Lowest A1C you've ever heard of in a T1?

Very interesting post. I looked further and found it was an 1800’s procedure, that was revamped. This shows the current preceedure

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The lowest I have been is 5.2, the highest 14.1. I was hovering around 5.5 for several years and this year I have slide back up to 5.7, 5.8, 5.7 and in January 6.0.

I like the upper 5’s do not like the low 6’s and will work to get back to 5.5 to 6.00 My endo wants me at 6.0 to 6.5

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I don’t think I am going to watch all of this video, because I don’t want to go there again, which is probably silly. The only painful part was the injection of pain killer.
One of my hands was in very bad shape when I had the first procedure. It still does not lay flat, but is much better than it was. I hope that I need no further treatment.

Thanks for posting the video.

I think I ran a 5.4 last time. That was too low for me. I was reaching a critical meltdown in low BGs. I try to keep it around 6.1. That way if I’m off - upper 5’s is still OK.

You are amazing. that’s such fantastic control! Getting mine below 7 was a big deal. My latest one was 6.8. For me that’s great. Are you all on the pump? I think it’s great you’re able to keep your sugars in the normal range.

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I’m working through my second frozen shoulder right now. It’s awful. About a month ago though, I fell and landed on the frozen shoulder. Hurt horribly and subluxed the shoulder (which for me is easy to do bc of my connective tissue disorder—prior to frozen shoulder, both of my shoulders were extremely hypermobile). Sure enough, once the immediate swelling went down, my PT found I’d gained significantly mobility in that shoulder, probably bc the fall broke apart the capsule somewhat. Probably not the best method for treatment though… Unfortunately wasn’t enough to fix it, so I’m still having pain and still have a lot more mobility to gain back, but it was a jump in the right direction.

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Thanks ame_e. No, I still prefer shots. I do enjoy my CGM though when it is working correctly.

Now that I am retired, it is pretty easy for me to keep a low A1c.

OMG cardamom, what a way to improve your shoulder! So sorry that you are having to deal with this.

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I am semi-retired. I work at home as a freelancer, and have been for four years. Glad you are able to get such great control Marilyn. I find the lack of stress of not having to get out of the house and not have to work in an office beneficial to my health, as well as the opportunity to create my own schedule and walk every day.l Good to hear from you.

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I didn’t know that frozen shoulder and trigger fingers is caused by diabetes. I have been having these issues on and off for decades! I never connected it to D. But I do notice now that I have better control that they occur less often.

I agree with so many others in that the TiR and SD values are most important. If these values are controlled well, then the A1c will be, too. I try to keep my TiR (60-140 mg/dL) in the >90% range and SD in <15% range. I can achieve it some days, other days, no!

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Thanks! Anyone who has had to deal with or is dealing with frozen shoulder has my empathy—it is not fun!

My understanding is that frozen shoulder is not a complication of diabetes and poor glycemic control, but rather comorbid with (tends to co-occur with) diabetes because it is very likely an autoimmune process in which an initial injury like tendinitis of the supraspinatus (part of the rotator cuff that is easily injured) that then results in autoimmune responses that basically attack the shoulder capsule, resulting in the adhesions. It’s not only common in T1D but also autoimmune thyroid disorders, which also tend to co-occur, suggesting a common type of auto-immunity potentially underlying all three issues.

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That is sort of what I understand as well about it. However after speaking with researchers in a study that. I was in ,it seems like high sugars can exacerbate the already existing issue.

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A1c of 5.1%. After getting a Dexcom. Before that I was 6.2% and that was after I got a Libre and an insulin pump. Those things really helped!

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In the video, they say the procedure can be done again. As often as needed over the lifetime. So there are options. Unlike when they do open incisions.

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This is so interesting to me. I have a frozen shoulder that resulted from tendonitis after a fall. I had an A1c in low 7’s
I went to two Orthopedic docs and the last one said it was common in diabetes and offered PT. I went for a few weeks.
Does PT really help? How long does it take for this to go away? I was told up to 3 years, Does it usually take so long?

My lowest A1c was 6.1, highest was 7.2, but it was likely higher earlier in my life, just not tested and recorded. Via my CGM, I spend about 80% of the time in range (TIR), but since my CGM-estimated A1c is higher than my bloodwork, by about .5, my actual TIR is likely a bit higher. Rather that prioritizing A1c or TIR it is easy enough to combine both in an average glucose with an estimated A1c along with standard deviation (SD) and TIR, at least when thinking about such things.

I am 60, diagnosed T1 at 17, and since the thread has been discussing joint-related issues, I’ve had frozen shoulder once in my 40s, and seem to experience something similar now, although not as severe, that comes and goes. I noticed Dupyutrens about 10 years ago, which has slowly gotten worse, and am researching people to see for diabetic hand, since I’ve developed some swelling and reduced range of motion in my other hand, so looking for someone non-surgical first. The NYU hospital nearby has a respected office of hand surgeons, I’ll likely go there, but there is also the nearby Hospital for Special Surgery (HSS) which is highly regarded as well.

My husband has a cousin who is about 65 years old now. He has had Type 1 since he was about 45 years old. He has never used a pump and only recently started using a Dexcom. Years ago I remember him saying his HbA1C was 4.8 and that when he went in hospital for gallbladder surgery, his doctor was quite concerned regarding how low it was and that he has been keeping it around that range. He eats a very, very low carb diet. I don’t know what it runs now.

Jack16, I have had needle aponeurotomy performed 3 times and that is certainly what I will have done if I need help again. I am so very glad that I did not choose to have surgery.

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I only have my experiences to relate to. I don’t think that PT helped my first frozen shoulder which the orthopedic surgeon eventually tore apart. My second frozen shoulder eventually loosened up after about a year. I didn’t have treatment for that. I am sorry to hear that you have a frozen shoulder, because they are hard to live with. I think that my first shoulder was more severely frozen.

As people who manage their glucose metabolism in manual mode, we are often torn by competing values and statistics. We would all like a relatively low glucose average but realize that a too low average can often mean spending more time hypo than is safe or healthy. Of course we could cruise along in the 70-90 range, like gluco-normals, but our metabolisms aren’t stable that way.

Our doctors value avoiding hypoglycemia above all else, even at the expense of spending too much time in hyperglycemia.

With the adoption of CGM tech by our kind, we’re now aware of glucose variability statistics like standard deviation and coefficient of variation (SD/mean). Low variability is an attractive goal.

We definitely don’t want to spend too much time in the hyper range as that feeds the risk of all those horror complications we’d rather not think about.

The A1c number alone can hide too many lows, too many highs, and unacceptable variability.

That brings us to time in range, TIR. A high percentage TIR (> 80%), folds in all these values:

  • Minimizes hypos

  • Minimizes hypers

  • Reduces glucose variability, especially if range is kept relatively narrow

  • Enforces a reasonable average glucose

The TIR number folds in all the things that we value into one simple statistic. It’s easily understood without a more advanced knowledge of statistics. The graphs that depict TIR make obvious at first glance whether you’re achieving your goal and suggests how to improve.

Since we are individuals, we can select the range that meets our needs. Diabetes advocacy organizations like to use 70-180 mg/dL but some of us prefer narrowing that range. It’s really up to us and this permits us to challenge our management abilities as we make improvements. If you’re consistently hitting 90+% TIR 70-180, you can adopt 70-150 as a challenge.

I think TIR consolidates all the worthwhile glucose management goals into one concise and easily understood statistic.

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