Hba1c Has Increased!

[GeminiMum]

Wonder if anyone with more experience than me can shed any light on why my HbA1c has increased from 40 three months ago to 41?

I was diagnosed with Type2 Diabetes Xmas 2017, reading was 55, in 3 months I decreased the HbA1c to 40 and to date I have lost 2st thanks to being on 500mg of Metformin. I also have endometriosis, my treatment causes both weight gain and sensitivity to sugar and I can't come off the medication as I have no quality of life (can't walk, drive, pain is horrendous), I've looked into other forms of control for the endometriosis and coincidentally saw a specialist on Monday who said stick with your current hormone treatment as I'm 50 and will hopefully hit the menopause in the next 2 years (I hope).

I have a very low carb diet, don't drink alcohol, tested bloods always come in under 7 (though as I basically eat the same foods every day now I only test anything "new" and spot test every now and then), I exercise for about a hour each day (have one day off a week). Stress levels have been high, so wondering if this could be a factor?

Just looking for any reassurance or ideas as to why HbA1c has increased, I know it's only by 1 but I was hoping to be in the 30-something, not getting closer to the pre-diabetic range.

Thanks in advance.

 

[Rachox]

Well done on your weight loss! I don’t think a rise of 1 is significant, as the numbers are only reported as whole numbers your 40 could well be 40.4 rounded down while your 41 could be 40.5 rounded up. If you are finger prick testing at home and you haven’t noticed any change I wouldn’t be worried.
Even after over a year I still test between 4 -7 times a day, but that’s just me, I like to put my readings into the MySugr app so I can see any trends and know straight away if things are taking a turn for the worse.

 

[Freema]

there is this thing about proteins , that eaten in excess they can actually be converted into sugar by ones liver... so the general rule is to only eat around 0.8 grams of proteins pro kg lean body weight, so if your lean weight is maybe 75 kg your fine amount of daily proteins would be in the range between 70-80 grams of daily proteins in total .. a bit more if doing a lot of weight lifting and other kinds of body building

my own HbA1c has also raised a bit... as long as it is in the area of forty and lower , I wouldn´t worry too much of that... just keep on doing your great job and keep your nose in the track

 

[GeminiMum]

Well done on your weight loss! I don’t think a rise of 1 is significant, as the numbers are only reported as whole numbers your 40 could well be 40.4 rounded down while your 41 could be 40.5 rounded up. If you are finger prick testing at home and you haven’t noticed any change I wouldn’t be worried.
Even after over a year I still test between 4 -7 times a day, but that’s just me, I like to put my readings into the MySugr app so I can see any trends and know straight away if things are taking a turn for the worse.

Thank you for that, I wasn't aware that numbers were rounded up and down so that helps. I was pretty low carb (due to endometriosis) pre diagnosis, but never lost any weight, so it's thanks to the Metformin as I've only tweaked my diet to remove potatoes, rice (only used to have a spoonful at most) and any obvious sugars (not that I added sugar to anything or had anything with sugar in it as wheat has been out for about 20 years which means cakes, biscuits etc have been out for years - also no cheese for years as endo doesn't like that either). So the weight loss I feel is due to the Metformin for which I'm grateful as it didn't matter what I did I couldn't lose weight at all.

Your HbA1c's are amazing, hopefully I'll get down to the 30's too. Can't think what else I can do to improve long range results, I joke often that if I cut anything else out of my diet or down that there won't be anything left to eat.

 

[GeminiMum]

there is this thing about proteins , that eaten in excess they can actually be converted into sugar by ones liver... so the general rule is to only eat around 0.8 grams of proteins pro kg lean body weight, so if your lean weight is maybe 75 kg your fine amount of daily proteins would be in the range between 70-80 grams of daily proteins in total .. a bit more if doing a lot of weight lifting and other kinds of body building

my own HbA1c has also raised a bit... as long as it is in the area of forty and lower , I wouldn´t worry too much of that... just keep on doing your great job and keep your nose in the track

Ah I wasn't aware that proteins could convert to sugars! I have been going for protein to eat if hungry (nuts / cold chicken / sausage etc) will keep an eye on that too.

 

[NicoleC1971]

As Rachox says, its a tiny increase and could just be a natural variance in the turnover time of your red blood cells. I don't know what hormone treatment you are on but it seems likely that anything which causes weight gain is likely to be implicated in continuing insulin resistance. Hormone treatments tend to work by making the body think its pregnant and we all know how resistant to insulin diabetic women can get when pregnant.
The stress produced by monthly pain can't help either?
Hopefully all this will cease and desist when your cyle stops but in the meantime you have done well to have a healthy HBA1c.

 

[Rachox]

Thank you for that, I wasn't aware that numbers were rounded up and down so that helps. I was pretty low carb (due to endometriosis) pre diagnosis, but never lost any weight, so it's thanks to the Metformin as I've only tweaked my diet to remove potatoes, rice (only used to have a spoonful at most) and any obvious sugars (not that I added sugar to anything or had anything with sugar in it as wheat has been out for about 20 years which means cakes, biscuits etc have been out for years - also no cheese for years as endo doesn't like that either). So the weight loss I feel is due to the Metformin for which I'm grateful as it didn't matter what I did I couldn't lose weight at all.

Your HbA1c's are amazing, hopefully I'll get down to the 30's too. Can't think what else I can do to improve long range results, I joke often that if I cut anything else out of my diet or down that there won't be anything left to eat.

Thank you for your kind words about my HbA1cs, I have my next lab tested one in a couple of weeks, so fingers crossed!
Your 40 and 41 are both non-diabetic so you can be happy with that. I suppose there is the possibility of increasing your Metformin, with your Drs permission of course, if you think it will improve things all round for you. I currently take 3 x 500mg per day but am looking to reduce it soon.

 

[GeminiMum]

As Rachox says, its a tiny increase and could just be a natural variance in the turnover time of your red blood cells. I don't know what hormone treatment you are on but it seems likely that anything which causes weight gain is likely to be implicated in continuing insulin resistance. Hormone treatments tend to work by making the body think its pregnant and we all know how resistant to insulin diabetic women can get when pregnant.
The stress produced by monthly pain can't help either?
Hopefully all this will cease and desist when your cyle stops but in the meantime you have done well to have a healthy HBA1c.

I'm on Norethisterone constantly, so don't have a break therefore thankfully no periods, but you are right body is put into a pregnancy like state. Hence that could be causing issues too.

 

[bamba]

As @Rachox says - a rise of a single point is at the limits os the test's accuracy.

The first two weeks of my A Level Physics course covered the limits of accuracy of measurement, and how the range of the errors extend as you use thsem in calculation.

Appendix 1 of this document ( http://www.who.int/diabetes/publications/report-hba1c_2011.pdf ) lists factors - other than diabetes which can affect the results including whether you take Vitamin C or Asprin.

There was an interesting thread on the subject here https://www.diabetes.co.uk/forum/threads/hba1c-accuracy.128923/