Type 1 diabetes study shows reduced link between HbA1c and hypoglycemia

A study published in this week’s PLOS magazine finds the link from hypoglycemia to HbA1c (average blood glucose) levels has declined in type 1 diabetes.
Beate Karges and colleagues from the RWTH Aachen University in Germany analysed HbA1c levels in 37,539 children and young adults in Germany and Austria, who all had type 1 diabetes, between 1995 and 2012.
The link between HbA1c and hypoglycemia and comas was studied using models which used HbA1c as a continuous term, with adjustments made for sex, age, diabetes duration, and insulin treatment regimes.
The risk reduction of severe hypoglycemia and comas was strongest in patients with HbA1c levels of 6.0 per cent–6.9 per cent (0.96 and 0.90 reductions each year) and 7.0 per cent – 7.9 per cent (0.96 and 0.89 reductions each year).
The authors of the study acknowledged the cause of this reduction is not yet clear, but they believe there was an increase in blood testing during this time, as well the usage of insulin analogs and insulin pumps.
In a statement, the authors concluded: “The previously strong association of low HbA1c with severe hypoglycemia and coma in young individuals with type 1 diabetes has substantially decreased in the last decade, allowing achievement of near-normal glycemic control in these patients”.
This news should provide some reassurance to our forum users who have previously expressed concerns after receiving a low HbA1c result, only to be told by doctors they will subsequently have more hypoglycemic attacks.
One user, Miss90, had previously written: “So I had my latest HbA1c today, which was 6.1. I’ve worked very hard to get this and I’m pleased. However, the consultant said it’s ‘too good’ and the result is one or two hypos a week”.