Help! Should I be happy or worried about what my Dr. said? (A1c 5.2)

#1

Hi everyone,

I was diagnosed a few months ago and my previous A1c was 6%. Today, I went to get the results for my A1c and it went down to 5.2%! Of course, I am happy about this, and my doctor seems to be very satisfied with it too. However, my fasting glucose is still between 95-116, never below that. My levels 2 hours after eating are usually between 125-145...I even had a few 160's and even two 180's. I am very worried about this because I understand that every time our blood glucose is above 120 our eyes, hearh, kidneys, and other organs get damaged. I asked this to my doctor and he said that this is not true, that what matters is the average (A1c) and not the spikes. I told them that I am concerned because it usually takes 3 hours for my glucose to go below 140 after eating and that adds to 9 hours per day if I count my 3 meals. My doctor still thinks that there is no danger of having even 160-180 levels sometimes, as long as my A1c is low...I want to believe my doctor, but I also want the best for my health, I want to postpone complications for as long as I can and I want the best medical approach. What do you think? What is your doctor telling you about this? I would like to know if your doctors think the same way as mine about this. Thanks for your help and support friends.

FORGOT TO ADD: I am Type II and not taking medications, just diet and exercise. I don't go low on my glucose, just high...my lowest is in the 90's. Thanks again

#2

The problem is when your in the really low A1C club, is your very likely to easily go low…Your doctor is afraid of nighttime lows (if i were to guess), and your at a point where if something goes wrong, it can go wrong in a big way…Are you using any CGMS or something? Oddly enough It takes me about 3 hours to see my BG drop from a full meal bolus… Honestly trying to bring down your A1C lower than 5 is getting into the area of diminishing returns… As always YMMV… but normal A1c is between 4-6… so your just risking severe hypos trying to go below 5. Your in the (normal zone) and should be preventing most complications… Your still going to end up with some complications but you are in an ideal area to avoid most of them.

#3

http://www.diabetes-symposium.org/index.php?source=&sourceid=0&… is the graph that sorted, for me, the problem you are discussing . It is the graph of 21 normal or non-diabetics’ glucose over 24 hours.

It comes from this lecture which is worth listening to:

What is Normal Glucose? – Continuous Glucose Monitoring Data from H…

#4

Hi John, thanks for responding to my question! I didn’t mention that I am Type II and I am not taking medications, just diet and exercise so far. I never get low glucose readings, only high. You ask if I am on CGMS, sorry, I don’t know what that is, I am new to diabetes, just a few months since I was diagnosed. I assume that you are talking about some type of meds, but I’m not taking any…yet. Thanks again and I wish you the best…take care.

#5

My bad for making an assumption… Your really doing excellent for just diet and exercise… Seriously though I wouldnt sweat it… You really dont want to be taking meds if you can help it… But that post-meal thing is something to watch out for…If the post meal gets worse, you might be going in the direction of something that handles the post meal BG but for now id just watch it

CGMS=Continuous Glucose Monitoring System…
I was under the mistaken impression that you were on medication and insulin… My bad.

Your doctor still could be worried about lows…If your that good without meds, the meds may bring you low… I know that sounds silly but if your that good without them, you could be brought down too much. Some type II meds can cause hypoglycemia…

_john

#6

Thanks again John, I was waiting for you to reply. I am learning a lot of things, thanks for explaining what CGMS is, I thought it was a med. And what you say makes a lot of sense, maybe I can go too low if I take meds, I didn’t ask this to my Dr. because he insisted that I don’t need meds. i will continue watching my postprandial readings and try to keep them as low as I can…I may sound to exaggerated because I know that my A1c is optimal compared to other people here, but the information I found on the website: www.bloodsugar101.com is very scary, even in my situation. Somewhere in this website it says: “The studies you will read below, some of which are not cited in the AACE guidelines, make a cogent case that post-meal blood sugars of 140 mg/dl (7.8 mmol/L) and higher and fasting blood sugars over 100 mg/dl (5.6 mmol/L) cause permanent organ damage and cause diabetes to progress”. This is what I tried to tell my doctor, but he just kept saying that I am doing good. I wish I could do better, and I am trying hard…even if I’m always hungry…that’s why I was hoping for some meds, to eat a little more and still keep my sugars under control. Thanks again, take care.

#7

Afraid I disagree with your doctor. An A1c is the best we’ve got now, but it’s an average. An average doesn’t say much about control since obviously lows & highs balance each other. Two people with the same A1c could have very different individual readings.

Level is preferable to highs & lows cancelling each other out, of course. Damage occurs over 140. You don’t want to stress your pancreas & burn it out with many highs.

You are doing great without meds!

#8

I agree with both Johna and Gerri

my thinking is that the doctor is acting reasonably. Now that does not mean you have to settle. If you wish to improve your numbers I suggest additional exercise in the 1 1/2 to 2 hour range. Now, on the other hand, I woudl not go nuts. your doing a good job and sure you might do better, but lets not go crazy, because if you do you will eventually throw inteh towel and you will be in a heck of a mess.

rick phillips

#9

unless it is a really really high spikeI wouldn’t stress too much about it - cause otherwise you’ll go crazy. a bad spike sucks and I’ll try to deal with it but I try not to get really worked up about it - cause there’s always another test

#10

First off, your A1c is great, but as Gerri pointed out, it’s only one tool. According to Blood Sugar 101, it’s an accurate test for predicting health outcomes for some conditions, but not for other.

Blood Sugar 101 is owned (is that the right word?) by TuDiabetes member Jenny Ruhl. She also has a book by the same name, which you can buy on the site.

http://www.phlaunt.com/diabetes/

#11

Thanks, good luck with your A1c too!

#12

Thanks, I guess that’s the only way I can improve my numbers…by exercising more…I am already doing the best I can with food…Take care!

#13

Yes, I guess you are right, I shouldn’t go crazy, but I will do something about it trying not to stress too much…Thanks for your support. Take care you too.

#14

Thanks fo rthe link! I will look for the book too. Take care.

#15

Wow, 30% sounds like a good number to me…that makes me proud of my accomplishment! I just hate those spikes for nothing…I eat the same thing and sometimes I get a big spike, and sometimes I don’t…it’s hard, I guess what has helped me control my glucose is my fear of the complications…every time I want to eat something not so good, I think about my losing my eyesight, getting a stroke, etc…Same thing when I don’t feel like exercising…Thanks for your support and take care you too…

#16

Why does everyone treat Blood Sugar 101 like its gospel… It has some good advice but it is not the end all… She is NOT a doctor, she is NOT a cde, her numbers for beta cell destruction arent proven, and shes very sensationalist… She scares noobs… who like starting anything else, have to build into it… AquariusNL is on the right track, shes starting relatively low carb and your trying to scare her… Her A1C is great… and as I said, if her post prandials creep up theres a problem but shes FINE… geesus. stop trying to scare people into your beliefs… Do you people want to directly be responsible for her lows going on some sort of medication?.. Her spikes are very close to a nondiabetic… though the postprandials could be a problem…No doctors do not always know whats best but her A1c is WELL within that of a normal person!..

Only believe half of what you read online… Rome wasn’t built in a day and NEITHER SHOULD BE DROPPING YOUR BG low to the point that you have no leeway and something can make you drop like a rock. Glucagon and/or an ambulance ride/hospital visit arent fun…To be frank, lows are more damaging than a high… YMMV

IF we really wanted to try preserving beta cells. she should get into a study for an immunomodulator to extend the “honeymoon” that even T2’s have…

If Jenny ever does a Bernstein, and actually gets her degree, then she can tell me what to do, untill then, its just advice.

#17

I would appreciate it if you did not make assumptions about what I am doing (scaring AquariusNL) or how she feels about the information that I offered her. It is she who wondered if there might be more information available. Alan and I simply shared with her information that we have found useful. Your hostility is unwarranted and unwelcome.

#18

I think that you should be happy. Goodness knows that I would be very happy with your numbers (though I know that we should not compare numbers). Sounds like you are doing everything right and that you understand your condition well.

From what I read, it sounds to me like your blood sugar has been out of range 5 times! That’s excellent! Shoot for 140 after meals. That is a good goal, but there is no need to panic if it is higher on occasion. Sounds like that is the exception rather than the rule!

#19

Aquarius - Let the Sunshine In (ok, I’m a child of that era - couldn’t help myself)

IF YOU DON’T READ ANYTHING ELSE - READ THE INFO ON THIS WEB SITE AND/OR GET JENNY’S BOOK!!!

Cheri

#20

A 5.2 is SUPER DUPER!!! Just keep learning and learning - about the disease and your own body - and you will do GREAT! Taking ownership is very empowering…take everything you hear from the medical profession with a grain of sale and check it out yourself.

GOOD LUCK!!!