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Diabetes

Low A1C

02/17/2009

Question:

I do not have diabeties and my A1c came in at 3. I have been having hypoglycemic attacks quite frequently. I almost fainted last night and I am very concerned as I am trying to eat exactly what I should be. I exercise 5-6 times a week, eat healthy and have had to take to carrying glucerna bars, candy, etc. in my purse, car and other various places. On several occassions my blood sugars would not respond to treatment and I had to sleep it off. My glucose levels when I test during these times are in the 60`s but last night I could not test I was immediately given juice and it worked quickly. What more can I do and is there anything that my doctor should be doing, I have not seen a doctor since being diagnosed as hypoglycemic.

Answer:

I would say that you probably need to be evaluated by an endocrinologist, a specialist in hormone disorders, including diabetes and hypoglycemia.  I can't tell from the information provided whether the HbA1c value can be taken at face value but I am very interested in finding out.  There can be other things affecting the red blood cell where the hemoglobin molecule resides besides blood sugar that may cause the hbA1c to be low.  Some of them are diseases of red cells but I study both diabetes, hypoglycemia and changes that happen in people with perfectly normal red blood cells apart from changes in blood sugar that can account for such variations.  Please feel free to contact me with more information.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati