September 17, 2003
A1c (Glycohemoglobin, HgbA1c)
Question from Lowell, Massachusetts, USA:
My 26 year old daughter was diagnosed with type 2 diabetes eight months ago and spent six days in the hospital with DKA [diabetic ketoacidosis]. She has taken exceptionally good care of herself since and has lost a lot of weight (420 pounds down to 278 pounds). She is only taking Lantus, and her A1c is 4.6%. I don’t understand why her doctor is not happy about her A1c dropping from 13.9% to 4.6%. Is there something wrong with an A1c around 4.5%? How low is too low and why? Her meter indicates her average blood glucose is around 80 mg/dl [4.4 mmol/L] is that too low?
Answer:
I think that a hemoglobin A1c of 4.6% is great. Did her physician tell her he was unhappy with the result or are you wondering why he does not decrease or stop the Lantus? To understand the latter, you would have to ask her physician. It may not be appropriate to stop the Lantus, especially if she is on a large dose. However, decreasing the dose over time may be appropriate to avoid hypoglycemia.
JTL
