]

I was just wondering what peoples perception of there hbA is for example i was told 6.5 is spot on but anything under 7.0 was good, even when i got a hbA of 7.2 my doc was really pleased, also what level hbA is considerd to be dangerous.I have spoke to Northerner already about this in pm(hope you dont mind me mentioning your name)and he was saying some us sites say aim for 4.5% that to me seems low . .What does everyone else think, and are you always pushed to improve your hbA when you get the results .

 

[SilentAssassin1642]

hi steff. Last time i was at clinic, consultant told me that my 6.5% was too low (frikken muppet) and that I should be aiming for something like 8-9% for the next one as she wanted me to stop having hypos and to run myself really high

I think she was a fraud...

 

[Steff]

hi steff. Last time i was at clinic, consultant told me that my 6.5% was too low (frikken muppet) and that I should be aiming for something like 8-9% for the next one as she wanted me to stop having hypos and to run myself really high

I think she was a fraud...

Ty Sam i just think it would be of interest to find out what we where all told regarding the aim for our hbA1c .

 

[katie]

Your A1c should be below 6.5%

 

[SilentAssassin1642]

Ty Sam i just think it would be of interest to find out what we where all told regarding the aim for our hbA1c .

definitely. Doc told me that 6-6.5% was perfect. As did DSN. No idea where the consultant got the 8-9% thing from

 

[Northerner]

definitely. Doc told me that 6-6.5% was perfect. As did DSN. No idea where the consultant got the 8-9% thing from

That might be 'old knowledge'. I think children/teenagers are generally expected to have higher HbA1c than adults, and also they used to think that the risk of hypo outweighted the risk of complications. I was told to get it below 6.5% and personally feel comfortable in the mid-5% range (last one 5.6%) with relatively stable levels (few highs and lows). If it fell below 5% I would start taking a serious look at if I was being too obsessive and tight with my control.

As I said to Steff, some US sites in particular regard 4.5% as a figure to aim for (largely due to the influential diabetic Dr. Bernstein). However, this article makes intersting reading:

http://www.healthcentral.com/diabetes/c/17/59130/normal-a1c-level

So, really, it could be anything from 4.5-6% and be 'normal' or equivalent to a non-diabetic.

 

[Freddie99]

HbA1c for a non diabetic ranges between four and seven percent. Ideally we should aim to get into that zone to inhibit future complications from arising. That said, the targets for HbA1c should be tailored to an induviduals circumstances. There are times when perhaps a marginally higher HbA1c would be of greater benefit for an induvidual. Don't qoute me on that as I'm not a medic. Personally I am not comfortable with a finger prick blood test being below 5 mmol/L. I can't comment upon having an HbA1c below five percent as I've never been able to get the damn thing below eight percent.

 

[Old Holborn]

I was just wondering what peoples perception of there hbA is for example i was told 6.5 is spot on but anything under 7.0 was good, even when i got a hbA of 7.2 my doc was really pleased, also what level hbA is considerd to be dangerous.I have spoke to Northerner already about this in pm(hope you dont mind me mentioning your name)and he was saying some us sites say aim for 4.5% that to me seems low . .What does everyone else think, and are you always pushed to improve your hbA when you get the results .

I was told to aim for something between 6 - 6.5%.

 

[squidge63]

I was told 6 - 6.5 % as well... my last one was 9.4% but at least it was down from 9.6%.. get my next result on Tues when I go for my appt with the dr.. best I have had was 6.1%

 

[wallycorker]

..........some us sites say aim for 4.5% that to me seems low..........

4.5% is achievable - I know certain people on these diabetes forums who manage to maintain levels as low as that - both Type 1 and Type 2.

My last one was 5.1% but I'm taking mine lower.

Best wishes - John

 

[Steff]

4.5% is achievable - I know certain people on these diabetes forums who manage to maintain levels as low as that - both Type 1 and Type 2.

My last one was 5.1% but I'm taking mine lower.

Best wishes - John

Is they no dangers in wanting to go lower wallycorker?

 

[LisaLQ]

Mine was 6.7 (I think), and they said that was really good, but they'd prefer it under 6.5.

I think to get it under 5 you'd have to eat a diet of cardboard, mind you, how many carbs is in the average cardboard box...?

 

[SweetGuy]

According the the NICE type 2 guidelines <6.5% is like the gold standard but >7.5% is trigger level before intervention with insulin or other non-oral medications should be considered.

This is the script that most GPs work from:

http://www.nice.org.uk/nicemedia/pdf/CG66FullGuideline0509.pdf

This if for type 2 only

 

[sofaraway]

I think generally type 2 can go lower, if they are not on hypo inducing meds as there isn't the same danger as insulin users.

For me personally I was aiming to be 6-6.5, Have run as low as 5.4% and really that was too low for me, I was having 3-5 hypos a weeks running that A1c.

My last was 5.9% and I was happy with that as were my team, I don't want to go any lower. I need to run at a level that i can work in a demanding stressful job, drive, exercise and running as I do vastly reduces the chance of severe hypos.

 

[wallycorker]

Is they no dangers in wanting to go lower wallycorker?

Firstly, I'm a non-insulin dependent Type 2 on metformin and diet only. Also, I do not suffer from hypo' symptoms in any way whatsoever that are obvious to me.

As regards whether there are any dangers in wanting to go lower then, quite frankly, I don't know. However, personally, I have absolutely no concerns about taking my blood glucose levels to those found in a non-diabetic person.

What I do know is that there are real dangers in running blood glucose levels too high at levels where mine used to be when my HbA1c was as high as 9.4%. Most of us are well aware that such levels put diabetics at risk of all sorts of health problems - the most serious of those being heart disease, eye problems that can lead to blindness, amputations, kidney damage that can result in dialysis becoming necessary etc, etc.

Even relatively minor problems and symptoms have all disappeared since I have lowered my blood glucose levels - and some of them I hadn't even recognised as being connected with my diabetic condition. All I know is that they aren't those things aren't there any longer - e.g. thrush, itching, getting up in the night to go to the toilet, night time cramp in the calves, pins and needles in my hands and forearms etc, etc.

Personally, I'm a great deal happier now that my blood glucose levels have become consistently lower. In fact, very, very much happier!

Best wishes - John

 

[xxlou_lxx]

Mine is 4.1 well was last time I was checked! my bloods run at 4 all day and night with ocasional dip that I know to expect so am prepared to eat at that time, never any major hypos but in pregnancy id prefer to be this low im usually around 5.6%
The docs are fine with it tho just tell me my hba1c is better than theirs lol
9th of march and ill become more human again 😛

 

[Steff]

Mine is 4.1 well was last time I was checked! my bloods run at 4 all day and night with ocasional dip that I know to expect so am prepared to eat at that time, never any major hypos but in pregnancy id prefer to be this low im usually around 5.6%
The docs are fine with it tho just tell me my hba1c is better than theirs lol
9th of march and ill become more human again 😛

This thread was started in honour of your hbA actually Lisa it got me to thinking about the levels of hbAs and when they go low is they any dangers .x yours was the lowest i had ever seen since i joined .

 

[Northerner]

This thread was started in honour of your hbA actually Lisa it got me to thinking about the levels of hbAs and when they go low is they any dangers .x yours was the lowest i had ever seen since i joined .

The bottom line is that you NEED glucose in your blood, otherwise your brain is starved of energy - this is the only source of energy it can use. If it doesn't have enough then you can go into coma and die. It seems logical that repeated, extreme hypos are going to have a cumulative, detrimental effect on the brain, although I'm only speculating there. There is a limit to how low you can safely drive it and that will vary from person to person - so some people will have a 'natural' and sustainable level of 4.x%, others will need a higher level. For me, it's a bit like cholesterol - we keep getting told to drive it lower and lower, but we still need a certain amount of it or we will be in serious trouble. Safe lower levels of these numbers seem to be neglected when advice is given out.

 

[wallycorker]

Mine is 4.1 well was last time I was checked! my bloods run at 4 all day and night with ocasional dip that I know to expect so am prepared to eat at that time, never any major hypos but in pregnancy id prefer to be this low im usually around 5.6%
The docs are fine with it tho just tell me my hba1c is better than theirs lol
9th of march and ill become more human again 😛

Hi,

That is an achievement! Well done! I think that is the lowest that I've come across. However, the situation is very different for you as a Type 1 than it is for a non-insulin dependent Type 2 such as me. More of an achievement for you I would have thought because of the risk of hypos that you need to deal with as well.

The other Type 1 who I communicate with on another forum - and manages his situation in the mid-4s - recently told me that he has less hypo' incidents at the lower level compared when his levels were higher. Is that the same for you?

The doctors and nurses all tell me the same thing - i.e. that my HbA1c is better than their own.

I hope that your pregnancy goes well. Is it your first?

Very best wishes - John

 

[xxlou_lxx]

No, I just think that when u have ur bms a bit lower then u lose ur hypo awareness. I notice a hypo more if I have spent most of the day on 6 as opposed to 4. Once this little madam arrives then ill be running my bms at 7/8 for a few days in order to get my awareness back.
It has not been too much of a problem though as I take my blood sugar way more now than before pregnancy so i have noticed the pattern of my bloods better throughout the day and am prepared for it.

I reckon id be a bad type 2 though, at least if i want chocolate i can take some insulin so I wouldnt really have ur will power!!
I think you have a harder job to keep ur sugars stable than I do lol