Nine months ago, I was diagnosed with diabetes by a random blood sugar of over 200 mg/dl [11.1mmol/L], and a two-hour glucose tolerance test value also over 200 mg/dl [11. mmol/L]. My A1c at that time was 5.7%, and my most recent A1c was 4.4%. Does this low A1c mean I don’t have diabetes? What A1c level is considered too low?

Hemoglobin A1c only reflects average glucose values over the past six weeks or so. It is not diagnostic of having or not having diabetes. A low value could mean that all your blood glucose readings are within normal range. It could also mean that you are having too many episodes of hypoglycemia.

You should discuss this with your diabetes team and consider doing a profile of blood glucose values to double check what your blood glucose readings are on a daily basis.

SB

[Editor’s comment: People with certain hemoglobin traits can have falsely low A1c results. If you are concerned, you might want to be sure that the A1c testing that you have had done recognizes these traits, or you might want to be tested for them.

Your situation might well be clarified by monitoring sugar levels continuously for several days to try to sort out what’s happening in more detail. See The Continuous Glucose Monitoring System.

SS]