How Low Is Too Low When It Comes to A1c and Blood Sugar?
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- Опубліковано 16 лип 2024
- How low should you go?? Trying to go as low as you can works great for winning the limbo, but diabetes is another story. Keeping your A1c much below 7 does not necessarily equal fewer complications, and it can actually have dangerous risks.
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Hello to everyone who responded to this video. We do appreciate everyone’s opinions, but hopefully we can agree to disagree. WE feel, based on very large clinical studies and thoughtful analysis by some excellent diabetes specialists at the American Diabetes Association and other large diabetes organizations, that below 7% is a very safe range not only to avoid hypoglycemia, but importantly to avoid complications.
The 2023 Standards of Care in Diabetes from the ADA lists targets for glycemic control. These targets are the gold standard that are respected and followed by healthcare professionals around the world. In section 6.5a of the Standards of Care on glycemic targets it states:
An A1C goal for many nonpregnant adults of
The same ADA standards of care that this year mentions GLP1s 169 times, and mentions dietary therapies under a dozen times?
@@DrRyanAttar and the same ADA standards of care that were totally ignored by their CEO who reversed her T2D. Not to mention their previous chief scientist Ratner who totally reversed his position on dietary therapies.
@@daviddikeman7423 and the ADAs own research shows diabetic complications are occurring even before that 6-7% range. Edelman can ignore this all he wants for himself but it’s criminal that he is lying to diabetics who are trying to avoid and reverse the same complications that he already has. Prediction: Edelman will turn off comments on future videos and/or block all of us.
@@DrRyanAttarWell now, if I might articulate on the predominant issue plaguing our nutritional research methodologies, it'd be that a considerable portion of these studies don't employ what we'd term 'experimental, randomized designs.' Merely spectating folks' dietary habits-or, even less reliably, depending on their recollections of what they've consumed-and attempting to correlate this with health repercussions, is, in essence, an exercise in futility. It's my firm belief that this approach should be significantly curtailed. We've already allocated an ample amount of our resources and intellect, not to mention stirred up a considerable amount of bewilderment. At this juncture, it's imperative we steer our focus anew. The allocation of our financial backing, resources, and scholarly endeavors ought to be redirected towards methodologies that hold the promise of generating more definitive insights.
Thank y'all kindly, TCYOD, for your steadfast support of them big ol' randomized controlled trials. Y'all are truly champions of evidence-based medicine, I do declare.
My highest A1c in 25 years of being T1D was 6,6%. I developed many diabetic problems during these years. Went down to 4,8% after cutting the carbs and most of the problems went away in two years.
This comment should be at the top of the list. 6-7% a1c is not benign. Videos like this are harming diabetics!
A high carb diet almost guarantees large swings up and down, with the danger of fast-onset lows, and possible roller coasters in blood sugars. The more carbs you eat, the harder it is to control.
Prediabetes is diagnosed from A1C 5.7% because there are many studies showing complications at this level.
Thanks for that information. I'm trying to find those studies but Google is failing me. Will you send me a pointer to them?
@@schoch6 www.ncbi.nlm.nih.gov/pmc/articles/PMC9679265/
When you are on a high carb diet (ADA recommended) swings in blood sugars are so big that you can't safely lower A1C to normal levels. That is why they recommend A1C up to 7% and do not see the point in lowering it. BUT have you tried low carb eating? You can safely get a much lower A1C.
@@user-nr5he3ic9o majority of people with T1D do not achieve even a1c 7%.
If low carb diet would be recommended as standard of care I am sure A1Cs be a lot lower
A1c 7% recommendation for diabetics is killing them slowly, but this is OK for doctors because long term complications are not doctors problem... But severe hypo could result in lawsuit against them.
Hypoglycemia is the only side effect of exogenous insulin. Does it not follow less insulin results in less occurring and less severe hypoglycemia? So how does one use less insulin? In my own N=1 experiment, it was choosing both less glycemic carbs as well as smaller carb portions while increasing the other two macronutrients, fat and protein with the emphasis on protein.
Protein needs insulin coverage despite the fact that we're taught that it doesn't. It's a much slower rise and easily covered with insulin. Carbohydrates, especially in large amounts are unpredictable. You might nail the dose one time, go high another time, and go low another time. Large doses of rapid acting insulin are also unpredictable. On a LCHP meal plan following Dr. Bernstein's methods, I am 98% in range with a 4.7% a1c (obviously not a result of hypos) and I consider a 120mg/dL high. No amount of carb counting and dosing for carbs perfectly would get me those results. @@user-nr5he3ic9o
This is dangerous advice! My young son had an 11 A1C when he was diagnosed with T1D 18 months ago. He's at 4.8 and thriving. Gaining weight, growing tall super fit and athletic. Get off the Carbs and control diabetes.
Yes!
"no additional benefit from going below 7" is absolutely false and not supported by the literature. They said "we have done the research". No you have not. Even the ADA's own papers comparing hazard ratios between 4.5 and 5.7 show a 5x increase in retinopathy for instance.
Amazing that they missed that paper. Unfortunate for their patients 😕.
That interesting. Will you please send a link to that paper?
Are you a follower of Dr Bernstein by chance? If not he's here on UA-cam at 89! He got type one at 11. He is completely against the idea that 6.9 is good enough. He believes all diabetics can enjoy non-diabetic glucose levels and virtually eliminate the risk of complications instead of just delaying the onset of etc. Of course he doesn't believe that you can "eat whatever you want/just like everyone else". He eats very low carb. No grains or fruit. He lives on protein and vegetables. Diabetes Solution is his book. This Dr Edelman has retinopathy.
Thanks, I've been stressing because I can't get mine below 6.3 and my morning numbers are around 120. Ugh!
And 7 verses normal? Like my husband who went from 12.6 to 5.6 on a whole, real food, low carb diet?
If the people running this channel are reading, I hope you are taking these negative comments seriously and taking the time to re-evaluate. Because you are actively hurting people right now with this video.
Great content- thank you gents
Thanks - appreciate it!
What complications do these "professionals" already have? Please confess.
I'll keep the stable (standard decision less than 20mg/dl) normal blood sugar I've had for the past decade by using a protein focused very low carb diet. A1c hasn't been over 5.5 for 11 years and never had a low I couldn't treat myself.
I've also finished several full ironman events, as well as have my CDL and an active job unloading 20,000lbs of food daily with a hand cart, safely. I couldn't do this safely on a high carb and sunsets high insulin dose diet like these two would prefer, even if my A1c was double the healthy level.
Glad there are so many sane comments here!
I too would like to know what complications these "professionals" have.
My experience tells me better. In 1995, my first A1c was 6.5 and I could barely walk. 2 frozen shoulders, 2 frozen hips, slow movement, could barely get out of a chair. There was no information about skeletal complication and type 1 diabetes. Then I found Dr. Bernstein and went low carb with intense insulin therapy. Got my A1c down to 4.9 and all my skeletal issues complete went away! YOU ARE WRONG. T1d for 53 years. 69 years.
Here's an idea: you can normalize your A1c to less than 5% AND avoid hypos by dramatically dropping the carbs and thus taking a fraction of the insulin one used to. The law of small numbers.
The solution to hypoglycemia is not high blood sugars like you all are suggesting - irresponsible!
Yup!
This is terrible advice I had complications at 6.0 to 7.0 it wasn’t until I got my a1c below 5.5 that my body could heal. I’m type one and follow Dr.B with great success. This is terrible advice and should be taken down.
With all due respect, if you don't like their advice and you have your own doctor telling you otherwise then by all means listen to your own physician. I think these two gentlemen have done a great amount of research on the subject. My own endocrine doctor echoes many of the things that are said in this video. All of the complications that I personally had happened many years ago when my diabetes was out of control, and I'm talking like an A1C of 10. I certainly don't think this should be taken down, it's just information that can be listened to and if you don't feel the same way then you simply ignore the advice.. A1C used to be the gold standard, Now I believe that time in range is a much more important metric to follow. If your A1C is 5.5 but most of the time your blood sugar is sub 50 to get it to that level, that's no good for you either. Obviously I mean no disrespect to you and I wish you the best in your health.
Amen! Lows are avoided following Bernstein's protocol. Lows are essentially insulin overdoses. If you eat a diet that needs very mild doses of insulin (low carb diet), it makes avoiding lows so much easier. 6-7% a1c will guarantee us diabetic complications. I aim for truly normal and non-diabetic blood sugars... my last a1c was 4.6%. Blood sugars are flat and stable in the 80s and 90s.
It's a big con job they're selling T1Ds telling them there's no complications in the 6s or even 5s. I got neuropathy in my feet at 5.8-6.0% and reversed it by getting my A1c below 5%. Nobody told me that was even possible I thought I was doing great in my management. Will never be conned by these types of people again - T1Ds are starting to wake up 🎉
Open payments data from the government reports Steven Edelman made, If you add up 2016-2022, $1,401,831 from industry. Hmmmmm....
"Follow the Money" & Whom they Associate with.
This is very unfortunate advice. Low carbs, meaning low insulin = stable blood sugars within normal range. Why not give this advice? Lows are caused by high doses of insulin which are completely avoidable given the right diet. Also A1C of 7 is too high and will cause complications, otherwise why would doctors who treat TD2 even care once their patient goes out of normal range. Why would we even have a "normal range" of below 5.7 if above that was completely fine?
I wonder what there A1Cs are since they both are T1Ds?
We know they are at least at 7%!
My son was dx T1 at 20m old. We did what the Dr said and followed ADA guidelines. At 8, he was dx with Retina damage and we now have to go to a specialist each year. This is horrible advice. Use the law of small numbers. Small carbs- small doses. Little risk of hypos.
You guys don't have a clue! Are you T1D? Have you tried having neuropathy, frozen shoulders, carpal tunnels, numb toes, losing eyesight..? Cutting carbs solves the problems and we have no hypos this way.
They are T1D. I can only imagine the issues they must deal with if they have an A1c at 7+.
Are you sure they are T1Ds? @@michellemcclorey201
Most diabetics don't want to talk about their problems. They like their food too much to do something about it. @@michellemcclorey201
maybe they don't follow their own advice. they won't tell us that.@@michellemcclorey201
Where did you get the idea their A1c was over 7%? The clearly said the goal is 7% and I remember at one point they said they are achieving that.
Love doctors E and P!! Both have had T1D since they were 15 years old. I'm feeling my best after 42 yrs of T1D. I couldn't handle Dr. Bernstein's super low carb diet as I had zero energy and brain fog for weeks. Low carb, med. Protein and lots of veggies and fruits work for me.
You didn’t give the low carb diet time to work. Many feel this way after starting a very low carb diet. And if you’re still eating fruit, you’re not doing yourself any favors. You’re endangering yourself
@@user-nr5he3ic9oTradeoffs, a necessary evil, the lesser of 2 evils. It's a mindset. Edelman has already developed retinopathy and had to get injections in his eyes. Many people find that more unappealing than following a strategy that virtually eliminates the possibility that u will ever go blind etc.
"…in the effort to try to avoid long term complications they're making a higher risk for something that can happen today or tomorrow." that's me.
Probably one of the most intelligent videos regarding diabetes I’ve watched in a long time
Above all , stay safe. This has been lost in the on line conversations.
Hypoglycaemia causes damage. There is a balance, find that and be well
Hypo and hyperglycemia can be avoided in the same way.
My endo told me this several years ago but I needed to be reminded of it again. Thank You!
My a1-c was 12 now it's 4 is that good
Are you seeing a diabetes doctor or primary care doctor for diabetes?
My brother was diagnosed in his early 40s. He died less than 20 years later of complications after having his diabetic foot amputated.
So, in fact, he didn’t get hit by a bus.
I seriously cannot believe you posted this video. Your poor patients
Y'all, let me tell ya, when I stumble across them UA-cam videos with folks bragging, "How I wrangled my A1C below 5.7," I near 'bout fall off my chair laughing. Bless their hearts, they think they've caught the moon in a mason jar. Now, if I had my druthers, those titles oughta read more like, "How I've been kickin' it complication-free with diabetes for X years." It's like my Aunt Mabel used to say about her pecan pie recipe - it ain't just about the sweetness, but how long it keeps you coming back for more without giving you a toothache. Same goes for managing diabetes, it ain't just the numbers, it's the long haul without your gears grinding to a halt!
Why is this video even allowed it's very dangerous and bad information
How is this dangerous or bad information. They are telling you not to stress as much once you get to 7 and in which case you do go below 6 you are likely going to have lots of low.
@vanriker895 keeping an A1C of 7 means that the person is diabetic and is in danger of experiencing all the complications of diabetes. So yes, it is a big deal. A type 2 diabetic should thrive to get their A1c back to at least 5.6, which is normal. You might want to try reading other comments under this video and all the things that are happening to people.
criminal. just keep eating the foods you shouldn't and pay through the nose for medications. or fix the cause. you choose.
Yall have lost your damn minds. Period.