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What Does It Mean To Have A Low A1c?

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This is a message to all youth throughout the country and the world that are affected by type 1 diabetes - please hold on.

Hemoglobin A1c Levels And Risk Of Severe Hypoglycemia In Children And Young Adults With Type 1 Diabetes From Germany And Austria: A Trend Analysis In A Cohort Of 37,539 Patients Between 1995 And 2012

Abstract Severe hypoglycemia is a major complication of insulin treatment in patients with type 1 diabetes, limiting full realization of glycemic control. It has been shown in the past that low levels of hemoglobin A1c (HbA1c), a marker of average plasma glucose, predict a high risk of severe hypoglycemia, but it is uncertain whether this association still exists. Based on advances in diabetes technology and pharmacotherapy, we hypothesized that the inverse association between severe hypoglycemia and HbA1c has decreased in recent years. Methods and Findings We analyzed data of 37,539 patients with type 1 diabetes (mean age ± standard deviation 14.4±3.8 y, range 1–20 y) from the DPV (Diabetes Patienten Verlaufsdokumentation) Initiative diabetes cohort prospectively documented between January 1, 1995, and December 31, 2012. The DPV cohort covers an estimated proportion of >80% of all pediatric diabetes patients in Germany and Austria. Associations of severe hypoglycemia, hypoglycemic coma, and HbA1c levels were assessed by multivariable regression analysis. From 1995 to 2012, the relative risk (RR) for severe hypoglycemia and coma per 1% HbA1c decrease declined from 1.28 (95% CI Continue reading >>

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  1. dangreenman

    Low A1c Numbers

    I have diagnosed with type 2 diabeties for about 1 year, My last 3 A1C results have been 4.7, 4.8 & 4.3 repectivley. Is this normal for a diabetic?? I do not take insulin. Just stay away from sugars, carbs, and take Glyberide

  2. Gabby

    Another thing that could be giving you such good A1c numbers (those are more normal for a non-diabetic person) could be things such a donating blood as well. Do you donate on a regular basis?
    Otherwise, as many have said, it could reflect having too many lows. To be honest, if your A1c is in that range, I would be thrilled as long as you are not suffering to achieve that reading.

  3. gregsteele

    Im fairly new and have only had one a1c since my diagnosis it was over 17 when diagnosed a month ago it was below 6 do you have a lot of lows ? if so ask dr about a glucagon shot to carry with you those numbers sound to low to me love to all GREG

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Ask The Diabetes Team

Question: From Burton, South Carolina, USA: Nine months ago, I was diagnosed with diabetes by a random blood sugar of over 200 mg/dl [11.1mmol/L], and a two-hour glucose tolerance test value also over 200 mg/dl [11. mmol/L]. My A1c at that time was 5.7%, and my most recent A1c was 4.4%. Does this low A1c mean I don't have diabetes? What A1c level is considered too low? Answer: Hemoglobin A1c only reflects average glucose values over the past six weeks or so. It is not diagnostic of having or not having diabetes. A low value could mean that all your blood glucose readings are within normal range. It could also mean that you are having too many episodes of hypoglycemia. You should discuss this with your diabetes team and consider doing a profile of blood glucose values to double check what your blood glucose readings are on a daily basis. [Editor's comment: People with certain hemoglobin traits can have falsely low A1c results. If you are concerned, you might want to be sure that the A1c testing that you have had done recognizes these traits, or you might want to be tested for them. Your situation might well be clarified by monitoring sugar levels continuously for several days to try Continue reading >>

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  1. DOP

    Low A1c & heart attacks

    My last A1c was 5.1 and the doctor said it was too low. She wants me to keep it between 6 and 6.5. She says a new study shows increased risk of heart attacks for people with A1c below 6. Has anyone else heard of this? The reference she made was to the Accord Study. I could not find a great deal of information about this study, only some vague references.

  2. saraknic

    That study was a big topic around the boards a few months ago.
    Personally, I don't think 5.1 is too low, especially for a Type 2 diabetic who is porbably achieving it without too many lows. If it is a 5.1 because of a lot of times in hypoglycemic ranges - then yes, it is too low.
    Here are some threads that may interest you:
    http://www.diabetesdaily.com/edelman...-dangerous.php
    http://www.diabetesdaily.com/forum/n...d-after-deaths (please read this one all the way through - it is a long but good thread)
    This is also an important one:
    http://www.diabetesdaily.com/forum/n...sive-treatment Shortly after the ACCORD study was published, the ADVANCE study was published and basically said the opposite was true.
    Happy reading!

  3. Spike

    Originally Posted by DOP
    My last A1c was 5.1 and the doctor said it was too low. She wants me to keep it between 6 and 6.5. She says a new study shows increased risk of heart attacks for people with A1c below 6. Has anyone else heard of this? The reference she made was to the Accord Study. I could not find a great deal of information about this study, only some vague references. That's gotta be tough on non-diabetics, who's A1c's will be under 6.

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Anemia And Hemoglobin A1c Level: Is There A Case For Redefining Reference Ranges And Therapeutic Goals?

Segun Adeoye, Sherly Abraham, Irina Erlikh, Sylvester Sarfraz, Tomas Borda and Lap Yeung. Abstract Background: Hemoglobin A1c (HbA1c) has been adopted by physicians as a surrogate for monitoring glycemic control. There exists concern that other factors beyond serum glucose concentration may affect glycation rates and by extrapolation HbA1c levels. Study Objectives: The study attempts to discern clinical differences in HbA1c levels in patients with anaemia compared to patients without anemia, quantifying and showing the direction of such differences. Study Design: Using a convenient sampling method and a set of inclusion and exclusion criteria, it examined (retrospectively) patterns in [Hb] and HbA1c in non-diabetics with and without anemia. Results: The study observed a statistically significant 0.4units (8%) difference in the mean HbA1c in anaemia vs. non-anaemic populations. Reference ranges of HbA1c for non-anaemic population and anaemia subtypes was computed. Computed ranges for anaemia group and its subgroups were significantly wider compared to non-anaemia population. Modest but statistically significant correction of anaemia did not result in significant changes in HbA1c. Di Continue reading >>

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  1. classicdame

    The A1c is a 90 day average of blood sugars. 4.9 translates to an AVERAGE blood sugar less than 90 mg/dl. This means the patient could be having hypoglycemia events, which can be fatal.
    Suggestions: patient may be checking blood sugar infrequently and/or at a time when real-time BS is normal. Patient may be on medication that drops the blood sugar to a below-normal range (this can be adjusted by MD). Patient may not be eating enough or may be overdoing exercise.
    Thankfully there are now many meds for DM and the physician or NP should be able to determine the best therapy for this patient. The WRONG thing to do is self-medicate and hope for the best.

  2. *ac*

    I did my senior practicum in diabetes and have studied and lived with it extensively.
    A1c is not really an average, because most of the blood cells are not 90 days old. On a curve, most of them would fall into the 2 or 3 week old range. That it's commonly called an average is a pet peeve of mine.
    It can also be scewed by having many hypos coupled with many hyperglycemic excursions - this can result in a fairly low A1c, but have been a very dangerous way to get there. Also, recent studies show that wide swings are more dangerous than high A1c.

  3. classicdame

    Agreed. But when I am consulting with patients or nurses who just want "the bottom line" I do not try to give more info then they need. That is why I called it an average. It implies there are highs and lows. The important thing for Grammyj to know is that the healthcare provider needs to be consulted and asked "what does this mean to ME?"

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