HbA1c not aligning with home testing?

[Bluetit1802]

I hva e the same problem. Have been diagnosed as diabetic for just over a year and my H!AC has gone down from 147 to 35 in that time. However my home tests have consistently been considerably worse than my H1AC results. I juts got a control solution to check my meter , but these allow sucgh a range that whilst the meter passed the test there is still room for it to be wrong.

I struggle for a meaningful answer. Home testing meters are allowed to be fairly inaccurate, H1AC may not be a true reflectin of your blood if your blood sugar over time does not last very long. So where are you left when trying to assess your control - for me is getting the number down to 35 success and injust need to maintain? or should I be attempting to get my meter numbers down - currently showing an average of 8.3, against my H1AC equivalent to 6

There are large groups of people for whom the HbA1c is not a reliable indicator. The test relies on everyone having red blood cells that live for the average amount of time before dying off and being replaced by new ones - somewhere around 120 days. This is an average. Some have red blood cells that die off a lot quicker, and some have them that live a lot longer. Also, if there are some abnormalities with your red blood cells, such as anaemia, this will also skew the results.

http://www.diabetes.co.uk/forum/thr...due-to-red-blood-cell-age-variability.110793/

http://www.pathology.leedsth.nhs.uk/pathology/Portals/0/PDFs/BP-2013-01 Diabetes.pdf

http://www.ngsp.org/factors.asp

https://www.diabetesdaily.com/forum/testing-blood-sugar/83550-measuring-glucose-high-hematocrit/

 

[infinitemantra]

I have read the links thanks - any suggestions? - are H1AC tests which also test and factor in red blood age available? is this something I can ask my doctor for? or other accurate tests. I just checked my meter yesterday with a control solution - however this was pretty irrelevant as the margins were huge. the high solution was deemed correct if between 12mmol and 20 (it came in just below 18)

From these threads and my reading I am now assuming that whilst positive my lowered H1AC is probably not as good as it looks

 

[Bluetit1802]

I have read the links thanks - any suggestions? - are H1AC tests which also test and factor in red blood age available? is this something I can ask my doctor for? or other accurate tests. I just checked my meter yesterday with a control solution - however this was pretty irrelevant as the margins were huge. the high solution was deemed correct if between 12mmol and 20 (it came in just below 18)

From these threads and my reading I am now assuming that whilst positive my lowered H1AC is probably not as good as it looks

As far as I know, the tests for how long our red blood cells live is complicated, expensive, and not generally available. There is another test other than the HbA1c called a Fructosomine test that is similar to the HbA1c but measures a shorter period than the 2 to 3 months. You could try asking for this, but there are only a few labs in the UK that do the analysis and the sample has to be sent off to one of those. I asked for one and was told no. (My HbA1c is always significantly higher than any of my other measuring aids - meter and Libre)

http://labtestsonline.org.uk/understanding/analytes/fructosamine/tab/test/

You could also look at your full blood count results (from print outs or on-line if your surgery puts test results on line like mine does.) Examine all your red blood cell markers and haemotocrit PCV to see if you are out of range or teetering on the edge. There may be a clue there, or there may not.

 

[Alison Campbell]

@infinitemantra, that is an incredible drop in HBA1C and you should be very happy. I think you meter reads a little high from what you have said about using the test solution. All meters I have had do read a little high which I prefer as motivating.

I still feel it is a valuable tool for measuring trends rather than specific readings as I don't have to worry about hypoglycemia.

 

[jonjaz]

Is there a danger that all this testing is a little like people who jump on and off their scales every 5 minutes? I eat something my BS reading goes up I exercise my BS goes up I have a drink my BS goes up or sometimes it goes down. From what I can tell a diet works if your trousers fit and the weigh in at the clinic says 140kg when 12 weeks ago it was 143kg. The body's systems are hugely complicated many things are proven to raise and lower your BS hay fever and diesel fumes for example being stressed or relaxed also change our BS so I would go with the H1AC test and chill.

 

[Glink]

Funny this would bump up, because my latest round of tests were fantastic from the lab, and didn't at all match my at-home readings, which have not been very great at all lately. I'm giving up on self testing (no risk of lows here) for the next 3 months to see if it improves my quality of life at all.

However, my diet was never intended to make my trousers fit or to make me lose weight--my challenge is more the other symptoms such as frequent urination, thrush, slow healing, and fatigue. I tested to try to inform my eating choices and interpret symptoms--if I was high I would skip meals until my sugars came down; if I wasn't high but had a sore throat and fatigue I still ate but assumed I was getting a cold. Your experiences may vary.

 

[Bluetit1802]

Funny this would bump up, because my latest round of tests were fantastic from the lab, and didn't at all match my at-home readings, which have not been very great at all lately. I'm giving up on self testing (no risk of lows here) for the next 3 months to see if it improves my quality of life at all.

However, my diet was never intended to make my trousers fit or to make me lose weight--my challenge is more the other symptoms such as frequent urination, thrush, slow healing, and fatigue. I tested to try to inform my eating choices and interpret symptoms--if I was high I would skip meals until my sugars came down; if I wasn't high but had a sore throat and fatigue I still ate but assumed I was getting a cold. Your experiences may vary.

I think I would carry on self testing and give up on the HbA1c. I wouldn't care if I never had another they are so way out. I know my meter reads more or less accurately with a few rogue ones thrown in. I have checked it against lab plasma tests. I know my Libres read low so I always add a whole mmol/l to what they tell me, and still my HbA1c is around 6 points higher. My red blood cells must live a very long time. Still, better that way than the HbA1c being too low or I might just relax too much and end up where I started.