a1c

is there a too low range for an a1c? I just left my endo’s office and my last a1c was (woohoo!!! I couldn’t believe it!!!) 5.5, but he said that it might be getting too low especially seeing how i’m getting ready to start the pump and that usually lowers it more…

could it just be this low due to all the lows i kept having awhile back?

Elizabeth

Elizabeth, I don’t know the answer to your question for sure, but I would think that your thoughts are correct. I want to say congratulations to you for the great A1c. That is fabulous. I don’t think there is such a thing as too low of an A1c, because the lower we are, the closer to “normal” we are. Of course, if low A1c is caused by extreme lows all the time, then that is not a good thing at all.

I suspect your assumption may be correct. I’d like to congratulate you Elizabeth. For MDI, I’d say that’s real good. Best I could get on MDI was 7.3.
Good luck when you start pumping. We might have to “reign” you in on your A1C’s then. :slight_smile:

Normal, non-diabetic A1c range is in the mid-high 4’s, so striving to be as close to normal is great. Congrats on the 5.5!

Docs justifiably worry about A1cs being low if this means patients are having too many lows. Silly to say that pumping will lower it more, if pumping levels you out with less lows & less highs.

Did you bring the endo your BG logs? Could be that he noted the lows.

Your A1c could be due to the lows you’ve had. A1c measures average for about 3 months, so check back if you kept records.

Yeah see I don’t get a Dr.'s that say stuff like that. I thought all the meds and pumps and stuff is that way we could be as close to NORMAL as we can be. Of course we don’t want lows to do it but as long as we are not, isn’t that what we strive for?

Nobody can keep their bg at exactly the same level. The equivalent of 5.5% A1C is 111 mg/dl. The good doctor assumes that your bg is not 111 mg/dl all the time. The good doctor assumes that the range of your bg is determined by the tools you use. When I used shots and bg strips the bg standard deviation was 60. That means for an A1C of 5.5% my bg would have been outside 111-60=41 and 111+60=171 for 33% of the time. I never achieved A1C of 5.5% while being on shots and bg strips. The key to determining whether your A1C is too low or not is to know the bg standard deviation. There is no lab test for bg standard deviation. If you have the software for your bg meter it will tell you. I don’t think the good doctor will get reimbursed for downloading your meter. This is the reason why no doctor in my 36 years of D ever asked to download the data from my bg meter.

I am sorry if I bored you. Congrats on your A1C. You are definitely heading the right way. Ask your good doctor why an A1C of 5.5% is too low. I hope you will get more than a blank stare.

I think you are right on target with the standard deviation. The only safe way to bring your HbA1c down to lower levels below 6% is to start to understand variations and standard deviation (SD) and make sure that you not only drive your average blood sugar down, but you drive your SD down at the same time. You cannot risk having serious lows on an ongoing basis.

According to my meter, my average for the last 30 days is 154 and my 60 day average is 120. I do have high highs and low lows and a SD of 60 is just about right on for me. i think that the reason that he was concerned about an a1c of 5.5 is that it’s down from my last one of 9.0, which was during my honeymoon period and that’s history now! i’ve been really concerned about not only what I eat, but also the carb content in the last few weeks as I’m taking my nutrition classes right now and it’s been really interesting! I’m trying to have the “best” control that I can possibly have. Hopefully, it’s even lower next time!

Elizabeth, the most important factor is that you care. During my first 10 years of D my A1C must have been above 8 (A1C had not been invented by then). You will be fine. Just keep it up.

Dave, I don’t see the contradiction. Your wife’s standard deviation is good without effort. I am just saying that low A1C should go hand-in-hand with low standard deviation.

I am glad things have gone so well for you. Perhaps you will be able to experience control like Dave’s wife and not have to worry about your standard deviation. Unfortunately, many diabetics do have to worry about lows. I’m sorry if the MATH caused brain distress. I do hope that the carb counting works out for you, it can really help you improve your control (and probably bring the SD down a good bit).

well, i am the daughter of a college mathematics professor… so i’ve got more math skills than i know what to do with! math has never been an issue for me… now spelling on the other hand… that’s a whole different story! lol

believe it or not, even my dad has an accountant! I stopped taking math classes at differential equations and decided to pursue other interets… like boys! lol

You might want to update your A1C in your profile. I many times use the profile as reference point.

I agree. I am saying: “Tell me your SD and I can tell you what A1C is reasonable.”. No mention of effort.

the funny thing is, when i came to chiropractic school, i was told that i needed to take college algebra and college physics, i laughed and my admissions advisor was like, what’s so funny, i told her i had college algebra in 9th grade and i’ve taken four courses in physics… she made me get my high school transcripts to prove it, i told her that you can’t take calc I-III and DE without college algebra!

Any math that I came across is child’s play compared to diabetes. Math is predictable. Diabetes is not. If curing diabetes was as easy as a math degree I would be cured.

hahaha… that’s like i really didn’t pass english lit… and i hate to say it, but low cut shirts got me a C to pass!

I agree!!!

dave, any good suggestion on pasta besides avoid it all together? I had 2 cups of pasta tonight (~80g of carbs, all total dinner was 125g of carbs with 12 units of novolog, had a bit of a high before dinner) and was fine until now… getting ready to go to bed and i’m at 296… if only diabetes was like math!