Which is worse?

[SerialLurker]

I know neither option is good, but generally, which is worse for your health:
A consistently slightly elevated BG for a long time (e.g. more than a year)
OR
A wildly fluctuating BG with big spikes & dips that produces the same "average" result as the consistently slightly high BG?

Just wondering as (as far as I can tell) the HbA1c will not be able to differentiate between the two cases, and I would have thought different treatment approaches would be needed for each case?

 

[Northerner]

Fluctuating levels would be much less desirable - it is thought that it is the spikes and troughs in levels that cause the most damage to the fragile blood vessels in the eyes and kidneys, in particular.

This is probably why many medicals ask if you've had a lot of hypos if you have a low HbA1c - they find it hard to believe that a good HbA1c can be achieved unless you are keeling over on an hourly basis! 😱 The aim is to achieve both - good day-to-day, steady levels and an HbA1c below 48 mmol/mol 🙂

 

[trophywench]

Absolutely true what you say - and all of us has to try and avoid peaks and troughs first and foremost. However because we are human and prone to err - sometimes they are unavoidable - as long as we try to identify WHY for each individual one - and then act to try and avoid it in future - that's the important bit.

Overall - try to achieve a happy medium between the two!