News
Top blogs
Podcast
Topics
Events“LCHF dropped a1c 3.5% in 3 weeks which is crazy (no meds)”
Some huge A1c drops in new diabetic patients this week…
LCHF dropped A1c 3.5% in 3 weeks which is crazy (no meds). pic.twitter.com/vIwQYT99D1— Ted Naiman (@tednaiman) March 4, 2016
Comment
Check out this new update from Dr. Ted Naiman. Note that the A1c test measures average blood sugar over 2-3 months. So these massive drops in just a few weeks are truly impressive and indicate that the blood sugar levels rapidly more or less normalized.
Not eating carbs is a super effective treatment in type 2 diabetes.
More
Earlier
New Study: Improved Diabetes Control With a Low-Carb Diet
“Low Carb vs. High Carb – My Surprising 24-Day Diabetes Diet Battle”
Insight: Beating Diabetes with Dr. Michael Mosley – Full Episode Online
By the way, does DietDoctor have a target range for ideal A1c?
I don't really have an ideal range to give you. Personally I'm at about 5.0 % (US) or 33 mmol/mol (EU) but as long as you're significantly below the normal maximum you should be fine.
I would have guessed that, but didn't want to bias the answer.☺
re: …but as long as you're significantly below the normal maximum you should be fine.
As I've written before (not sure about here), it's actually difficult to find a chart of A1c vs. all-cause-mortality, but here's one:
http://www.thefatemperor.com/blog/2015/3/21/blood-glucose-and-heart-d...
Although observational, the low data points are probably not confounded by diet, because it's not easy to get below 6.5% unless one is on a low carb diet.
The curve, by the way, is U-shaped. Mortality heads back up down below about 4%, as going that low usually involves some unrelated pathologies. So what's the sweet spot? Somewhere under 5%, I'd guess, but 5.0 may suffice. Here are some targets from other programs:
8.0% ADA “less stringent”
7.0% ADA “reasonable goal”
6.5% ADA “more stringent”
5.2% Perlmutter (Grain Brain)
5.0% Davis (Wheat Belly)
4.7% Bernstein (Diabetes Solution)
“More stringent” may be ADA-speak for “our grain and sugar industry sponsors don't want you to even be aware of the possibility of going lower”.
That could well be. I personally would be nervous about going below 4.5% without first understanding what's happening in parallel with Fasting BGs and Postprandial BGs.
re: …such that the HbA1C test is a misleading metric of average blood sugar.
It apparently can produce persistently idiosyncratic results even in the ranges of interest to LCHF eaters. RBC lifespan may be a factor.
re: The data presented do not disambiguate these possibilities.
HbA1c in the context of keto and various LCHF diets really needs some RCT study, but by the time it ever happens, we'll probably be able to predict the results from the growing army of anecdotes.
My morning fasting glucose the past six months has generally been 3.8-4.2 mmol/L (over 90% of the time) so I would not be fussed about HbA1c at 4.0%. My HbA1c was 4.5% when measured about a year and a half ago, but my morning blood sugar then was a little higher then (4.4-4.7 mmol/L range, about 75% of the time).
So, I have to pay for my own HbA1c tests. They run about $70, so I don't do them that often.
You can buy a tester, good for 2 tests, for half that, or US$17 per test, on Amazon. Kits with more strips are available, and may be insurance-reimbursible, but you might not be able to use up all the strips before they expire (± gaming the expiry with refrigeration).
Don’t know about other brands, but the A1CNow testers are matched to the consumables, and ALL of it expires at the same time (at least a year out on a freshly manufactured unit). You can’t buy more test strips separately. Cartons are dated. On line, look for some statement about expiration date (and use a site with credible recourse if the product turns out to be well into or past expiry).
Shelf life is extended with refrigeration. The product is typically not shipped refrigerated, however (at least ours wasn’t).
Bayer exited this business a couple of years ago. Any Bayer kits still on the market are entirely expired.
re: …she said that we test too much in the US. Then she wanted to put me on a statin!
You need a real doctor, but you have probably figured that out.
Recently, I had my "regular" doctor give me a cholesterol and glucose test on Monday after about 12 hours of fasting. I paid for a better cholesterol test, blood sugar, and HbA1c test, which I had done on Friday after 4.5 days of fasting. I want to see what the differences are. Unfortunately, while I'll know fasting blood sugar differences, I will not know HbA1c differences. I'm still awaiting the results of the second sets of tests.
As for the doctor, it's difficult to find one who believes blood sugar/insulin resistance is bad and cholesterol is meaningless (except as being a marker for insulin resistance), as I do. I've not met one personally.
Standard lipid panel, or advanced lipoproteins?
On the standard panel, the only measures I consider useful are HDL and TG (and since we're mooting target values, I'd proposed over 60 mg/dL for HDL and under 60 mg/Dl for TG).
LDL-C and TC are generally useless, unless at extreme values. The ancient Friedewald equation falls apart entirely for low carb. At most, these metrics might suggest: "get an actual lipoprotein test, like LDL-P".
Further, if you are actively losing weight, any lipid/lipoprotein or even BG tests are suspect.
Other studies show a correlation between A1c and microvascular risk, and postprandial glucose spikes and macrovascular risk.
Some diabetics who test their BG show an A1c which is consistently high, or low, compared to their spot readings. Fructosamine (if available) generally correlates better to the spot readings. So the relationship isn't simple - but close enough for jazz - "normal" numbers correlate to "normal" levels of risk.