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Dr. Andrew Rynne

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Can a patient with A1C level of 4.2 have hypoglycemia?

Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2269 Questions

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Posted on Fri, 23 Sep 2016 in Thyroid Problem and Hormonal Problems
Question: Is it possible to have A1C of 4.2 but still experience hypoglycemia? For example I have to eat 3 small protein fat meals throughout the day w complex carbs. If I go longer than 6 -7hours without I get lightheaded. But my blood sugar is good so how is this possible. Can mild insulin resistance cause even w ideal a1c
doctor
Answered by Dr. Mirjeta Guni 1 hour later
Brief Answer:
Your a1c level is suggestive for hypoglycemia.

Detailed Answer:
Welcome and thank you for asking!
Regarding to your concern i can say that Hba1c 4.2% is in the lowest normal ranges and is suggestive for hypoglycemia. To be sincere in my practice i have not seen values under 4 %.
At the females of your age reactive hypoglycemia is common but important is to exclude an organic one ( hypoglicrmia that occurs fasting) even though the chances for it are low.
To prevent reactive hypoglycemia i would recommend to eat 5 times a day, 3 normal meals and 2 snacks and to avoid food with high glycemic index and coffee.
You should not stay more than 3 hours without eating something and if you are overweight i would advice to loose weight in order to regulate the insuline production and resistance.
Hope the information will help.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mirjeta Guni 51 minutes later
Can weight loss cure mild insulin resistance
doctor
Answered by Dr. Mirjeta Guni 3 hours later
Brief Answer:
Yes.

Detailed Answer:
Welcome back!
ye, wight loss is the best treatment of insuline resistance.
Please accept the answer if you do not have further questions.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 1 hour later
Can weight be lost with just diet & exercise without medication? Is the insulin resistance causing the hypoglycemia ?
doctor
Answered by Dr. Mirjeta Guni 35 minutes later
Brief Answer:
Diet and exercise is the best treatment of obesity.

Detailed Answer:
Yes, weight can be lost with diet and physical activity. If they do not function there are medications too, but only after you have tried diet and physical activity for 6 months and when BMI is over 30.
In obese people there is an insulin resistance and an inappropriate secretion of insulin by the pancreas.
Wish you good health.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 1 hour later
Is my a1c indicative of diabetes or pre diabetes
doctor
Answered by Dr. Mirjeta Guni 8 minutes later
Brief Answer:
In your case Hba1c is not relaible to make diagnosis of prediabetes.

Detailed Answer:
In your case, when frequent hypoclicemic episodes are frequent Hba1c is not very relaible to exclude a prediabetes. Because low values modify the average of the three months.
You should check the glucose level fasting and 2 hours after eating. A value of 110-126 mg/ dl fasting or 140-200 mg/ dl postprandial in 2 different findings makes the diagnosis of prediabetes.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 7 hours later
Can weight loss cure pre diabetes
doctor
Answered by Dr. Mirjeta Guni 17 minutes later
Brief Answer:
Yes.

Detailed Answer:
Is the treatment of choice.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mirjeta Guni 3 hours later
My post prandial blood sugar2 hours after eating is 109
doctor
Answered by Dr. Mirjeta Guni 32 minutes later
Brief Answer:
Very good

Detailed Answer:
Very good. Nothing to worry about.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mirjeta Guni 52 minutes later
3 hrs later was 97. Is that dropping too fast?
doctor
Answered by Dr. Mirjeta Guni 1 minute later
Brief Answer:
No, it is mormal.

Detailed Answer:
This is the normal glycemic curve. Just check the fasting glycemia to exclude a high level in the morning and start to loose weight to improve your reactive hypoglycemia and to prevent a probable Diabetes in the future ( especially if you have familiar hystory for Diabetes).
Will be a pleasure to answer your further questions in the future.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mirjeta Guni 59 minutes later
What should the fast glucose be ideally? Also, I get tired about 15-20 minutes after eating even a low carb meal. Is that blood sugar or blood pressure? I have lower blood pressure in general
doctor
Answered by Dr. Mirjeta Guni 10 hours later
Brief Answer:
70-105 your ideal fasting glucose.

Detailed Answer:
Hello,
Ideal fasting glucose level would be 70- 105 mg/ dl.
If you doubt to have hypoglycemia 20 min after eating, it is very easy, just check it when you have that feeling and if it is over 70 mg/ dl it can be due to hypoglycemia.
At your age the blood pressure should be low ( 110/70 mm/hg).
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. Mirjeta Guni 16 hours later
I felt funny about 30minutes after eating so when I checked glucose was 118? Is that bad?
doctor
Answered by Dr. Mirjeta Guni 2 hours later
Brief Answer:
It is normal

Detailed Answer:
Hello,
The values is normal. If you had the symptoms of hypoglicemia at this moment, well it is excluded.
Until now i do not see any problem with your glucose level.
Regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Mirjeta Guni 26 minutes later
So its not indictating hypoglycemia? Does anemia affect glucose reading?
doctor
Answered by Dr. Mirjeta Guni 24 minutes later
Brief Answer:
Anemia may affect HbA1c reading not the glucose level.

Detailed Answer:
No, it is not indicative for hypoglycemia. Anemia may affect HbA1c level, not the glucose reading.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Mirjeta Guni 13 hours later
Fasting am glucose was 82. What does that indicate
doctor
Answered by Dr. Mirjeta Guni 8 minutes later
Brief Answer:
It is normal.

Detailed Answer:
It is perfect! I would advice not to check the glucose level anymore, only if you have symptoms of hypoglicemia you should check it at these moments. If it under 70 mg/ dl you should contact your treating physician, if it is above 70 mg/dl than the symptoms are not due to hypoglycemia.

Hope the situation is clear for you now.

Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mirjeta Guni 33 hours later
I went wigout eating for 4.5 hours and started to feel a little hypo. When I took blood sugar was 82 same as fasting. Is that normal or low
doctor
Answered by Dr. Mirjeta Guni 10 minutes later
Brief Answer:
It is normal.

Detailed Answer:
Hello,
The blood sugar four hours after eating should be the same as fasting. So i would consider perfect your glycemic profile.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Mirjeta Guni 3 hours later
Is there a diabetes pill, besides metformin, used to treaf non diabetic insulin resistance and also aid in weight loss?
doctor
Answered by Dr. Mirjeta Guni 1 hour later
Brief Answer:
See below

Detailed Answer:
Hello,
Until now only metformin is approved by Food and drug administration to treat insulin resistance (when confirmed with HOMA IR).
Liraglutide is a good medication too, that helps more than metformin to loose weight but is an injection. This medication is available with doctor's prescription.

The best treatment anyway is to loose weight with diet and physical activity.

Wish you good health.

Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 42 minutes later
Is this considered insulin resistant? Was done fasting.
doctor
Answered by Dr. Mirjeta Guni 8 hours later
Brief Answer:
Glucose level is needed too.

Detailed Answer:
To judge about insuline resistance you should check at the same time the glucose level and insuline level.
Than HOMA IR can be calculated and the diagnosis of insuline resistance is made.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mirjeta Guni 6 hours later
Glucose was 82 at the same time
doctor
Answered by Dr. Mirjeta Guni 8 hours later
Brief Answer:
Yes, you have insuline resistance.

Detailed Answer:
Hello,
Your HOMA IR result is 4.2 ( if the insuline measurment is (mUi/ml). It means that you have insuline resistance.
For three months i would recommend diet and physical activity. You should loose weight, especially the fat deposited in the abdominal region.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mirjeta Guni 49 minutes later
Can metformin help w weight loss? Also, can the insulin resistance be causing my feelings of hypoglycemia?
doctor
Answered by Dr. Mirjeta Guni 1 hour later
Brief Answer:
Hello

Detailed Answer:
Metformin aids weight loss by reducing your natural instinct of hunger, so you eat less. So it is down to you to loose the weight by eating healthily and less.

Physical activity would help much more, especially if it is focused in loosing abdominal fat.

Regarding to the hypoglycemic like symptoms , the persons with insuline resistance have a greater tendency to do reactive hypoglycemia due to inappropriate insuline sectretion from pancreas but it is not your case, because you have never confirmed a glucose level under 70 mg/dl.

Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 44 hours later
I started metformin for the insulin resistance. Ive noticed it makes me urinate a lot? Also, I am on 1,000mg is that generally an appropriate amount?
doctor
Answered by Dr. Mirjeta Guni 18 minutes later
Brief Answer:
Don' t think your symptom is related to metformin.

Detailed Answer:
Hello,
In my practice and in scientific literature i have not seen such a side effect while using metformin.
You should exclude a urinary infection.
Regarding the dose i would consider it the right one.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 38 minutes later
Can the metformin cause me hypoglycemia?
doctor
Answered by Dr. Mirjeta Guni 12 hours later
Brief Answer:
Metformine causes rarely hypoglicemia.

Detailed Answer:
Metformine causes in 10% of cases hypoglycemia.
It is considered rare and in general is mild.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mirjeta Guni 2 hours later
About how long does it take the body to adjust to the met and side effects to stop?
doctor
Answered by Dr. Mirjeta Guni 13 hours later
Brief Answer:
Try to lower the dose

Detailed Answer:
Hello,
If you have side effects of metformine is recommended to lower the dose (in your case 500 mg in the evening) and try to increase it after 2 weeks.
Regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. Mirjeta Guni 8 hours later
Can pcos/insulin remission go into remission with treatment
doctor
Answered by Dr. Mirjeta Guni 2 hours later
Brief Answer:
Yes it can.

Detailed Answer:
Hello,
When Insulin resistance is confirmed, metformine has a lot success.
It is very important to loose weight too woth diet or physical activity.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mirjeta Guni 3 days later
Does high insulin cause dhea s to also rise? And does lowering insulin cause dhea a to also decrease?
doctor
Answered by Dr. Mirjeta Guni 5 hours later
Brief Answer:
Yes, insulin resistance increases androgen level.

Detailed Answer:
Hello,
There are some mechanisms that confirm the how insulin resistance causes high androgen production, but it stimulates mainly the ovarian androgen. DHEAS is an indicator of adrenal production of androgen and in these cases an congenital adrenal hyperplasia should be excluded.
There are studies that confirm the relationship between lowering insulin resistance and decrease in androgen level.
Hope i have answered your query.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Mirjeta Guni 6 hours later
How is cogenital hyperplasia ruled out
doctor
Answered by Dr. Mirjeta Guni 27 hours later
Brief Answer:
To rule out CAH;

Detailed Answer:
Hello,Welcome back,

You need to check:

-Testosterone level
-17 OH Progresterone
-Cortisol level at 8.00 a.m.

Will be a pleasure to help you further.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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