Well, Gary, if you're Type 2, I'd say your condition is called "Being
Under
Tight Control" and is completely laudable & enviable. Congratulations!

If you are Type 1--speak to others (though it's still sounding great to
me).

Good luck.

I would say there is nothing at all wrong with an a1c of 5.2 or
5.2.... Actually, most people here would like to be there.

Will, T2

Gary,

A proper answer to this question is pretty complex, and would probably
best be answered by a hematologist. There are a number of possible
pathologies that can account for an abnormally low A1c.

First, if you are a believer in the old wives' tale that the HbA1c is
somehow an "average of the past 90 day's BG levels", you need to get
over that idea. Glycosylation of hemoglobin is a very non-linear process
that is effected by magnitude and duration of BG over a non-linear time
period.

IOW, a short spike doesn't affect A1c very much, but a longer term
period of hyperglycemia will. For example, a 2 or 3 hr spike of 300 will
have less cumulative effect than a week at 150. In addition, it is a
popular misconception that once glycated, there is no mechanism for
unglycating hemoglobin. This has been proven to be untrue, however a
hypo incident will not somehow suck the glucose off the RBCs.

To further complicate things, the impact of these hi and low events is
modulated by their time proximity to the time of the blood draw. If
something happened 10 weeks ago, its impact on today's A1c is less than
if it happened 3 weeks ago.

Charly Coughran posts more regularly on MHD, and has been interested in
A1c for quite a while. Aside from having an intellectual curiosity about
the subject, Charly happens to work at a major university, although in a
different discipline. His employment gives him the benefit of access to
world class research libraries, and he has posted frequently on this
subject. He is also the author of the section on A1c in Part 2 of the
FAQs which you can read at
http://www.faqs.org/faqs/diabetes/faq/part2/index.html .

The other part of the equation which is important is the kinetics
involved in the creation and destruction of hemoglobin. If you have
pathology that interferes with the rate or quality of hemoglobin
creation, this will affect A1c. If you have an injury, or donate blood,
or suffer from a dysplastic syndrome, this will affect your A1c.

If you are really concerned that A1c is not truly reflecting your spot
glucose numbers, the easiest step is to use another simple blood test
called a fructosamine test. Instead of measuring the glycation of
hemoglobin, it measures the glycation of albumin, another component of
blood. This should help you and your doc decide if your fears are warranted.

Jim

Someone else posted the long answer to your question. The short answer
is "Anemia."  If your blood cells aren't living as long as normal, you
can have an abnormally low A1c and should have a fructosamine test.

In my own experience a 5.2% A1c correlates with blood sugars that are
about 97 fasting and rarely spike over 120 mg/dl.

--Jenny

http://www.phlaunt.com/diabetes  Diabetes Info

http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
Sugar Under Control

I don't think so!! Many of us labor intensely to get an A1C under 6 - my
ultimate goal is to go under 5. I believe average for a healthy
non-diabetic is around 4.5 - 4.7.

5.1 and 5.2 are NOT low A1c readings.  They are Normal A1c readings
for a tightly/well controlled type 2 diabetic or an extrememly tightly
controlled type 1 diabetic.  An A1c reading of 8 or 9 is abnormally
HIGH and puts you at a very high risk of diabetic complications like
nerve damage, blindness, kidney failure, heart disease etc.

Anemia and other blood disorders can affect the A1c, rendering it useless.
Here are some links:

http://www.diabetestechnologies.com/

http://clinical.diabetesjournals.org/cgi/content/full/22/3/141

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
5345893&dopt=Abstract

What readings do you get with your meter?  Is that what leads you to think
your A1c is too low?  If not, it's cause for celebration.  My last A1c was
5.2, and I was delighted (so was my doctor).

MaryL

So, why are you eating out of control?

The hemoglobin A1c (HbA1c) test is a simple blood test that indicates
how well your diabetes has been controlled over the past three months.
Unlike daily blood glucose testing, which measures your blood glucose
level at the moment you test, the HbA1c test provides a broader picture
of your overall glucose control.

Hemoglobin is a protein in red blood cells that carries oxygen.
Hemoglobin picks up glucose from the bloodstream, becoming "glycated."
As blood glucose rises, so does the level of glycated hemoglobin.

Once hemoglobin becomes glycated, it remains that way for the life of
the red blood cell, which is three to four months. This means the HbA1c
test can provide a picture of your glucose control over several months.

Test results reflect the percentage of glycated hemoglobin in your
bloodstream. People without diabetes typically have an HbA1c level of
5%. Studies have shown that people with diabetes who are able to keep
their levels at 7% or less reduce their risk for complications such as
blindness, kidney diseases and nerve damage.

The American Diabetes Association recommends that people with
insulin-dependent diabetes have an HbA1c test four times per year and
that all other people with diabetes have test twice peer year. It is a
simple test that requires only one sample of blood. There is no need to
fast. The sample can be taken at any time of the day -- even right
after a meal.

HEMOGLOBIN A1c (%) EXPECTED VALUES
3-6% Non - Diabetic
6-9% Good Control
9% Fair to poor Control

A Usenet article or a print article?

I've posted occasionally that I got down to 4.9

But that was on a diet that had me losing a pound a day.

With a more sensible diet, I'm staying around 5.5