Can your A1C be TOO low?

1

Just a technical question I guess but I need guideline for future..with some description of my situation.

My latest A1C was 4.9 this was on June 11th. Before that my diagnosis A1C was 9.2 in Feburary- so I got it down pretty low in only 3 months - thanks too a low carb diet (but I lost too much weight!). The nurse told me those are non-diabetic numbers. I know that between 4% and 6% is normally for non-diabetics.

I still eat low carb and my numbers stay low. But as some of you know, I am a skinny T2 and I wish I could gain some weight back. (or at least not lose anymore - I am 5'4" and I now weigh around 100 lbs). The only way I think i can do that is by eating more which is hard when you are trying to control your numbers (as we all know too well!).

With my A1C so low I was wondering if I could be eating more than I am? I notice I am getting hungry more often which didn't happen to me before I didn't have much of an appetite before (this is normal for me for all my life - not just a d thing).

But my REAL question for this thread is - can a persons A1C go too low? I know some people have mentioned on here that too low an A1C can cause hypo episodes so far I don't have any of those.

I will test my A1C again in a week or two and we shall see what it this - but I think it might be lower than 4.9 or at least the same.

With an A1C of a 4.9, can I "afford" to be a little looser with my diet and my numbers so I can gain some weight? (Ok, i know "afford" is a bad term but I couldn't think of anything else!)

Any opinions?

Also, what is the lowest A1C you have ever heard of another diabetic having? (or even a non-diabetic!)

2

That’s pretty awesome!

A low A1C doesn’t cause hypos. Really, it’s the other way around. If you have lot’s of hypos, one consequence could be that your A1C becomes deflated relative to your actual level of control, especially if you are still having lot’s of highs. I don’t know that diabetics have to worry too much about having an A1C that’s too low if they are in good control otherwise. At 4.9, you certainly don’t have to worry about it if that number represents your level of control.

I’m not a T2 or on a low-carb, so I can’t really give you much advice on how to gain or maintain your weight. I imagine that if you your appetite can tolerate more protein and fat then you can up your calories without adversly affecting your A1C.

3

Thanks FHS. Yeah, I did pretty good - that 9.2 scared me and I wanted it gone! (well, my doctor was freaked about it so that made me freaked! :))

I know I read a few posts a bit back on here that some people said with a low A1C there was a chance at have hypos. Maybe it depends on if you regularly have too low numbers? Being T2 and on met, I haven’t had that problem so far.

I think you lost me on “A1C becomes deflated relatieve to your actual level of control” - but I think you mean that if I have a low A1C but my numbers are high on a regular basis than something is amiss? Is that right? I have seen that chart for the average numbers and how they corelated to what the A1C will be and mine was correct for the last time.

I was just wondering if it was possible or dangerous to end be too low on the A1C. I would think that if you had alot of low numbers you might end up with a low A1C but I think most people on here that have lows (meaning too low - hypo) usually have many highs too so it probably evens out.

Thanks for the advice. Yes, I am trying to get more fat and protein in. I am a vegan so it is hard to get in the protein and fat without eating too many carbs. But I think I can increase what I eat in the afternoon since that is when I don’t eat the most and probably should be eating more often. But I guess with my low A1C, I can afford to have some more higher numbers so I can eat more. I can look forward to more snacks! :slight_smile:

4

Your A1C is “non-diabetic” level. That’s great. It does give you the leeway to try to put on a little bit more weight. Your control is fantastic. Can you meet with a dietitian? That might give you the biggest boost. Talk to your doctor about getting a referral if that’s necessary. My last A1C was 5.9 and I find I’m coveting your score. :slight_smile: My sister is T2 and you’re eating her lunch – maybe you should. She could miss a couple and not be any worse for the wear.

5

WOW you sound EXACTLY like me!! I’m 5’4 103 lbs and diet/exercise controlled only “type 2”. If you do not mind me asking, how old are you? And yes!! I would def. say you could add in more carbs now with such an excellent A1C!! You may even be able to come off of metformin, did your Dr mention that to you? Keep up the good work! How many carbs were you eating per day?

6

Yeah, that’s exactly it. The A1c is supposed to measure your average level of control over the last 90 days. There are a lot of way’s to get a given average. For example, you can have a string of highs, or even a string of days in the highs followed by a string of hypos or days with lot’s of hypos and the overall result would be a decent A1c.Ideally, you want steady BG numbers that are in the normal range between 70 and 120.

Honestly, with an A1c of 4.9, it’s hard to imagine a way to string together enough hypos to offest high numbers without the peaks and valleys sticking out like a sore thumb. It would be something you’d definitely notice. If you’re not having dangerous hypos you’re doing great!

Maybe someone else has insight into what would be considered a dangerously low A1c.

7

Hi LiL MaMa,

That’s great to hear I am not alone on this (well, not ‘great’ because we are too thin but you know what I mean).

I am 40 but I will be 41 in about a week and a half.

For the Met, well, since I have no insurance I don’t go to the dr. often to avoid costs. (I need to switch to a low cost clinic here but I am trying to find one). I didn’t want to go on the Met at diagnosis because I hated the idea of being on pills everyday (I hate swallowing them too!) but my dr. was freaked about the ‘higher level’ A1C so he made me all worried (since I had not a clue at that time how to do this) so I caved. I wanted to the diet and exercise thing. But know, I haven’t actually asked about getting off the Met yet. I did send my new doctor (not a cheap doctor) my new A1C which I had done free at CVS so he knows what it is (hopefully he looked at it) and did refill my prescription.

He did say to me that since I am so thin that this is likely genetic (which it is) and I will probably be on Met for the rest of my life. I didn’t ask him about getting off it but I did ask the first doctor who diagnosed me but he was used to dealing my patients who are overweight and do not do low carb and control their numbers so he said that he had only seen one person go off - but I don’t think he had a lot of experience with different types of diabetics. Mind you this was a low cost clinic in an urban neighborhood where the doctors there see alot of poor patients who eat very poor diets so they have probably not much success, as he said.

I don’t know if I believe this - because it is genetic means you are stuck on meds for your whole life but it is hard to find a doctor who might think otherwise. I mean, all T2 is genetic and the lifestyle kicks it of (or age in my case). If I had money and insurance, I would have no qualms about going from doctor to doctor until I found a more "open-minded’ one. But right now I am kinda stuck.

My cousin who also has diabetes and probably the same bad genes as me (except she was very overweight) did go down on her Met prescription. I take 500 2x a day and she was doing the same and she is now down to one dose but her A1C is higher than mine because she doesn’t pay attention to her carbs as much like I do. She came off the second dose after a year I believe. I am hoping it will be similar with me. It would be nice to at least go down to one day.

I eat alot of the same meals now to make it easier on me so I stopped calculating for every meal but at the beginning was I was coming up with a meal plan. I have some of the old stuff written down and I looks like (depending on lunch and dinner, breakfast is always the same) I was at 35 to 40 carbs a day. If i had a portion for beans for dinner it coudl be more, but I need the beans for the folic acid plus I like beans! I normally eat beans now when I am in the 70s or 80s before dinner if I am higher I go with a lower carb veggie burger (no bun).

Right now, I think my carbs might be bit higher as I am eating more snacks in the afternoon and I swtiched some of my breakfast stuff and it look like my breakfast which was 11 carbs before is now 17 (but my protein is higher which I need).

Keep in mind that before I changed and was diagnosed - I ate mostly bread, pasta and potatoes. So I am not suprised that I had an A1C of 9.2 with all the carbs I ate. So even though my carbs at not super duper low like I was keeping them at the beginning, my numbers are still staying good. I think the Met has something to with it too.

Don’t know if this is just me but I often notice if I include something new into my diet routinue that if it has carbs I might have a higher number at first but than if I eat it regular after that it doesn’t effect me that much - this might just be a crazy fluke but I honestly see this.

8

Hey, you only have one more point to go! You are at a 6% and that good.

I was proud of my last A1C but I honestly didn’t think it would be that low. I was totally shocked! I though I was gonna be like a 6 or 7 ish. I had it done when CVS clinics were doing those free ones I actually went at the end of the offer and I asked the nurse how many people came for it and she said alot and she said out of all the diabetics I tested the lowest A1C and they only person a bit lower than me was a non-diabetic who came in to see if she was diabetic to check. I woulda been happy with a 6 I tell you.

But I realize too that the A1C is just an average for that period of three months - it just shows I have been a good girl I guess! Too bad it doesn’t mean any more than that (like low A1C = diabetes healing!) I realize that if I go crazy with the carbs I could easy go back up to a a higher average one day but doing this has made me realize that I was eating all the wrong stuff - all that bread and everything I was eating and not much of anything else. I am better off this way but now, I am hoping to eat a bit more - even if my A1C goes up a little bit I would rather gain a bit of weight and be able to eat more.

Yeah, I definately DO NOT overeat - I am really careful about my portion so I could probably stand to up them a bit now. So, cut your sisters lunch in half and send it my way.

9

Without having hypos, a normal A1c is wonderful!

I lost too much weight at first eating low carb. I slowly added more protein to meals until I gained what I needed & have been able to maintain my weight. If you’re not eating sufficient protein & fat, you’ll be hungry easily.

10

thanks Gerri!

Yes, I feel that now that I have my A1C good (and far away from that 9.2) I am aiming on more fat and protein as much as I can. I am so used to eating two bigs meals I think my tum-tum is still getting used to the smaller three meals but now I feel like I can add some snacks (which I am doing) more nuts, protein shake (when I can afford it). I am going to start eating more avocadoes for the fat and coconut oil at night (heard it might help us skinny T2’s but we shall see can’t hurt to try!). I think if I keep up on the higher protein my weight will come back up. How long it did take you?

I just started being more hungry lately. I wasn’t before. Maybe it is because i am gaining muscle with my weight lifting?

11

Did he tell you the opposite Alan? :slight_smile: Figures - see? We know more than they do because we LIVE it! I think a person who has a lifelong diabetes should be qualified to become an expert level diabetes counselor!

12

Ugh, what kind of a doctor is that, eh? What a moron! :slight_smile: Hope you found someone more knowledgable!

13

A 4.9 down from 9.2 is beyond fabulous!

You’re right that three smaller meals are better than two large ones for keeping things more level.

I needed to gain about 8 lbs. Realize that doesn’t sound like much, but I’m 5’2". I was under 100 lbs–too thin. It took me about a month. I added protein slowly–1 additional ounce at lunch & dinner to start. I’m T1 & protein effects BG. I didn’t want to eat too much protein at once not knowing how to dose insulin for it.

Protein shakes were an easy way for me. I also added protein powder to low carb baking. Simple way to get more protein without feeling like I was exploding. I use NOW brand unflavored whey isolate protein powder. Whey isolate has the highest percentage of protein. My health food store sells it in the bulk section. I mix it with unsweetened almond milk, unsweetened cocoa powder, sometimes a shot of decaf espresso & sweetener. Very low carb & delicious.

Increasing muscle mass is the best for reducing insulin resistance.You’re burning calories, so makes sense that you’re more hungry.

14

Ok, thanks. I want to use more of the protein powder (I get the vegan stuff which is good to numbers) but my food stamps don’t pay for it so I can only get so much. But I trying (for now) at least one every other day. I like them because they fill me up - I add some powered stevia and right now I have a chocolate flavored one. I wish my store had it in bulk but nope. They do have a big selection of different sorts and flavors though. :slight_smile:

It doesn’t seem like protein effects my BG so I think I should be safe adding more. So adding the protein was the key for you are putting the weight back on? Not necessary more fat?

Thanks for the advice and explaining that - I was wondering why I was getting more hungry than I was in the beginning! :slight_smile: At least I can eat more now!

15

I don’t think there is any problem with having an A1C that low unless it reflects that you are having too many hypos (which it doesn’t sound like you are). In the first few years I was diagnosed I saw both 4.8 and 4.9. My endo was not concerned. They have increased over the years to the high 5’s and low 6’s a few times, which I think is mostly related to the total loss of my beta cells ( the first few years I was in a honeymoon and things were definitely easier for me), and met getting the pump and restricting my diet less.

So no, I think it is great actually, especially for someone not taking insulin and not battling lows. And yes, if you want to gain more weight you could probably ease up a little bit and let yourself eat more. Your BMI is really low if you are 5’4" and 100 pounds!

16

Protein powder shakes fill me up, too. I can’t handle more than one scoop per shake. I also use hemp powder. I tried pea protein, but it tasted too much like peas:) I avoid soy,so never tried that kind.

Yep, just protein did it. Good fats like avocado are higher calorie, so that sure won’t hurt but I didn’t increase fat much.

17

I saw those pea protein ones and the carbs were pretty high! The hemp powder ones were actually higher too than the soy ones. I hate peas so I don’t think I would try that regardless. The soy ones were actually the best carb low wise next the to the whey ones and they had the highest amount of protein for the lower carbs. :slight_smile:

18

Pea protein I have is 1 carb per scoop, not high. The hemp protein powder I use (Nutiva) is 7 carbs for 4 TBS with 6 grams of fiber, so not high either at 1 carb for 4 TBS. I use 1 or 2 TBS.

Don’t care for the pea taste & only add it to soup to use it up.

I don’t think processed soy is healthy. Miso, tamari, tempeh are good, but not the over use of highly processed soy that’s in too many foods.

19

I have been as low as 4.3 and my doctor was estatic (T2). My last was 4.6. I would not worry about a 4.9 for a second, unless you are having hypos. I DID have to get off met b/c I was bonking when excercising at 4.3.