Confused

[Buckley82]

my doctor has biagnosed me as prediabetic
After speaking to friends and family the believe he is wrong. My BG levels after 12-14 hours fasting are always between 7.3 and 7.6
I have bought a test so I can keep an eye on it my self as after two tests three weeks apart one being 7.6 the other 7.3 he hasnt really said much, my aunties diabetic nurse says I should be having another test done

Can anyone help

 

[catinahat]

Hello Buckley82, welcome to the forum
I have t2 and my fasting levels are usually around 5•2 to 6 which is a little below yours, what was your HbA1c result ?
Below 41 is non diabetic, 41 to 47 is pre- diabetic and above 48 is diabetic

 

[Bluetit1802]

Hello and welcome,

With fasting results like those I would be surprised if your doctor hasn't done an HbA1c test. Your fasting tests indicate possible diabetes, not merely pre-diabetes. Anything over 7 warrants an HbA1c, and this would confirm matters either way. If you didn't have an HbA1c test, I strongly advise you to ask for one.

 

[Buckley82]

Hello and welcome,

With fasting results like those I would be surprised if your doctor hasn't done an HbA1c test. Your fasting tests indicate possible diabetes, not merely pre-diabetes. Anything over 7 warrants an HbA1c, and this would confirm matters either way. If you didn't have an HbA1c test, I strongly advise you to ask for one.

Thank I will ask when I see him next week about other test, my friend has tested again for me today after fasting for 14 hours and it was 7.3

 

[Buckley82]

Hello Buckley82, welcome to the forum
I have t2 and my fasting levels are usually around 5•2 to 6 which is a little below yours, what was your HbA1c result ?
Below 41 is non diabetic, 41 to 47 is pre- diabetic and above 48 is diabetic

I don't know what my HbA1c is as doctor hasn't had these tests done

 

[catinahat]

If you didn't have a HbA1c test your Dr has used just the FGT test to make his diagnosis

Fasting Plasma Glucose Test (FGT)
The FGT test works by measuring the level of glucose in an individual's blood after a period of fasting.

Anyone who is at a high risk of pre-diabetes should be given the FPG test. This includes those who are severely overweight or obese, people of South Asian or African-Caribbean descent, or anyone with a family history of diabetes.

The fasting plasma glucose test is performed after a person fasts for at least 8 hours.

Individuals who have a blood glucose level greater than or equal to 7.0 mmol/L (126 mg/dl) will be retested and, if the results are consistent, diagnosed with diabetes.

If the results areless than 7.0 mmol/L(126 mg/dl) but greater than 6.1 mmol/L(110 mg/dl) the individual will be diagnosed as having impaired fasting glucose, or pre-diabetes.

As bluetit1802 said your levels are in the diabetic range, you need to go back and ask for a re-test

 

[Buckley82]

If you didn't have a HbA1c test your Dr has used just the FGT test to make his diagnosis

Fasting Plasma Glucose Test (FGT)
The FGT test works by measuring the level of glucose in an individual's blood after a period of fasting.

Anyone who is at a high risk of pre-diabetes should be given the FPG test. This includes those who are severely overweight or obese, people of South Asian or African-Caribbean descent, or anyone with a family history of diabetes.

The fasting plasma glucose test is performed after a person fasts for at least 8 hours.

Individuals who have a blood glucose level greater than or equal to 7.0 mmol/L (126 mg/dl) will be retested and, if the results are consistent, diagnosed with diabetes.

If the results areless than 7.0 mmol/L(126 mg/dl) but greater than 6.1 mmol/L(110 mg/dl) the individual will be diagnosed as having impaired fasting glucose, or pre-diabetes.

As bluetit1802 said your levels are in the diabetic range, you need to go back and ask for a re-test

I defo will
I just want a better understanding of what I'm dealing with

 

[Bluetit1802]

The current NICE guidelines for the NHS state that if a person's fasting blood glucose test is 7 or above it should be followed by an HbA1c. This is why I am very surprised you haven't had one. My own surgery is even going straight to an HbA1c without the FBG test as the FBGT are notoriously unreliable due to many factors, and are only a snapshot of what your level was at the time of the test. An HbA1c will tell you a sort of average of your levels over the previous 2 to 3 months.

 

[rosserk]

The current NICE guidelines for the NHS state that if a person's fasting blood glucose test is 7 or above it should be followed by an HbA1c. This is why I am very surprised you haven't had one. My own surgery is even going straight to an HbA1c without the FBG test as the FBGT are notoriously unreliable due to many factors, and are only a snapshot of what your level was at the time of the test. An HbA1c will tell you a sort of average of your levels over the previous 2 to 3 months.

Can you point me to the NICE guidelines that state fasting blood glucose should be followed by a HBa1c test?

 

[ButtterflyLady]

Can you point me to the NICE guidelines that state fasting blood glucose should be followed by a HBa1c test?

In NZ, doctors just go straight to HbA1c testing for screening and diagnosis, and only use FBG if there is a reason to.

 

[ButtterflyLady]

my doctor has biagnosed me as prediabetic
After speaking to friends and family the believe he is wrong. My BG levels after 12-14 hours fasting are always between 7.3 and 7.6
I have bought a test so I can keep an eye on it my self as after two tests three weeks apart one being 7.6 the other 7.3 he hasnt really said much, my aunties diabetic nurse says I should be having another test done

Can anyone help

I agree with others who have said these results are enough to diagnose diabetes, and that an HbA1c test should have been done and needs to be done.

I'm puzzled as to why your friends and family believe he is wrong, because even if you had prediabetes or borderline/early prediabetes, that is a health issue that needs attention. Your doctor is right to be looking into this, and you will need to take actions or it is likely to get worse and eventually cause permanent damage. Sorry but being realistic is better than playing it down.

 

[Buckley82]

I agree with others who have said these results are enough to diagnose diabetes, and that an HbA1c test should have been done and needs to be done.

I'm puzzled as to why your friends and family believe he is wrong, because even if you had prediabetes or borderline/early prediabetes, that is a health issue that needs attention. Your doctor is right to be looking into this, and you will need to take actions or it is likely to get worse and eventually cause permanent damage. Sorry but being realistic is better than playing it down.

They believe he is wrong in diagnosing prediabities and that he should have diagnosed diabities or at least ordered more test to confirm this. They are all diabetic themselfs so know the readings are a sign or diabities not pre

 

[ButtterflyLady]

They believe he is wrong in diagnosing prediabities and that he should have diagnosed diabities or at least ordered more test to confirm this. They are all diabetic themselfs so know the readings are a sign or diabities not pre

Ok thanks, that makes more sense. I had wondered if they were non-diabetics who for some reason were downplaying prediabetes. Whether it is pre-D or D, you will have a choice of whether to take action to get your blood sugars under control or not. Would you like some info about managing either of these conditions? The info is the same for both.

 

[Bluetit1802]

Can you point me to the NICE guidelines that state fasting blood glucose should be followed by a HBa1c test?

I'm sorry, I can't find them now.

 

[Buckley82]

Ok thanks, that makes more sense. I had wondered if they were non-diabetics who for some reason were downplaying prediabetes. Whether it is pre-D or D, you will have a choice of whether to take action to get your blood sugars under control or not. Would you like some info about managing either of these conditions? The info is the same for both.

Yes I would, that would be brilliant thank you

 

[ButtterflyLady]

Yes I would, that would be brilliant thank you

Ok, cool. I will tag @daisy1 who has some info she posts for people new to the forum or prediabetes/diabetes.

 

[ButtterflyLady]

Can you point me to the NICE guidelines that state fasting blood glucose should be followed by a HBa1c test?

I was curious about this and looked up the current NICE guidelines (massive documents... glad I don't have to learn and use them!). They seem to say either FBG or HbA1c are fine, ie equal in value:

"For people with possible type 2 diabetes (fasting plasma glucose 7.0 mmol/l, or above, or HbA1c is 48 mmol/mol [6.5%], but no symptoms of type 2 diabetes):

• Carry out a second blood test. If type 2 diabetes is confirmed, treat this in accordance with NICE guidance on type 2 diabetes. Ensure blood testing conforms to national quality specifications."

Source: http://pathways.nice.org.uk/pathway...tent=view-node:nodes-possible-type-2-diabetes

 

[Bluetit1802]

I found this, written July 2011.

http://www.pulsetoday.co.uk/clinica...sting-for-diabetes-diagnosis/12341186.article

 

[rosserk]

I was curious about this and looked up the current NICE guidelines (massive documents... glad I don't have to learn and use them!). They seem to say either FBG or HbA1c are fine, ie equal in value:

"For people with possible type 2 diabetes (fasting plasma glucose 7.0 mmol/l, or above, or HbA1c is 48 mmol/mol [6.5%], but no symptoms of type 2 diabetes):

• Carry out a second blood test. If type 2 diabetes is confirmed, treat this in accordance with NICE guidance on type 2 diabetes. Ensure blood testing conforms to national quality specifications."

Source: http://pathways.nice.org.uk/pathways/preventing-type-2-diabetes#path=view:/pathways/preventing-type-2-diabetes/managing-risk-of-type-2-diabetes.xml&content=view-node:nodes-possible-type-2-diabetes

Thank you at my practice if you have two random blood glucose measurements over 11.1 which is also a diagnosis method advocated by NICE and the WHO. The practice will not accept the results and insist on a positive HBA1c which can miss diabetes under certain circumstances. If the HBA1c comes back below the cut off point they will ignore the two random tests and offer no explaination other than you are NOT diabetic! Which would indicate that random blood tests are not accurate so why are NICE and WHO saying they are? There seems to be a correlation between testing methods used and the area you live in. For example someone in Wales could be diagnosed diabetic based on two random blood sugars but someone in England is not even though both patients had the same result.

 

[ButtterflyLady]

Thank you at my practice if you have two random blood glucose measurements over 11.1 which is also a diagnosis method advocated by NICE and the WHO. The practice will not accept the results and insist on a positive HBA1c which can miss diabetes under certain circumstances. If the HBA1c comes back below the cut off point they will ignore the two random tests and offer no explaination other than you are NOT diabetic! Which would indicate that random blood tests are not accurate so why are NICE and WHO saying they are? There seems to be a correlation between testing methods used and the area you live in. For example someone in Wales could be diagnosed diabetic based on two random blood sugars but someone in England is not even though both patients had the same result.

I quite agree. There seem to be different testing methods all over the place.

To me, it seems logical that FBG + HbA1c would cover most scenarios, and if the picture still wasn't clear, you could throw in a GTT, which seems to be handy in certain circumstances. Random BGs, to me, are only useful for screening people at places like pharmacies or shopping malls, to pick up frank diabetes or coax people into getting proper FBG/HbA1c testing done.

(The above comments only apply to T1 and T2/pre-D, because the other types, and related dysglycaemic conditions like RH, seem to require more in depth testing and analysis.)

All very interesting.