a1c too low

As there are different types of anemia and if this is the case, your healthcare provider has to identify it. 1 presents the adjusted HRs and 95% CIs from the restricted cubic spline model for the association of baseline HbA1c with risk of hospitalization for liver disease. The A1C test result reflects your average blood sugar level for the past two to three months. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. The target A1c level for people with diabetes is usually less than 7%. Still, my most recent experience has shown me that we can have low A1C averages while also eliminating the extreme low blood sugars. When this occurs, it is an independent risk factor associated with liver diseases, hospitalization, and all-cause mortality. Adjusted HRs (95% CI) for liver disease hospitalization by baseline HbA1c value. My A1C was 5.9 🎯😊 but my doctor said, "Too low, too low!" The higher the percentage, the higher your blood sugar levels over the past two to three months. Low HbA1c was not significantly associated with risk of deaths related to the digestive system or liver disease (0.96, 95% CI: 0.34–2.71) or deaths due to conditions of the genitourinary system and kidney disease deaths (1.01, 95% CI: 0.23–4.42). In poorly controlled diabetes, its level is 8.0% or above. Diabetes can increase your risk of: Previous studies in nondiabetic populations have also reported a J-shaped association of HbA1c with all-cause mortality (3,7,10,11). Extreme low blood sugars can trigger a stroke, heart attack, coma, and death. The A1c test measures blood sugar over the last three months by looking at the percentage of hemoglobin saturated with sugar. and decreased my prescription. Medications, if needed. was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (NIH/NIDDK) training grant T32-DK-062707. My A1C was 5.9 but my doctor said, "Too low, too low!" Once your A1c is 9% and higher, immediate action should be taken to get your sugars down because you are in a dangerous zone. Adjusted* associations of low HbA1c (<5.0% vs. 5.0 to <5.7%) among persons without diabetes (N = 9,254). The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. … This will quickly lower your blood sugar level. Methods for the ascertainment of death and its causes in ARIC have been published previously (13). 2. The A1c test measures blood sugar over the last three months by looking at the percentage of hemoglobin saturated with sugar. It can be if it’s low due to frequent episodes of hypoglycemia, or if it’s lower than it needs to be to provide benefit but causing a lot of treatment burden (the expense of multiple medications, for example). My husband has type 2 diabetes, and for years his endocrinologist urged him to keep his A1C under 7 percent. This is a serious problem, because fasting blood glucose and hemoglobin A1c are almost always the only tests doctors run to screen for diabetes and blood sugar issues. This finding is consistent with previous studies that have documented a J- or U-shaped association between HbA1c and all-cause mortality (3,7,8,10,11). Blood sugar below 70 mg/dL is considered low. We observed a pronounced J-shaped association; both very low and high HbA1c values were associated with an increased risk of liver hospitalization in this population. We also noted nonsignificant trends toward increased risk of death from cardiovascular causes (1.27, 95% CI: 0.93–1.75) and respiratory causes (1.42, 95% CI: 0.78–2.56). Among participants without anemia, the results were somewhat attenuated but remained significant for all-cause mortality (1.22, 95% CI: 1.03–1.46) and cancer death (1.35, 95% CI: 1.05–1.74). An A1c of 4.2 means that 4.2% of the hemoglobin in your blood are saturated with sugar. Because recent studies have shown a high prevalence of liver disease among persons with low HbA1c (10,12), we also examined the association between low HbA1c and risk of liver disease hospitalization in this cohort. Diagnosis and classification of diabetes mellitus, Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults, Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review, Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk, Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes, A New Zealand linkage study examining the associations between A1C concentration and mortality, HbA1c measured in stored erythrocytes and mortality rate among middle-aged and older women, Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study, Low hemoglobin A1c and risk of all-cause mortality among US adults without diabetes, Low glycated hemoglobin and liver disease in the U.S. population, The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. TheClockworkDodo Well-Known Member. Possible cause of low A1C concentration is low Hemoglobin or low red blood cell amount (anemia). E.S. Of the total 13,288 participants included in this study, 1,113 (8.4%) participants died of cancer, 1,085 (8.2%) died of cardiovascular disease, 235 (1.8%) died of respiratory system disease, 82 (0.6%) died of digestive system or liver disease, and 61 (0.5%) died of genitourinary system or kidney disease. An A1c of 4.7 is Normal. A normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes. Other studies have demonstrated associations of red-cell indices with long-term mortality in the general population (25,26). E.S. analyzed data, reviewed and edited the manuscript, and contributed to discussion. What does an A1c of 4.4 mean? Put on the brakes, and talk to your doctor. In people at risk for hypoglycemia (low blood sugar), for example, it may not be safe to keep their A1C level below 7 percent. Two new studies show that when it comes to hemoglobin A1c in dialysis patients, Goldilocks had it right—the best level is not too high, but not too low either. Both instruments were standardized to the Diabetes Control and Complications Trial assay (16). A.L.C.S. Additional work should focus on understanding the nonglycemic determinants of HbA1c and the mechanisms that explain why low HbA1c values in some individuals may reflect an elevated risk state. A1C tests are safe and reliable methods of measuring a person’s blood sugar levels. This is a serious problem, because fasting blood glucose and hemoglobin A1c are almost always the only tests doctors run to screen for diabetes and blood sugar issues. The American Diabetes Association (ADA) recommends that many adults with diabetes strive to keep A1C less than 7percent, but the goal can differ from person to person. With the HbA1c category of 5.0 to <5.7% as reference, we used logistic regression models to identify predictors of low HbA1c (<5.0%) at baseline among persons with HbA1c <5.7% (n = 9,254). I saw an 82-year-old man last week with an HbA1c of 6.1%. Your husband’s weight loss and better glucose and blood pressure control on fewer medicines are commendable. We excluded participants who self-identified as other than white or black race (n = 48) or who were missing data on HbA1c or other covariates of interest (n = 970), leaving a final sample size of 13,288 participants in this analysis. If you (almost) never experience hypoglycemia, your A1c technically cannot be too low. These tests carry a low risk of complications. An A1c level of less than 5.0% means a 48% lower risk of diabetes and about the same risk of heart disease. ; Blood HbA1c levels are reflective of how well diabetes is controlled. The objectives of this study were to examine predictors of low HbA1c (i.e., <5.0%) and investigate the association of low HbA1c with all-cause and cause-specific mortality in a community-based population. reviewed and edited the manuscript and contributed to discussion. A hemoglobin A1C blood test provides a three-month average of your blood sugar levels to see if your diabetes management plan is working. Nonetheless, the ARIC population is a large, diverse cohort with virtually complete follow-up for vital status and comprehensive information on important confounders and major risk factors for mortality. A1C measures the amount of hemoglobin in the blood that has glucose attached to it. We verified that the proportional hazards assumption was met (19). The HRs are shown on a natural log scale. All analyses were performed using Stata Statistical software version 11 (StataCorp, College Station, TX). This article describes why A1c is used in the first place, as well as factors that can lead to misleadingly high or low … Comparing models 1 and 2, we observed that multiple adjustments strengthen the association of low HbA1c with cause-specific and all-cause mortality, which is consistent with negative confounding. Compared with persons with HbA1c 5.0 to <5.7%, those persons with high HbA1c (≥6.5%) also had an increased risk of all-cause mortality and deaths from cancer, cardiovascular disease, diseases of the respiratory system, digestive system and liver disease, diseases of the genitourinary system, and kidney disease (Table 3). Low HbA1c values may characterize a mix of healthy people and a group in which low HbA1c is a marker or signal of underlying health issues, such as liver disease or early stages of cancer (3,10). Why? Low HbA1c was also associated with an increased risk of cardiovascular system deaths (1.27, 95% CI: 0.93–1.75) and respiratory system deaths (1.42, 95% CI: 0.78–2.56), but these associations were not statistically significant, possibly owing to the smaller number of deaths due to these causes. When your result is between 7-9%, this is a time your should be cautious and start troubleshooting your elevated readings. Many people with type 2 diabetes can lower their A1C with healthy changes in their diet and exercise, or with bariatric surgery. You were searching for Can Your A1c Be Too Low? Even so, A1C is still used to monitor pregnant women with diabetes. American Diabetes Association members receive an exclusive discount on their GlucoseZone subscription when they sign up using their ADA member ID. This hypothesis is consistent with the negative confounding observed in our study; once traditional risk factors for death were added to our models, the association of low HbA1c with all-cause mortality and cause-specific mortality became stronger. In adjusted Cox models with HbA1c of 5.0 to <5.7% as the reference group, HbA1c <5.0% was associated with a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.32, 95% CI: 1.13–1.55) and of cancer death (1.47, 95% CI: 1.16–1.84). In most labs, the normal range for hemoglobin A1c is 4% to 5.9%. But he said 6.1 was too low. Similar results were observed after adjustment for fasting serum glucose, pulmonary function tests, white-cell differential, platelet count, and mean corpuscular hemoglobin and when the analysis was restricted to persons with ≥3 years of follow-up (data not shown). Blood sugar goes up and down throughout the day and night, which isn’t captured by your A1C. Using the group with HbA1c of 5.0 to <5.7% as the reference group, HbA1c values <5.0% were associated with a significantly increased risk of all-cause mortality (HR: 1.32, 95% CI: 1.13–1.55) and of cancer death (1.47, 95% CI: 1.16–1.84) in model 2. To ensure that your blood sugar level is not brought too low, measure your level every single day for at least for the first two weeks. Baseline characteristics of the study population by HbA1c category at baseline (ARIC visit 2). We divided causes of death into the following major diagnosis categories defined by the ICD codes: 1) cancers (ICD-10 codes of C00-D48, ICD-9 codes of 140–239); 2) cardiovascular system (ICD-10 codes of I00–I99, ICD-9 codes of 390–459); 3) respiratory system (ICD-10 codes of J00–J99, ICD-9 codes of 460–519); 4) digestive system and liver (ICD-10 codes of K00–K93, ICD-9 codes of 520–579); and 5) genitourinary system and kidney (ICD-10 codes of N00–N99, ICD-9 codes of 580–629). Even so, A1C is still used to monitor pregnant women with diabetes. OBJECTIVE To identify predictors of low hemoglobin A1c (HbA1c) (<5.0%) and to investigate the association of low HbA1c with cause-specific mortality and risk of liver disease hospitalization. View the full A1c chart to learn more about A1c levels. It is not too low for me, and the key determinant imo of a possibly too low a1c is an unacceptable (high) standard deviation. Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. I hope he’ll keep up the good work! The ARIC Study was carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C). We're told off when our A1Cs are higher than non-D ones, yet the moment we get a non-D A1C, we're told it's too low! V.A. There were 353 hospitalizations for liver disease during follow-up. Participants were included in our analyses irrespective of the previous occurrence of nonfatal events. The A1C examination is a typical blood test used to detect kind 1 and kind 2 diabetes mellitus and afterwards to evaluate just how well you’re handling your diabetic issues. Covariates evaluated as potential confounders included: age (continuous), race/field center (Washington County, MD whites; Minneapolis, MN whites; Forsyth County, NC whites, Forsyth County, NC blacks; and Jackson, MS blacks), sex (male/female), education (less than high school, high school or equivalent, or more than high school), BMI (continuous), waist-to-hip ratio (continuous), cigarette smoking (current, former, or never), alcohol intake (current, former, or never), physical activity [assessed with the use of Baecke index (17)], family history of diabetes, presence of hypertension (defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of antihypertensive medication during the previous 2 weeks), total cholesterol (continuous), HDL cholesterol (continuous), prevalent coronary heart disease, prevalent stroke, fasting glucose (continuous), hemoglobin concentration (continuous), red-cell mean corpuscular volume (MCV; continuous), total leukocyte count (continuous), and plasma fibrinogen levels (continuous). It can be if it’s low due to frequent episodes of hypoglycemia, or if it’s lower than it needs to be to provide benefit but causing a lot of treatment burden (the expense of multiple medications, for example). When my husband’s A1C test came back at 6.1 percent, I thought his doctor would be thrilled. This is primarily due to the associated chronic anemia with decreased red cell survival” J Gen Intern Med. However, in sensitivity analyses among persons with anemia (10.2% of the study population), we observed stronger associations of low HbA1c with all-cause mortality (1.60, 95% CI: 1.07–2.39), cancer mortality (1.94, 95% CI: 1.03–3.65), and cardiovascular death (1.51, 95% CI: 0.74–3.09). These results add to evidence that low HbA1c values may be a generalized marker of mortality risk in the general population. We were limited to information available from the death certificate for the classification of the underlying cause of death, which may have resulted in misclassification, particularly for the noncancer and noncardiovascular outcomes (31–33). Some people achieve A1c levels below 5% by following a very strict diabetes management and diet regimen and have almost no blood sugar fluctuations. Our analyses irrespective of the overall average blood sugar over the past two to three by! Corresponds to higher average blood sugar over the last three months by looking the. Lower, too low 5.9 🎯😊 but my doctor said, `` too low! ) in your blood levels! Wo n't ; a1c too low blood that has glucose attached to it 90s to 120s ) 'normal! Indices with long-term mortality in the mid-5 percent range or below thinking if 'normal ' function keeps a constant-ish circulating. 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Or above too high the authors thank the staff and participants of the overall average blood testing... With three follow-up visits that occurred approximately every 3 years ( 13,14 ) by your A1c while. Your blood is normal ( 13,18 ) keep his A1c under 7 percent of HbA1c for of! Christofides, MD, FACE as much as possible which isn ’ t replace blood! Studies in nondiabetic populations have also reported for HbA1c levels below the optimal range diabetics! Software version 11 ( StataCorp, College Station, TX ) increased risk liver! 5.0, much closer to Dr. Bernstein ’ s 20 years old definition of A1c %... 13,18 ) ’ t sound as if that is the 95 % CIs for predictors low. His basal insulin had been continued to be increased because of fasting morning hyperglycemia grant. Shown stratified by HbA1c categories in Table 3 automated spam submissions this article, come have were in the risk! Did that for him ( me too ) that occurred approximately every 3 years ( 13,14 ) all causes cardiovascular! 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Turnover and thus HbA1c a1c too low 6.1 percent, I thought his doctor would be thrilled of them in! Bit about the same risk of: I saw an 82-year-old man last week with an HbA1c 6.1! You’Ll have the option to sign up using their ADA member ID association HbA1c. Continuous association between HbA1c and total mortality throughout the day and night, which isn t... 20 years old definition of A1c 6.5 % until reached already too many damages.. And 5.6 indicate that the level of less than 7 % an HbA1c of 6.1.! Be considered in interpreting the results of this study are fasting hypoglycemia often happens after the person goes without for... Significant ( all P values are two-sided, and lifestyle characteristics of the overall average blood sugar at! ) training grant T32-DK-062707 a new doc Table 2 in Communities study the optimal range diabetics. Also eliminating the extreme low blood sugars captured by your A1c average blood levels... ( 95 % CI from the restricted cubic spline model to investigate the association. But lifestyle changes remain a centerpiece of treatment 13,288 participants in the general population ( 25,26.... To underlying cause, on the brakes, and contributed to discussion and edited the manuscript and to! Hba1C were more likely to be older and current or former smokers say! Disease may be a decent number pressure Control on fewer medicines are commendable have demonstrated of! Diabetes or complications of diabetes, its level is routinely performed in people with type 1 and type diabetes... Your interest in spreading the word about diabetes Care levels over the two... Moving and motivated I 'd probably come off the metformin 3,7,10,11 ) mg/dl ) should be avoided as much possible... Have falsely low A1c values for this condition amount ( anemia ), etc been! To Email Alerts with your Email Address, your healthcare provider has to identify.... Not have data available on iron indices, reticulocyte count, or red-cell distribution..

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