Lowering HBA1C too quickly

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Laconic

Laconic

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Relationship to Diabetes
Type 2
Is it better to lower it gradually and not dramatically, I say this because mine initially was almost halved from 110 in less than 2 months, the sudden changes to your body in the long run I’m a bit concerned about
 
Gradually, I suffered consequences with my eyes from plummeting and some others have too xx
 
My eyes have actually improved now but initially were blurry, when I suddenly reduced all the carbs as my diet had been very high carbohydrates prior to diagnosis.
My prescription has altered dramatically now from needing near vision glasses to being short sighted and needing them for distance and driving
 
I required urgent eye injections less than a month into my diabetes diagnosis due to a plummet in hba1c, had I listened to the advice given out by most and not bothered going to get my eyes checked it could've been much worse, despite good, stable control they also believe that's what caused my proliferative retinopathy less than 2 years in, I talk from experience and wish I'd known that dropping your hba1c too quickly could do more damage than good, you seem to have been one of the lucky ones if it hasn't effected you, I however wasn't
 
Well Kaylz, I'd agree with a lot of what you just said, mainly in respect of better to reduce BG at a steady plod than at a sprint - BUT I still reckon that part of your being hit with such a rotten load of problems, is still partially down to luck, I'm afraid. Or your genes, or your great grandad on your father's sides, genes or what your great great grandma's diet was - all 'stuff' that none of us have ever had and will never have, any control over whatsoever!

We'd all drive ourselves completely bonkers if we started to try and find out WHY any of us got landed with diabetes (or eg die straight hair, or eg seborrheic keratoses) in the first place, so it's just a complete waste of time trying to ponder it.

IMHO! 🙂
 
As the youngest of Four Siblings plus both my late parents were diabetic, I’m the only one in my family who has the disease and my brother who constantly has a high carb, sugar, alcohol diet and gets tested every year is always in non diabetic range...
 
Hello @Laconic slowly does it is the way to go, I was HbA1c 156 at diagnosis and 48 three months later. I now suffer Diabetic Peripheral Neuropathy (DPN) and it affects my mobility, the DSN said I lowered it too quick but the Consultant said its the luck of the draw so who`s right? Both of them me thinks if that makes any sense? I also have a problem with my right eye but that is a fairly new problem which I put down to the luck of the draw but the DPN I put down to lowering my HbA1c too quickly. If you are down to half of you original HbA1c I would try to keep it at that until you next test, hope this helps take care.
 
I got down from 110 to 39 in roughly 4 months is this too soon. Also have had eyes kidneys tested and all satisfactory
 
I would not worry too much if you have had all the checks and they have come back ok. It is a big drop in a short time. No one seems to know for certain, I suspect there are many factors why some people get complications.
 
Laconic said:
I got down from 110 to 39 in roughly 4 months is this too soon. Also have had eyes kidneys tested and all satisfactory
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I wouldn't sweat it. If yr microvascular stuff looks ok - no retinopathy, nothing wonky with kidneys - then I think things are fine.

AFAIK, the main issue with bringing it down very quickly is possible temporary increase in retinopathy. Anyway, that's what my eye guy told me.
 
Laconic said:
My eyes have actually improved now but initially were blurry, when I suddenly reduced all the carbs as my diet had been very high carbohydrates prior to diagnosis.
My prescription has altered dramatically now from needing near vision glasses to being short sighted and needing them for distance and driving
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I was diagnosed with T1, at the same time as finding a big change in my prescription. Still a result of high BG. Once I got the BG levels back down my old glasses were fine. (The optician gave me new ones free as they felt that they should have spotted the diabetes. I still go back to the same optician. A good move on their part.)
 
Can one actually do this? Can one control the speed at which HBA1c falls? Most find that the problem is to get it down at all, and never have much idea of what it will be until after the test.
 
There are quite a few papers and reports about how rapid reduction in HBA1C can cause permanent problems to the retina/macula. Reducing slowly can be achieved by setting higher BG targets to begin with and regular BG testing/use of Libre to regularly monitor levels to check that you are meeting/close to these targets.
 
You have to remember that when a person is already morbidly obese, 15kg still won't likely be a huge proportion of their total weight in some cases.

My total weight is c.63kg so losing 15kg would be damned frightening! If you eg. weigh 190kg (30 stone) losing 15 kg (just over 2 stone) isn't as scary.
 
AJLang said:
There are quite a few papers and reports about how rapid reduction in HBA1C can cause permanent problems to the retina/macula. Reducing slowly can be achieved by setting higher BG targets to begin with and regular BG testing/use of Libre to regularly monitor levels to check that you are meeting/close to these targets.
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This is my point: even with frequent checking and many injections I can NOT meet or get close to any target concistantly. Can others fo this? Many type 11s are not even provided with BG test kits and certainly not Libre.
 
"Is it better to lower it gradually and not dramatically?"

I think gradually is the best way leonS. I'm T2 and reduced my HbA1c from 53mmol at dx to 31mmol over a period of 16 months ~ I followed a low carb diet & exercise regime to achieve this.
*I have regular diabetes eye screening and given the all clear every time. Touch wood it stays like that.

But best I leave it to other T1 members to advise you. Good luck.
WL
Edited*
 
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I suspect with the increased use of continuous monitoring devices, the advice might change to targets of in range. To help reduce the risk.
 
leonS said:
This is my point: even with frequent checking and many injections I can NOT meet or get close to any target concistantly. Can others fo this? Many type 11s are not even provided with BG test kits and certainly not Libre.
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Hi Leon have you done a DAFNE course, if not that should help you. Have you got a Libre, if not please check the criteria and arrange to get one. If you cannot get close to target consistently it may be worth talking to your diabetes team about getting an insulin pump. Targets are not easy to achieve but it most definitely can be done e.g. my HBA1C is 6.3 and time in target 95%. I am very concerned that there are Type 1’s not being provided with BG test kits because NICE guidance is clear that they all should and there is criteria for getting the Libre. @everydayupsanddowns have you got further information that you can add to this please? It may be with starting this as a new thread.
 
AJLang said:
Hi Leon have you done a DAFNE course, if not that should help you. Have you got a Libre, if not please check the criteria and arrange to get one. If you cannot get close to target consistently it may be worth talking to your diabetes team about getting an insulin pump. Targets are not easy to achieve but it most definitely can be done e.g. my HBA1C is 6.3 and time in target 95%. I am very concerned that there are Type 1’s not being provided with BG test kits because NICE guidance is clear that they all should and there is criteria for getting the Libre. @everydayupsanddowns have you got further information that you can add to this please? It may be with starting this as a new thread.
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I saw someone reporting yesterday it maybe on Twitter, where the GP was refusing to prescribe testing strips as the person had a Libre. The person had informed the GP they were advised to still test at times with strips as well. This person was seeking advice to resolve the issue.
 
grovesy said:
I saw someone reporting yesterday it maybe on Twitter, where the GP was refusing to prescribe testing strips as the person had a Libre. The person had informed the GP they were advised to still test at times with strips as well. This person was seeking advice to resolve the issue.
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Good point Grovesy. It can be a struggle getting enough test strips when using the Libre. I think my CCG suggests 50 test strips a month if you have the Libre. I’d assumed that Leon meant that T1’s couldn’t get Libre or BG testing but from your post I now realise that I might have been wrong.
 
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