Thoughts on ideal A1c - Page 2

Go Back   The Diabetes Forum Support Community For Diabetics Online > Diabetes Forum Community > Diabetes

Diabetes This section of the forum can be used to discuss anything and everything to do with Diabetes. Please use this general Diabetes section for any comments or discussions that don't fit into the more specific forum categories below. Please also ensure that all posts and threads are on topic, about Diabetes.


Like Tree50Likes

Thoughts on ideal A1c - Page 2


Closed Thread
 
Shared Thread Thread Tools
Old 03-05-2016, 17:28   #11
Senior Member
 
bignick's Avatar
 
Join Date: Dec 2013
Location: Holladay, Utah
Posts: 1,221

Member Type
Type Undiagnosed
Diagnosed in 2012

2527 likes received
559 likes given
Default

Quote:
Originally Posted by mbuster View Post
I don't see how A1c can be the major factor. There are things affecting A1c results, like anemia, iron deficiency. liver and kidney disease, and lifetime of the blood cells. It may be affected by blood glucose, and maybe even daily average blood glucose, but daily averages can be the same if constantly at 100mg/dL or if it is 60mg/dL 1/3 of the time, 100 mg/dL one third of the time, and 140mg/dL one third of the time. Blood glucose, apples, and A1c, oranges, have been linked together, fruit, but there is not really a direct comparison.

Lower A1c can generally be associated with lower BG and thus lower insulin levels circulating in "normal people", but can also be driven down chemically as smorgan states, and my thoughts are that chemicals even include insulin, natural or exogenous. I really wish we could measure insulin levels, but then, I am just speculating it should be implicated as well.

I don't have any test results from younger days, not sure I was even tested, of A1c, but assume I was at one time normal and had A1c in an ideal range. It should have made me unsusceptible to diabetes and heart disease. Boy did something change if I was.
I think in many, maybe even most people eating the SAD and aging are responsible for elevation of BG and A1c. Some degree of metabolic syndrome in most is inevitable. Heart disease and diabetes are very closely related, so much so I almost consider them the same disease with characteristics of one or the other being dominant depending upon the individual.

MaJoie likes this.
__________________
Feb '18 A1c 5.2
Feb '18 Lab Results
FBG
Chol 262
HDL 45
Trig 108
LDL 194
Insulin 4.7 (2.0-19.6)
11/15/17 30 Day FBG average 109


Male 68 157 lbs. 6'


Self diagnosed 11/'13, eating LCHF, Ketogenic. My Cardiologist is trying to help me manage my BG levels as I have no PCP
bignick is offline  
Old 03-05-2016, 19:08   #12
Senior Member
 
Join Date: Jul 2011
Location: California, USA
Posts: 3,076

Member Type
Type 2
Diagnosed in 2009

4566 likes received
542 likes given
Default

Quote:
Originally Posted by bignick View Post
smorgan, all good points.

Maybe I should restate that I'd like to have the low to no risk of heart disease, diabetes and other diseases that a correlation shows in those whose A1c is in the 4.6-4.8% range.
Wouldn't we all. Did you get what I was saying about correlations not being "reversible" unless they actually represent direct causation? And, even then, only really if it an exclusive cause. That may be the case with the A1C, but from all the evidence it doesn't really look like it. I think we're still looking for ultimate causes.

Would a T2 who brings it down to 4.5 with insulin be the same as a non-diabetic with the same A1C? Or, the same as a T2 who brought it down with lifestyle alone? Doubtful. There are probably other things in play. Insulin is an obvious possibility. Total glucose metabolism in the cells is another. Google "methylglyoxal", there's LOTS out there.

Most of this data is terribly homogeneous consisting of people living very similar lives and eating very similar diets (at least from where I sit!). Have you heard of the ACCORD study? I don't think there were any sub-5s, but A1Cs were reduced (from terrible to just bad), but outcomes were WORSE.

grammaB, bignick, MaJoie and 1 others like this.
__________________
Salim Morgan, T2
66 Years
DX: 9/2009 A1C=10.7
A1C 2/2010: 6.7 (DX + 4 months)
A1C 5/2010: 6.0 (DX + 8 months)
A1C 8/2010: 5.7 (DX + 11 months)
A1C 11/2010: 5.1 (DX + 14 months)
A1C 9/2011: 5.6 (DX + 2 years)
A1C 7/2012: 5.5 (DX + 2 years 10 months)
A1C 1/2019: 5.5
Diet: Approximately C:10;P:15;F:75 (as % calories)
Exercise: Not much. Stairs at home & work.
NO MEDS, No Highs, No Lows
Grandkids: 22
smorgan is offline  
Old 03-05-2016, 20:51   #13
Senior Member
 
bignick's Avatar
 
Join Date: Dec 2013
Location: Holladay, Utah
Posts: 1,221

Member Type
Type Undiagnosed
Diagnosed in 2012

2527 likes received
559 likes given
Default

I did get correlations being non-reversible. I have read about the ACCORD study but not in detail. I did read more just now. As expected the intensively managed group was taking drugs, insulin and used lifestyle changes. That alone does not surprise me of the outcome at all.

Drugs and insulin can cause weight gain and inflammatory responses. This could easily cause more cardiac events.

If no drugs nor insulin were used and it was just diet (LCHF) ketosis, lots of exercise, weight loss, etc, I'd be shocked if the mortality rate was higher.

Drugs, insulin, etc. are artificial ways of dropping A1c. None of the benefits above like loss of visceral fat, weight loss, increased energy levels, lower BP and other health improvements associated with diet and exercise that also lower A1c and heart disease were discussed or heavily implemented.

There is not a lot of money to be made from healthy eating, fasting and exercising and weening one off of drugs.

Another thing to consider, all this talk is about glucose levels in the blood which just may be a symptom, with the underlying problem being the insulin level.

smorgan and MaJoie like this.
__________________
Feb '18 A1c 5.2
Feb '18 Lab Results
FBG
Chol 262
HDL 45
Trig 108
LDL 194
Insulin 4.7 (2.0-19.6)
11/15/17 30 Day FBG average 109


Male 68 157 lbs. 6'


Self diagnosed 11/'13, eating LCHF, Ketogenic. My Cardiologist is trying to help me manage my BG levels as I have no PCP
bignick is offline  
 
Old 03-06-2016, 05:20   #14
Senior Member
 
Join Date: Jul 2011
Location: California, USA
Posts: 3,076

Member Type
Type 2
Diagnosed in 2009

4566 likes received
542 likes given
Default

Quote:
Originally Posted by bignick View Post
Another thing to consider, all this talk is about glucose levels in the blood which just may be a symptom, with the underlying problem being the insulin level.
Yes. And/or the inability of the diabetic system to clean up after metabolizing glucose. This happens INSIDE cells and has no direct connection to the amount of circulating glucose. Contrary to popular myth, it is glucose which is the "dirty" fuel,not FFAs or ketones. It creates a variety of toxic by-products when successfully utilized for energy inside the cells. The most Googleable of them is "methylglyoxal".

A normal system has a variety of processes which dispose of and/or neutralize these toxins. This breaks down in a diabetic system and these toxins accumulate inside the cells. One trial on diabetics - including some "moderately" well-controlled ones - found 20 times the normal levels in T2s and something like 30x in T1s.

These toxins are direct agents in every known complication of diabetes including vascular damage, nerve damage and even beta cell dysfunction. They do exist in smaller quantities then glucose itself, but at the same time they are 50,000 more "glycating" than glucose.

Again, although in homogeneous populations, this could very likely have a nice STATISTICAL correlation with circulating blood sugar, there is no direct relationship between them. And, our myopic focus on the latter could actually be counter-productive. If we lower circulating blood sugar by forcing more of it into cells which are attempting to defend themselves against further toxification via insulin resistance, we may actually increase the toxins and the fundamental problem all while looking at improved or even "stellar" blood sugar numbers.

Since the real problems ("complications") take decades to materialize, people are different and you can't rewind time, this could very easily escape notice.

This is why I only really trust dietary changes to reduce and reverse damage. It is the only method which will lower 1) circulating glucose (happy meter), 2) 24 hour insulin levels AND 3) total glucose metabolized by cells for energy.

In fact, taking this to "keto" levels is the only truly effective way to achieve #3 because it is the way to get cells to not only reject/resist glucose (which they are already doing in a T2) even more ("good" insulin resistance) but more importantly to welcome and prefer its alternatives: FFAs and ketones. A system with chronically high insulin 24/7 cannot do that much at all, if ever.

MaJoie and Granny Shanny like this.
__________________
Salim Morgan, T2
66 Years
DX: 9/2009 A1C=10.7
A1C 2/2010: 6.7 (DX + 4 months)
A1C 5/2010: 6.0 (DX + 8 months)
A1C 8/2010: 5.7 (DX + 11 months)
A1C 11/2010: 5.1 (DX + 14 months)
A1C 9/2011: 5.6 (DX + 2 years)
A1C 7/2012: 5.5 (DX + 2 years 10 months)
A1C 1/2019: 5.5
Diet: Approximately C:10;P:15;F:75 (as % calories)
Exercise: Not much. Stairs at home & work.
NO MEDS, No Highs, No Lows
Grandkids: 22

Last edited by smorgan; 03-06-2016 at 05:27.
smorgan is offline  
Closed Thread

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
What is your ideal A1C? ooneill Diabetes 19 02-04-2016 01:16
Ideal 2 hr PP for HbA1c of 6?? IamSweet Diabetes 13 03-29-2014 05:38
Ideal BSL before bed Bear Diabetes 7 07-27-2013 14:03
Not an ideal mom for sure... carbcrazydog Diabetes Forum Lounge 16 04-30-2013 15:55
If medication is needed, is insulin ideal? wdmama Diabetes Medication and Supplies 7 06-04-2011 15:20

LEGAL NOTICE
By using this Website, you agree to abide by our Terms and Conditions (the "Terms"). This notice does not replace our Terms, which you must read in full as they contain important information. You must not post any defamatory, unlawful or undesirable content, or any content copied from a third party, on the Website. You must not copy material from the Website except in accordance with the Terms. This Website gives users an opportunity to share information only and is not intended to contain any advice which you should rely upon. It does not replace the need to take professional or other advice. We have no liability to you or any other person in respect of any content on this Website.


All times are GMT +1. The time now is 20:20.




Powered by vBulletin®
Copyright ©2000 - 2020, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.
User Alert System provided by Advanced User Tagging v3.1.0 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.