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Dr. Andrew Rynne

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Type 1 diabetic. Taking mixtard. What is the normal levels of HBA1C for a type 1 diabetic?

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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Posted on Wed, 23 Jan 2013 in Diabetes
Question: Hi, I am a type 1 diabetic since 6 years. I take human mixtard 30/70. My recent HBA1C was 6.7. I have two questions.
1.) What are the recommended levels of HBA1C for a type 1 diabetic?
2.) I took a VPT test recently for Knee, great toe and once more place whose name I cannot remember. The results of those tests varied from 20-35. Could you let me know what are the standard reference values of this test?
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Answered by Dr. Rahul Tawde 26 hours later
Dear XXXXXXX,
Thanks for writing in. Standard recommendation for HbA1c in type 1 diabetic is less than 7%. Its even better if less than 6.5% your A1c report is quite goid.
VPT is not done for knee. Its for sole and foot. Ref ranges vary from equipment to equipment but standard ref ranges are >40 severe impairment. 30 - 40 moderate. 20 to 30 mild, less than 20 normal. But its a bit subjective and depends both on examiner and patient
. All precautions to avoid ulcers will have to be done if they are above 30. Dont walk barefoot, examine youe feet regularly, use MCR footwear.
Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rahul Tawde 3 hours later
I just found my report of VPT test reports and here are the exact values.
Left Right
Knee 24 28
Ankle 30 35
Great Toe 36 32

I actually do not feel any pain or anything unusual in my feet. All my other reports like Lipid Profile, KFT, LFT and urine tests are normal but I was a bit worried about these VPT tests. Since these results suggest moderate neuropathy, is there any further tests that I must undergo that might better assess the condition of my feet?

My doctor has also prescribed "Neurodole" and "Pallrywyn" for 3 months.

I take good care of my blood sugar. I test it about three times a day. In short I just want to know that should I be worried about my VPT results? If yes, then what can I do to improve them?
doctor
Answered by Dr. Rahul Tawde 11 hours later
Dear XXXXXXX,
Im not very convinced about VPT results because your glycemic control is good and you are early in the course of TIDM to develop nerve damage of that extent. You can either repeat this test from a different lab or get Nerve conduction studies for more objective assessment of nerve function. You can also get F scan and gait analysis for designing appropriate footwear. Take all the precautions to avoid injury and infection of the feet and if possible XXXXXXX an podiatrist.
Nothing to worry as of now.
Shivaprasad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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