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Can You Have Too Low Of An A1c Level?

Is A Lower A1c Level Better Or Worse?

Is A Lower A1c Level Better Or Worse?

It seems logical that the lower our blood glucose levels are the better we will be. Most of us have always assumed that lower blood glucose levels would protect us better from the complications of diabetes. In fact, during the past two decades several studies showed a linear relationship between blood glucose, as measured by A1C levels, and worsened health. But now, several recent A1C studies have shown a J-shaped relationships, in which at the lower end some bad things happen, at the center things are better, and at the top end things are terrible. While linear relationships are the rule in observational studies, U-shaped and J-shaped curves aren’t uncommon, and some authors lump both of these shapes as U-shaped. All of the studies relating A1C levels and ill health — the earlier ones and the recent ones alike — are observational. They study correlations, which aren’t proof, because other confounding factors that the researchers didn’t take into account could have been the problem. 5.4-5.6 Seems Safest The first of these newer studies showing that a very low A1C level is unhealthier than a higher one came out in the February 2015 issue of Diabetes Care. This analysis of the German National Health Interview and Examination Survey 1998 that studied about 6,300 people for about 12 years indicated that people with an A1C level of 5.4 to 5.6 had the lowest risk of excess mortality. Because this result puzzled me so much, I asked Dr. Richard K. Bernstein for his reaction. “These A1c measurements were made years ago in Germany,” he replied, “before international agreement on how it would be measured. The modern elution method would likely give considerably different results. It is even possible that several different methods were being used at different sites Continue reading >>

Is My Husband's A1c Too Low?

Is My Husband's A1c Too Low?

My husband has type 2 diabetes, and for years his endocrinologist urged him to keep his A1C under 7 percent. A few months ago we went on a low-carb diet, and my husband lost over 30 pounds. The doctor took him off a sulfonylurea, cut his metformin dose in half, and removed two blood pressure meds.When my husbands A1C test came back at 6.1 percent, I thought his doctor would be thrilled. But he said 6.1 was too low. Why? Faith Goldman, Ladera Ranch, California Although I dont know all the details, I wouldnt necessarily say that your husbands A1C is too low. The American Diabetes Association (ADA) recommends that many adults with diabetes strive to keep A1C less than 7percent, but the goal can differ from person to person. Even tighter goals, such as less than 6.5percent, might be reasonable for people with relatively recently diagnosed diabetes and many years to live. A bit looser goal (such as less than 8percent) may be fine for those with advanced diabetes complications , other chronic illnesses, or shorter life expectancies. In all cases, hypoglycemia (low blood glucose, under 70mg/dl) should be avoided as much as possible. The ADA recommendations do not specify a low end of the target range for A1C, because it matters how people get to lower A1Cs. People without prediabetes or diabetes have A1Cs in the mid-5percent range or below. Many people with type2 diabetes can lower their A1C with healthy changes in their diet and exercise, or with bariatric surgery. It would be hard to say that these A1Cs are too low. When is someones A1C too low? It can be if its low due to frequent episodes of hypoglycemia, or if its lower than it needs to be to provide benefit but causing a lot of treatment burden (the expense of multiple medications, for example). It doesnt sound as if th Continue reading >>

5 Ways To Lower Your A1c

5 Ways To Lower Your A1c

For some, home blood sugar testing can be an important and useful tool for managing your blood sugar on a day-to-day basis. Still, it only provides a snapshot of what’s happening in the moment, not long-term information, says Gregory Dodell, MD, assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Health System in New York City. For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months. Called the A1C test, or the hemoglobin A1C test, this provides a more accurate picture of how well your type 2 diabetes management plan is working. Taking the A1C Test If your diabetes is well controlled and your blood sugar levels have remained stable, the American Diabetes Association recommends that you have the A1C test two times each year. This simple blood draw can be done in your doctor's office. Some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. The A1C test results provide insight into how your treatment plan is working, and how it might be modified to better control the condition. Your doctor may want to run the test as often as every three months if your A1C is not within your target range. What the A1C Results Mean The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 perce Continue reading >>

Low Blood Sugar Symptoms But Normal Levels

Low Blood Sugar Symptoms But Normal Levels

High blood sugar usually feels bad. Kerri Sparling of the blog Six Until Me said, “It’s a thick feeling in the base of your brain, like someone’s…replaced your gray matter with sticky jam.” Other people report physical symptoms such as fatigue, weakness, headaches, blurry vision, thirst, and frequent urination. These symptoms often drive people to seek help, which is a good thing. Other people can get used to high sugars. They may feel few or no symptoms. That’s not good, because blood vessel damage is still going on, even if you can’t feel it. If your body gets comfortable with higher blood sugars, normal sugars may start to feel bad. A woman named Angela posted to Diabetes Daily, “I feel so crappy when my [blood sugar] is in the 90s…. That seems to be about 50% of the time. Sometimes I test when I’m feeling GOOD and it’s [much higher]…. I want a low A1C, but I don’t want to feel ‘fuzzy’ all the time either.” What is happening is that Angela’s body adjusted to higher sugars. Now she’s getting tighter control, but she’s not used to it. On another site, diabetes educator Janet Mertz explained, “Because your body is accustomed to the higher levels, the lower numbers may now be perceived as too low…. Your body reacts like you’re having low blood sugar (hypoglycemia)…. It generally takes a couple of weeks for the body to adjust to the new, healthier numbers.” Another person wrote on Yahoo! Answers, “When I was diagnosed, my sugar was over 350. I started metformin and eating very little carbohydrate. My levels dropped to the 150s by the end of the week. I wasn’t anywhere near hypoglycemic, but I felt like I was. I had all the signs — dizziness, shakiness, and weakness. Within a couple of weeks, the symptoms disappeared. Continue reading >>

Ultimate Guide To The A1c Test: Everything You Need To Know

Ultimate Guide To The A1c Test: Everything You Need To Know

The A1C is a blood test that gives us an estimated average of what your blood sugar has been over the past 2-3 months. The A1c goes by several different names, such aswa Hemoglobin A1C, HbA1C, Hb1C, A1C, glycated hemoglobin, glycohemoglobin and estimated glucose average. What is Hemoglobin? Hemoglobin is a protein in your blood cells that carries oxygen. When sugar is in the blood, and it hangs around for a while, it starts to attach to the red blood cells. The A1C test is a measurement of how many red blood cells have sugar attached. So, if your A1C result is 7%, that means that 7% of your red blood cells have sugar attached to them. What are the Symptoms of a High A1C Test Level? Sometimes there are NO symptoms! That is probably one of the scariest things about diabetes, your sugar can be high for a while and you may not even know it. When your blood sugar goes high and stays high for longer periods of time you may notice the following: tired, low energy, particularly after meals feel very thirsty you may be peeing more than normal, waking a lot in the middle of the night to go dry, itchy skin unexplained weight loss crave sugar, hungrier than normal blurred vision, may feel like you need new glasses tingling in feet or hands cuts or sores take a long time to heal or don’t heal well at all frequent infections (urinary tract, yeast infections, etc.) When your blood sugar is high, this means the energy that you are giving your body isn’t getting into the cells. Think about a car that has a gas leak. You put gas in, but if the gas can’t get to the engine, the car will not go. When you eat, some of the food is broken down into sugar and goes into your bloodstream. If your body can’t get the sugar to the cells, then your body can’t “go.” Some of the sugar tha Continue reading >>

Can An A1c Be Too Low?

Can An A1c Be Too Low?

Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. While I was talking with my nurse she mentions that an a1c lower then 5.0 might not be healthy. I really didn't think about it until now. Mine is 5.8. Down from DX 8.7. What are the safe numbers? Dr Bernstein recommends an A1C below 4.8. If you haven't already, get and read Dr Bernstein's Book "Diabetes Solutions" - It is the ultimate book for any newly diagnosed Diabetic. Sorry but Bernstein's well off on that one. The normal range is believed to be about 4.5-5.5. To be honest, once you've got your A1C below 6 there's absolutely no benefit whatsoever in reducing it further. 5.8 is bloody great A1cm, your work is done and don't let some miserable little doctor who is terrified of bread and hasn't even heard of Lantus tell you otherwise. LocationSomewhare in the South Pacific??? I am with Dues on this one as if you were to go lower you will have more instances of lows so you don't want that. I would aim at 6 so keep up the good work. We really don't know what the impact of going sub-5 vs sub-6 is. It may be marginal for most, but it may be significant for others. For people like me with no margin for error when it comes to eye health, I'd not hesitate going as low as possible. A low A1C cannot be unhealthy. That's just nonsense. There's nothing good about cell glycation. It only serves to kill you. The pain comes from getting there. Hypos are a danger. If you don't follow best medication practices, it is a foolish target. Even with best practices it may not be achievable. If you can get off all meds, yes, go for it. Another pitfall may be general nutrition. Controlling food intake is a vital t Continue reading >>

How Low Can You Go?

How Low Can You Go?

Being that I talk to endocrinologists all day for work, I’ve certainly discussed my own care and issues with them. And a few of them I’m close enough with to share my latest A1c of 6.0%. I’ve been getting the expected high fives and “good work” comments, but I’m also getting a reaction that I didn’t expect: concern. Many of the endos I’ve spoken to have first congratulated me on the low number, and then given me that knowing look down the bridge of their nose and said “Now don’t go too low, you hear me?” Too low? I didn’t know there was such a thing for a person with diabetes. All our lives we’re told to keep the A1c as close to normal as possible, and that some guidlines indicate keeping an A1c below 6.5% is the best bet for staving off complications. And if 6.0% is close to a functioning pancreas percentage, then what’s the problem? My endo buds explained: low A1cs mean aggressive diabetes management. And being aggressive with insulin therapy means you’re bound for low blood sugars more often than your average diabetic bear. Turns out a low A1c is not only a great predicter of avoiding complications, but also means the patient is often dealing with frequent and possibly dangerous lows. Hypoglycemia is more dangerous in the short run than running high, because it happens quickly and must be treated quickly. Insulin is one of the most powerful – and dangerous- drugs in the world, and anyone who has diabetes knows that sometimes even the smallest errors or miscalculations can mean big consequences. I don’t personally feel that I suffered more frequent or scarier lows while getting to an A1c of 6%, but have any of you dealt with this issue? Did you keep going or decide to go up a few points to feel safer? And have any of you ever had this Continue reading >>

When Your Blood Sugar Is Too High Or Too Low

When Your Blood Sugar Is Too High Or Too Low

Sometimes, no matter how hard you try to keep your blood sugar in the range your doctor has advised, it can be too high or too low. Blood sugar that is too high or too low can make you very sick. Here's how to handle these emergencies. What You Need to Know about High Blood Sugar If your blood sugar stays over 240, it is too high. High blood sugar usually comes on slowly. It happens when you don't have enough insulin in your body. High blood sugar can happen if you miss taking your diabetes medicine, eat too much, or don't get enough exercise. Sometimes, medicines you take for other problems may cause high blood sugar. Be sure to tell your doctor about other medicines you take. This chart shows the ranges of blood sugar. Having an infection or being sick or under stress can also make your blood sugar too high. That is why it is very important to test your blood and keep taking your medicine (insulin or diabetes pills) when you have an infection or are sick. Your blood sugar may be too high if you are very thirsty and tired, have blurry vision, are losing weight fast, and have to go to the bathroom often. Very high blood sugar may make you feel sick to your stomach, faint, or throw up. It can cause you to lose too much fluid from your body. Testing your blood sugar often, especially when you are sick, will warn you that your blood sugar may be rising too high. If your blood sugar stays over 300 when you check it two times in a row, call your doctor. You may need a change in your insulin shots or diabetes pills, or a change in your meal plan. *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectations do not match CGM readings, and if not performed, may result in hypoglycemia. Please see important risk and sa Continue reading >>

Low Blood Sugar Symptoms And Ranges

Low Blood Sugar Symptoms And Ranges

Low blood sugar (hypoglycemia) definition and facts Hypoglycemia is the medical term for low blood sugar. It typically occurs as a side effect of medications for diabetes. The normal range of blood glucose is from 70 to 100 mg/dL in an individual without diabetes, Most people will feel the effects and symptoms of low blood sugar when blood glucose levels are lower than 50 mg/dL. Low blood sugar is treated by giving a readily absorbed source of sugar, including soft drinks, juice, or foods containing sugar. If the hypoglycemia has progressed to the point at which the patient cannot take anything by mouth, an injection of glucagon may be given. Glucagon is a hormone that causes a fast release of glucose from the liver. Hypoglycemia or low blood sugar is syndrome that results from low blood sugar. The severity and symptoms of hypoglycemia can vary from person to person. Blood tests can diagnose low blood sugar, and symptoms resolve when the levels of sugar in the blood return to the normal range. The medical term for blood sugar is blood glucose. What can cause low blood sugar? Despite advances in the treatment of diabetes, low blood sugar episodes occur as a side effect of many treatments for diabetes. In fact, these episodes are often the limiting factor in achieving optimal blood sugar control, because many medications that are effective in treating diabetes carry the risk of lowering the blood sugar level too much, causing symptoms. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes becomes tighter control of blood sugar. While peopl Continue reading >>

Nondiabetic Hypoglycemia

Nondiabetic Hypoglycemia

What is non-diabetic hypoglycemia? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well. What causes non-diabetic hypoglycemia? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Types of nondiabetic hypoglycemia Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria) Alcohol, especially with binge drinking Serious illnesses, such as those affecting the liver, heart, or kidneys Low levels of certain hormones, such as cortisol, growth hormone, glu Continue reading >>

Older Diabetics May Be Pushing Blood Sugar Too Low

Older Diabetics May Be Pushing Blood Sugar Too Low

(Reuters Health) – Older diabetics may sometimes do too good a job at keeping their blood sugar down, according to a new study. Regardless of age, people with diabetes are taught to keep their blood sugar below certain target levels. But many diabetics over 65 who have other health concerns may be at risk for pushing it too low, according to a new study. Particularly for older adults with multiple serious illnesses and functional limitations, the risks of low blood sugar, or hypoglycemia, may outweigh the benefits of tight blood sugar control, the authors write. “Older people are more susceptible to hypoglycemia,” said lead author Dr. Kasia J. Lipska of the Yale School of Medicine in New Haven, Connecticut. “As people age, their kidney function deteriorates and drugs (like insulin) may not be eliminated from the body as efficiently,” which can lead to low blood sugar, she told Reuters Health by email. Often, people with low blood sugar don’t realize they have it. Symptoms can include double or blurry vision, rapid heartbeat, headache, hunger, shaking or trembling, sweating, tiredness or weakness or feeling faint, trouble sleeping, unclear thinking, and other problems. Severe low blood sugar can cause seizures and brain damage. Intense diabetes treatment, which the study showed many older people are doing, increases the risk for hypoglycemia two to three fold, Lipska said. Her team used data on 1,288 diabetics age 65 or older, from the National Health and Nutrition Examination Surveys from 2001 through 2010. Based on their ability to complete activities of daily life, about half of the participants were generally healthy, 28 percent had “complex or intermediate” health and 21 percent had “poor” health. To see how tightly these patients were controllin Continue reading >>

A1c Test

A1c Test

Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if Continue reading >>

An Elevated Risk State?

An Elevated Risk State?

Go to: Abstract To identify predictors of low hemoglobin A1c (HbA1c) (<5.0%) and to investigate the association of low HbA1c with cause-specific mortality and risk of liver disease hospitalization. RESEARCH DESIGN AND METHODS Prospective cohort study of 13,288 participants in the Atherosclerosis Risk in Communities Study. Logistic regression was used to identify cross-sectional correlates of low HbA1c, and Cox proportional hazards models were used to estimate the association of low HbA1c with cause-specific mortality. RESULTS Compared with participants with HbA1c in the normal range (5.0 to <5.7%), participants with low HbA1c were younger, less likely to smoke, had lower BMI, lower white cell count and fibrinogen levels, and lower prevalence of hypercholesterolemia and history of coronary heart disease. However, this group was more likely to have anemia and had a higher mean corpuscular volume. In adjusted Cox models with HbA1c of 5.0 to <5.7% as the reference group, HbA1c <5.0% was associated with a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.32, 95% CI: 1.13–1.55) and of cancer death (1.47, 95% CI: 1.16–1.84). We also noted nonsignificant trends toward increased risk of death from cardiovascular causes (1.27, 95% CI: 0.93–1.75) and respiratory causes (1.42, 95% CI: 0.78–2.56). There was a J-shaped association between HbA1c and risk of liver disease hospitalization. No single cause of death appeared to drive the association between low HbA1c and total mortality. These results add to evidence that low HbA1c values may be a generalized marker of mortality risk in the general population. Adjusted* associations of low HbA1c (<5.0% vs. 5.0 to <5.7%) among persons without diabetes (N = 9,254) Continue reading >>

Understanding Diabetes

Understanding Diabetes

This information describes diabetes, the complications related to the disease, and how you can prevent these complications. Blood Sugar Control Diabetes is a disease where the blood sugar runs too high, usually due to not enough insulin. It can cause terrible long-term complications if it is not treated properly. The most common serious complications are blindness ("retinopathy"), kidney failure requiring dependence on a dialysis machine to stay alive ("nephropathy"), and foot and leg amputations. The good news is that these complications can almost always be prevented if you keep your blood sugar near the normal range. The best way to keep blood sugar low is to eat a healthy diet and do regular exercise. Just 20 minutes of walking 4 or 5 times a week can do wonders for lowering blood sugar. Eating a healthy diet is also very important. Do your best to limit the number of calories you eat each day. Put smaller portions of food on your plate and eat more slowly so that your body has a chance to let you know when it's had enough to eat. It is also very important to limit saturated fats in your diet. Read food labels carefully to see which foods are high in saturated fats. Particular foods to cut down on are: whole milk and 2% milk, cheese, ice cream, fast foods, butter, bacon, sausage, beef, chicken with the skin on (skinless chicken is fine), doughnuts, cookies, chocolate, and nuts. Often, diet and exercise alone are not enough to control blood sugar. In this case, medicine is needed to bring the blood sugar down further. Often pills are enough, but sometimes insulin injections are needed. If medicines to lower blood sugar are started, it is still very important to keep doing regular exercise and eating a healthy diet. Keeping Track of Blood Sugar Checking blood sugar wi Continue reading >>

Hypoglycemia (low Blood Sugar)

Hypoglycemia (low Blood Sugar)

What Is Hypoglycemia? Hypoglycemia may be described as low levels of sugar (glucose) in the blood. This is commonly seen in people who are diabetic, and their blood sugar levels fall too low - either because they took their medications and did not eat properly, or the dosage of medication is too high for them. Normal blood Glucose (sugar) levels are 60-110 mg/dL. Normal values may vary from laboratory to laboratory. Levels much lower than these can indicate hypoglycemia. Causes of Hypoglycemia: Causes of hypoglycemia may include: Excessive exercise, or lack of food intake Certain forms of alcohol may cause low blood sugar levels Certain kinds of tumors, affecting the pancreas (insulinomas) After stomach surgery People with kidney failure, who are on dialysis, may experience hypoglycemia. If you have liver disease, you may be at risk for hypoglycemia. You may have problems with your thyroid, adrenal, or pituitary glands. You may not be absorbing food that you eat very well, thus resulting in hypoglycemia. Symptoms of Hypoglycemia: You may feel sweaty, shaky or hungry. You may feel faint. Extremely low blood sugar levels may cause you to be confused, or disoriented. Severely low levels of blood sugar may cause coma. You may have a fast heartbeat, or feel palpitations. Things You Can Do About Hypoglycemia: If you are experiencing low blood sugar levels as a result of your treatment of diabetes, your healthcare provider may instruct you on the use of close blood sugar monitoring during this time. Follow all of your healthcare provider's instructions. Try to exercise. Low blood sugar levels are often temporary. If you are diabetic, you will have high blood sugars as well. Make a daily walk either alone, or with a friend or family member a part of your routine. Even light wal Continue reading >>

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