Diabetes 2 hair transplant - acceptable HbA1c range

[Snowman123]

What is an acceptable HbA1c range for a person with diabetes to have a hair transplant?

If you have diabetes 2 should you be refused treatment before a deposit is taken?

Should all clinics provide this test before procedure ?

I've read varying promotional hair clinic reports and medically reliable sites cited here:

NHS  UK - no mention of risk to diabetes patients  : https://www.nhs.uk/conditions/cosmetic-procedures/hair-transplant/

Clinics suggesting diabetes 2 is not always a problem:   1. https://drserkanaygin.co.uk/diabetes-and-hair-loss/  2. https://www.estecapelli.com/en/can-diabetes-patients-have-hair-transplantation/   3.  and so on if you Google the subject matter

One clinic puts a limiting range reaching 6 ( a measurement ) https://www.longevitahairtransplant.com/guides/hair-transplant-aftercare-for-people-with-diabetes/ , but I thought all diabetics would be over this.

What's the truth, medical view and guidelines that diabetics should be within for hair transplantation ? Anything official ?

 

[splitting hairs]

Diabetes is not a contraindication to surgery.  In fact, it doesn't matter all that much because hair transplantation is done under a local anaesthetic, so it does not require the patient to be nil by mouth on the morning of surgery.  

It sounds as though a clinic has turned you down after finding out that you are diabetic?  It is not ethical for a clinic to keep your deposit if they are refusing surgery due to discovering something in your medical history.  

Provided that you completed all of the medical history paperwork honestly, then no clinic can keep your deposit for this reason. 

In response to your question, your HbA1C should be less than 7%, indicating that your diabetes is well controlled. 

Edited November 23, 2022 by splitting hairs
Typo

[Snowman123]

5 hours ago, splitting hairs said:

n response to your question, your HbA1C should be less than 7%, indicating that your diabetes is well controlled. 

I’m confused as the example I have shows Longevita will not do the procedure over 6%.

That said, official government health bodies ( US, UK and Australia ) citing scientific studies or formal declarations do not communicate any significant risks with hair transplants. I found nothing specific relating to this blood test and the range.

Here’s another example:

Incidence of Complaints and Complications

The author has recorded the incidence of complication and complaints out of 2896 patients operated during June 11, 2009, to November 30, 2020. There were no significant or life-threatening complications

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719980/

Where do you get the 7% maximum from? 

[FluffyPanda]

2 hours ago, Snowman123 said:

Where do you get the 7% maximum from? 

This is more of a general guideline that we aim to make those with DM have an a1c <7% to be considered "well-controlled." The 7% is not related to a HT

[Snowman123]

2 hours ago, FluffyPanda said:

This is more of a general guideline that we aim to make those with DM have an a1c <7% to be considered "well-controlled." The 7% is not related to a HT

Would you go ahead if all other pre HT were normal at 7.3% for example ?  Would you refer to an endocrinologist report as stated in the above link for comfort that it was under control ?

[splitting hairs]

Different clinics have different protocols.  As I said, less than 7% indicates good glycaemic control over the previous 3 months.  If the clinic are not happy, they should just refer you to your GP, who can start oral antidiabetic treatment.  

[Snowman123]

35 minutes ago, splitting hairs said:

Different clinics have different protocols.  As I said, less than 7% indicates good glycaemic control over the previous 3 months.  If the clinic are not happy, they should just refer you to your GP, who can start oral antidiabetic treatment.  

Assuming a diabetic 2 patient is on medication  and an endocrinologist or GP is comfortable it’s under control, then what ?

Are there any published guidelines that you can refer me to specifically regarding HbA1c ? 

I mean, anyone under 6 as per Longevita’s protocol is non diabetic. So if I’m correct, have they made a mistake on their article cited in the opening post?

Sorry to persist, but a significant proportion of people now struggle with diabetes 2 and are likely to encounter this issue with uncertainty without universally recognized guidelines and transparency.
 

 

 

 

[splitting hairs]

4 minutes ago, Snowman123 said:

Assuming a diabetic 2 patient is on medication  and an endocrinologist or GP is comfortable it’s under control, then what ?

Are there any published guidelines that you can refer me to specifically regarding HbA1c ? 

I mean, anyone under 6 as per Longevita’s protocol is non diabetic. So if I’m correct, have they made a mistake on their article cited in the opening post?

Sorry to persist, but a significant proportion of people now struggle with diabetes 2 and are likely to encounter this issue with uncertainty without universally recognized guidelines and transparency.
 

 

 

 

Diabetes UK do a perioperative management guideline.  Check it out.  

[FluffyPanda]

1 hour ago, Snowman123 said:

Would you go ahead if all other pre HT were normal at 7.3% for example ?  Would you refer to an endocrinologist report as stated in the above link for comfort that it was under control ?

I'm not an endocrinologist or surgeon, but if an endocrinologist said they felt T2DM was under control, I would have no issue. I believe the hesitancy is due to the theoretical risk that uncontrolled diabetes leads to poor wound healing which increases the risk of post-surgical complications. Personally, I think a1c <6% is too strict when even 6.3% is considered pre-diabetic. My guess is you probably won't find many studies about this since most studies are done for more invasive procedures

[Snowman123]

10 minutes ago, FluffyPanda said:

I think a1c <6% is too strict when even 6.3% is considered pre-diabetic. My guess is you probably won't find many studies about this since most studies are done for more invasive procedures

Well, as you say, this range is pre diabetic, so why has Longevita included it in their cited article.

Do some clinics require pre procedure clearance from specialists before proceeding?  Why not an endocrinologist report ?

My feeling is that the article is a mistake and the threshold is way too low provided the patient is otherwise healthy and it’s under control. 
 

In the absence of specific medical guidelines relating to the a1c that can be cited to counteract concerns I think diabetics would not have confidence that clinics are communicating well to them.

One of the US .gov medical studies I cited above said that clear transparent communication was an imperative in the patient / clinic relationship. 
 

very unsettling IMO

 

 

 

[Snowman123]

I’ve just contacted Diabetes UK for guidance. So put my notes here should any further inputs be available.

By definition they say pre Diabetes 2 starts at an HbA1c of 6.5%.  A rate of 7.3% ( in my case ) falls well below the surgical procedure guidelines of 8.5%.  My diabetes is controlled by tablets.

Diabetes UK has suggested I ask what is the clinical basis for refusing treatment under 6.0. 

 

 

[FluffyPanda]

6 hours ago, Snowman123 said:

so why has Longevita included it in their cited article.

You'd have to ask them. We've sent people with diabetes to surgery all the time, so I personally think their cutoff of 6% is silly, but that's their decision. But if you're considering using them, I would run a search here. A lot of negative experiences with Longevita, so honestly diabetic or not, I'd go with someone else regardless.

[Snowman123]

Any suggestions of HT service provider that i can get a quote from to compare with, that would provide services for a diabetic 2 person with an HbA1c of 7.3 and on the day reading of around 5.5-6.0.   No underlying conditions and tablet controlled.