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05-01-2008, 07:17 AM
| | Senior Member
I am a: Type 1.5 | | Join Date: Dec 2006 Location: Canada
Posts: 646
| | | A1c How do hypo's bring them down?
We all know that high blood sugars are reflected in the A1c... that high bg results in sugar being 'stuck to the cells' after a certain period and stay there for the life of the cell..
Also that one can have a good looking A1c, even if running high numbers, if one also has a lot of hypos... my question is why? does being hypo somehow remove the sugar from some of the blood cells?
Anyone know how that works?
__________________  |
05-01-2008, 07:51 AM
|  | Senior Member
I am a: Type 2 | | Join Date: Mar 2008 Location: Nova Scotia, Canada
Posts: 1,444
| | As I understand it, the A1c gives an average/mean of your blood sugars over the last 90 days or so. I didn't think the highs "stick" anymore than the lows or normals. So in theory, if you are high every morning and low every afternoon you could end up with what looks like an healthy A1c  http://www.ianblumer.com - A1c...
__________________ ~ Frank Metabolic Syndrome Dx'd March 2003. Started MM 712 Pump April 2004. MM 722 + Contour Link April 2008. "...type 2 diabetes is associated with obesity... [so] most people assume that the excess weight causes the diabetes. But... it's possible that diabetes causes obesity" "One of the causes of your diabetes is a poor choice of ancestors." - Gretchen Becker - The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed |
05-01-2008, 07:58 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Jul 2006 Location: Portsmouth UK
Posts: 1,518
| | | which is why when you can only achieve an A1c of less than 8% by having lots of hypos, they start to t hink about pumping...
__________________ Stu 
Type 1 Since - 24/7/2006 HbA1c
13/10/2006 - 7.2%  | 15/12/2006 - 6.0%  | 29/06/2007 - 7.1% | 02/11/2007 - 7.8% | 29/02/2008 - 6.5%
Insulin - Levemir and NovoRapid | Meter - Accu-Chek Compact Plus mkII  Pasta is a gift that just keeps giving... |
05-01-2008, 08:00 AM
|  | Senior Member
I am a: Type 2 | | Join Date: Oct 2007 Location: Vermont
Posts: 1,124
| | | I don't know if this is right but...
I think of it like a car's air filter. If you drive on dusty roads a lot your filter gets dirtier faster. On less dusty roads the filter stays clean longer. So lower A1c's would result from the lower concentration of BG because there's less opportunity for bad stuff to stick to the cells. It's not just that you go low, it's the time you spend being low and the extent of it.
Just a guess.
__________________ Diagnosed Type 2 on Sept 11, 2007 - A1c 8.8, Dec 2007 A1c 6.0, Apr 2008 A1c 5.7
No meds, daily 81mg aspirin and multivitamin, nutrition & exercise. Lacto-ovo vegetarian since Sept 1986You can call me   |
05-01-2008, 12:34 PM
|  | Senior Member
I am a: Type 2 | | Join Date: Dec 2006 Location: South Dakota
Posts: 522
| | Quote:
Originally Posted by Stuboy  which is why when you can only achieve an A1c of less than 8% by having lots of hypos, they start to t hink about pumping... | I beg to differ.
I have been under 60 once in 6 months (56) and my A1c is 4.9.
I have not been over 140 in about 9 months, THAT is how you achieve great control.
-Lloyd
__________________
If it is to be, it's up to me! -Lloyd
5/12/08 A1c 4.9 2/18/08 A1c 4.9 11/2007 A1c 5.3 8/2007 A1c 5.5 6/2007 A1c 5.7
3/2007 A1c 6.9 12/2006, A1c 7.8 9/2006, A1c 8.5 6/2006 A1c 8.7 |
05-01-2008, 12:42 PM
| | Member
I am a: Type 2 | | Join Date: Oct 2007 Location: NE USA
Posts: 156
| | Quote:
Originally Posted by soso does being hypo somehow remove the sugar from some of the blood cells? | The glucose and the hemoglobin protein that it binds with reach a equilibrium point determined by the glucose level of the blood; that is the basis for the test. So, yes, glucose will unbind from the protein when ambient blood glucose levels are low enough. |
05-01-2008, 01:40 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Sep 2006 Location: Auckland, New Zealand
Posts: 1,844
| | Quote:
Originally Posted by Lloyd I beg to differ.
I have been under 60 once in 6 months (56) and my A1c is 4.9.
I have not been over 140 in about 9 months, THAT is how you achieve great control.
-Lloyd | I'm with Loyd on this. The popular notion that having a low HBA1c necessitates lots of hypos sounds logical, but actual experience suggests otherwise. I find the exact opposite to be true. The number of lows increases as HBA1c goes up. This happens because blood glucose becomes more volatile (standard deviation increases) as control deteriorates. The converse is also true. The number of hypos comes down as HBA1c is reduced because control is improving.
The effect of hypos on average blood glucose is also limited. Hypos don't last long because we treat them promptly. On the other hand, highs often last for hours (like when we are asleep).
__________________
In my humble opinion  
Type1 since 1977
MDI using Lantus, Protophane, Novorapid and Actrapid
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05-01-2008, 02:14 PM
| | Member | | Join Date: Sep 2006
Posts: 163
| | Quote:
Originally Posted by Lloyd I beg to differ.
I have been under 60 once in 6 months (56) and my A1c is 4.9.
I have not been over 140 in about 9 months, THAT is how you achieve great control.
-Lloyd |
Lloyd,
You might want to re-read Stu's post before you beg to differ, he said:
"which is why when you can only achieve an A1c of less than 8% by having lots of hypos, they start to t hink about pumping..."
Your control is great and obviously you work hard at it, but I think you missed the word "when" in Stu's post. |
05-01-2008, 02:22 PM
| | Senior Member
I am a: Type 2 | | Join Date: Dec 2006 Location: South Dakota
Posts: 522
| | Quote:
Originally Posted by JungleJim Lloyd,
You might want to re-read Stu's post before you beg to differ, he said:
"which is why when you can only achieve an A1c of less than 8% by having lots of hypos, they start to t hink about pumping..."
Your control is great and obviously you work hard at it, but I think you missed the word "when" in Stu's post. | Oh, yes, that's clear as mud.
-Lloyd
__________________
If it is to be, it's up to me! -Lloyd
5/12/08 A1c 4.9 2/18/08 A1c 4.9 11/2007 A1c 5.3 8/2007 A1c 5.5 6/2007 A1c 5.7
3/2007 A1c 6.9 12/2006, A1c 7.8 9/2006, A1c 8.5 6/2006 A1c 8.7 |
05-01-2008, 04:45 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Jan 2007 Location: UK
Posts: 760
| | Quote:
Originally Posted by Lloyd I beg to differ.
I have been under 60 once in 6 months (56) and my A1c is 4.9.
I have not been over 140 in about 9 months, THAT is how you achieve great control.
-Lloyd | I believe Stuboy is making a reference to the guidelines for pump therapy over here in the UK which some hospitals stick to rigidly. In essence, such places will only consider you for a pump if your attempts to get your HBA1c below 8 give you unpredictable and disabling hypos as a side order. The definition of 'disabling' has been 'needs the assistance of another person'. The fact that not many people fall into that category is one of the main reasons why pumpers in the UK account for around 1 in 50 T1s compared with 1 in 8ish for some other places in Europe which have public healthcare systems.
Gary
__________________
13 years of MDI
And then a little pump floats by
And now my pants are filled with tubes
That tangle all around my.... er .... knees
The hours I'm hooked up? All twenty four
And that's it for now until evermore
But I disconnect for up to an hour
For wonderful fun (and sometimes a shower) 
And when I 'suspend' it, it plays Barry White
And my wife knows she's in for one heck of a night
But only an hour of that night is with me
As an hour is all I'm allowed now, you see...
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05-01-2008, 05:21 PM
| | Senior Member
I am a: Type 2 | | Join Date: Dec 2006 Location: South Dakota
Posts: 522
| | Quote:
Originally Posted by Gary_W I believe Stuboy is making a reference to the guidelines for pump therapy over here in the UK which some hospitals stick to rigidly. In essence, such places will only consider you for a pump if your attempts to get your HBA1c below 8 give you unpredictable and disabling hypos as a side order. The definition of 'disabling' has been 'needs the assistance of another person'. The fact that not many people fall into that category is one of the main reasons why pumpers in the UK account for around 1 in 50 T1s compared with 1 in 8ish for some other places in Europe which have public healthcare systems.
Gary | .... and about 5% here in the USA
And I take HUGE issue with their stance that a pump has not been shown to help T2's, therefore they are not eligible.
I'm a T2, and my fasting glucose dropped 100 points (5.55) from the first night pumping on, due to the ability to control my Dawn Phenomenon via pump.
__________________
If it is to be, it's up to me! -Lloyd
5/12/08 A1c 4.9 2/18/08 A1c 4.9 11/2007 A1c 5.3 8/2007 A1c 5.5 6/2007 A1c 5.7
3/2007 A1c 6.9 12/2006, A1c 7.8 9/2006, A1c 8.5 6/2006 A1c 8.7 |
05-01-2008, 05:42 PM
| | Senior Member | | Join Date: Sep 2004
Posts: 5,445
| | Quote:
Originally Posted by Lloyd I beg to differ.
I have been under 60 once in 6 months (56) and my A1c is 4.9.
I have not been over 140 in about 9 months, THAT is how you achieve great control.
-Lloyd | But you're pumping....which totally defeats the point Stuboy was making. He's saying that's WHY pumping is good. You're essentially agreeing with him. |
05-01-2008, 05:49 PM
|  | Senior Member
I am a: Type 1 | | Join Date: Jul 2004 Location: Livonia, MI
Posts: 518
| | Quote:
Originally Posted by Funnygrl But you're pumping....which totally defeats the point Stuboy was making. He's saying that's WHY pumping is good. You're essentially agreeing with him. | Funny, you are correct. It was in his wording "when"...
I applaud those with low A1Cs who aren't hypo all the time... I sure cannot do it.
__________________
.scott.
.clear paradigm 722 w/ cgms.
.symlin when i remember.
4.23.08 A1C 6.2
1.23.08 A1C 6.5 |
05-01-2008, 05:52 PM
| | Senior Member | | Join Date: Sep 2004
Posts: 5,445
| | Quote:
Originally Posted by solox316 Funny, you are correct. It was in his wording "when"...
I applaud those with low A1Cs who aren't hypo all the time... I sure cannot do it. | I have a decent a1c, but have a fair amount of hypos too. I think type 1s physiologically see a lot more variance. |
05-01-2008, 05:53 PM
| | Senior Member
I am a: Type 1 | | Join Date: Jul 2004 Location: Livonia, MI
Posts: 518
| | Quote:
Originally Posted by Funnygrl I have a decent a1c, but have a fair amount of hypos too. I think type 1s physiologically see a lot more variance. | I was thinking that... but couldn't figure out the right way to say it. thanks
__________________
.scott.
.clear paradigm 722 w/ cgms.
.symlin when i remember.
4.23.08 A1C 6.2
1.23.08 A1C 6.5
Last edited by solox316 : 05-01-2008 at 05:55 PM.
Reason: typo
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