HBa1C What options?

[Galathea]

I have been monitoring my blood glucose levels for the past two weeks, they are between 7 and 8 first thing and can be anywhere from 7 to 19 two hours after food. They are currently 10.3. Despite having last eaten 4 hours ago.

Since I have been monitoring, I have dropped all pasta, bread, sweets, sugar cereals. So am following a low carb plan.... Though am still working it out.

Today, I showed the doc my results chart and the list of foods I have eaten and I asked if she thought I was pre diabetic. She agreed that my readings were too high, pursed her lips and said she would like to do a hba1c test. I made an appointment and they told me to fast for 16 hours before the test(?) and they can't do it for three weeks and it will then take another week to get the result.

Do I carry on with the low carb diet until then or do I go back to carbs.... Will low carb skew the results?

I am fairly keen to get the test done so I have a base line to work from. What is my best option for getting a test done privately? Can anyone recommend a test? Do the chemists do them?

The doc was also very keen to get my cholesterol measured... Is this relevant? I have avoided it for years because statins are a no go when taking thyroid medication. I have been hypothyroid due to auto immune for about 25 years.

Any advice much aporeciated......

Thanks.

 

[NoCrbs4Me]

A blood glucose of 19 mmol/l at anytime (i.e. random test) is indicative of diabetes, as are fasting levels above 7 mmol/l:

http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/tests-diagnosis/con-20031902

Stick to the low carb diet.

 

[andcol]

I agree stick with low carb. It will give you some improvement in you HbA1c over the next few weeks so when you get them just think you are likely to have been much worse if you hadn't low carbed. As for cholesterol - yes high blood glucose levels aer likely to through your lipid levels out. Not to worry as often low carb will also help to return these as well. I have my fingers crossed for you. Hope you get an all clear but I expect that will not be the case from your finger prick test results

 

[catinahat]

Hello Galathea, welcome to the forum
I really don't understand why you have to wait 3 weeks! to get your blood tested. There will be blood testing clinics at your local hospitals. Your gp should have given you a blood sciences request form. Take your form to the clinic, they usually have a ticket machine like at the meat counter in supermarkets, take a ticket and wait for them to call your number. No appointment needed, although it does take about a week for your gp to get the results.
Don't worry about the cholesterol test, it's better to know what your numbers are, if it's high you can discuss your options with your gp, you don't have to take statins if they don't suit you.

 

[Galathea]

Hello Galathea, welcome to the forum
I really don't understand why you have to wait 3 weeks! to get your blood tested. There will be blood testing clinics at your local hospitals. Your gp should have given you a blood sciences request form. Take your form to the clinic, they usually have a ticket machine like at the meat counter in supermarkets, take a ticket and wait for them to call your number.


Hi,
The doctor didnT actually hand me a form, it was all done on the computer.... The three week wait is because they want o take it early morning and don't have anyone available until then. Think I will call the hospital today, Mae sure they will doit if I call in, then I will Mae more fuss at the ocs and get them to print off the form.

Thank you.... I can deal with most stuff ok, but sometimes I just need another view on it all...

G.

 

[AndBreathe]

I don't know what the services are like where you live, but I can use my surgery, or cottage hospital, with a wait involved, or I can drive to the nearest large hospital (30 mile round trip), where there is a walk-in blood test unit. It is a little known service I discovered when I needed something done before it could be achieved locally. It could be worth making enquiries.

As my tests are usually fasting, I get up and out, and am usually first in the queue at the test centre. My blood is taken at 8am, on the nail (as the phlebotomists understand fasting tests, and they're usually upbeat and chatty as they haven't been ground down by what must feel like 10,000 other vials of blood during their day.

 

[Galathea]

I phoned the hospital in Dorchester today and they are able to take my blood for testing, all I have to do is walk in with the paper from my doctor.. I went to the docs for the paper but they cannot print it until tomorrow. They had never heard of anyone g oing to the hospital for testing and were worried they may not get the results sent to them but the hospital said its fine!

It really is Dozy Dorset here!

Thanks for your suggestions, its saved me a three week wait!

G x.

 

[Galathea]

I went to to the hospital for testing, then I went to my doctors on Monday for a repeat test. I called in to see a doc yesterday and took him a copy of my graph printed from my meter because I wanted him to prescribe test cassettes.

Turns out my hbac1 is 42, so not diabetic until it reaches 48... My latest fasting glucose taken on Monday was 7.3. And the one a few weeks ago was 6,8. ( They want me to retest in 2 weeks )

So he said no need for regular testing, once every three days is fine. The chart I showed which shows the spikes have massively reduced just shows I am testing too much.

Said not to eat anything which grows underground and my 1 stone wight loss. (Yippee) is good but not attributable to low carb high fat... I must remember calories in have to be less than calories out.

Will test my Hba1c in three months to see if its changed.
I am really pleased with how I am doing, in the last month average glucose has dropped from 8.2 to 7.8. I feel better and the weight is going.
Fewer spikes. Don't know if theses photos will show but the pink one is the earlier one and the white one is this week.

I think I need to keep testing and remain on the high fat low carb... This forum is helping massively. Thank you. I don't think the doctor is right about testing and I shall continue to do it,if only to see which foods cause a problem. Interesting that potatoes are a definite no but bananas are fine for me.

 

[Spiker]

Looking at those maximum values you are at least prediabetic if not already diabetic. Has your doctor seen these values? Does he not believe them?

 

[Galathea]

Looking at those maximum values you are at least prediabetic if not already diabetic. Has your doctor seen these values? Does he not believe them?

The doc glanced at those charts and said would' re test the hba1c in 3 months.... Offered no advice.

I

 

[Rillum]

So annoying that many doctors don't take self measurements seriously. Very good idea for you to continue low carbing. I have lower readings than this, and I'm prediabetic.

 

[Galathea]

All of the charts have been since I went on to low carb high fat. I half wish I had monitored whilst eating carbs, but once I got hold of a meter and tested, I changed diet immediately.

 

[Spiker]

On WHO criteria (endorsed by DUK) you are frank diabetic. What is your GP playing at?

http://www.diabetes.org.uk/About_us...vention/New_diagnostic_criteria_for_diabetes/


Methods and criteria for diagnosing diabetes

1. Diabetes symptoms (e.g. polyuria, polydipsia and unexplained weight loss for Type 1) plus:
   • a random venous plasma glucose concentration ≥ 11.1 mmol/l or
   • a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or
   • two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).
2. With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting random values are not diagnostic the two hour value should be used.

Haemoglobin A1c (HbA1c) testing to diagnose diabetes
An HbA1c of 48mmol/mol (6.5%) is recommended as the cut off point for diagnosing diabetes. A value of less than 48mmol/mol (6.5%) does not exclude diabetes diagnosed using glucose tests.

 

[Rillum]

Venous values are lower than capillary values, which is what we measure with the meters. As the venous values are 1-2 mmol/l lower, Galathea might not be diagnosed, but it would be great for you, Galathea, to have an OGTT or have your fasting venous blood measured. Fasting venous blood is cheap, so you have a better chance of convincing your doctor to order that.

 

[Spiker]

Capillary values only read 12% higher than venous plasma values. Yes the diagnostic criteria stipulate a venous plasma test. But the doctor is sitting looking at capillary test data that is very significantly higher than the venous plasma levels, much more than 12%, so he should be ordering venous plasma tests to confirm or deny, not just whistling for 3 months.

 

[mikej1973]

Capillary values only read 12% higher than venous plasma values. Yes the diagnostic criteria stipulate a venous plasma test. But the doctor is sitting looking at capillary test data that is very significantly higher than the venous plasma levels, much more than 12%, so he should be ordering venous plasma tests to confirm or deny, not just whistling for 3 months.

Post Pandral the venous readings are way lower than the capillary ones. Up to 25% I'm sure I read. I did my own test 2hrs post OGTT and got 7.4. The venous sample was 4.9

 

[Rillum]

The difference between venous and capillary BS, is larger in normoglycemic persons than diabetics, since the cells in the normoglycemic body are better at absorbing sugars. The capillary BS is the same as the arterial, while the venous is lower after sugar has been absorbed in the capillaries.
In the diabetic, the cells doesn't absorb as much sugar and consequently the difference is smaller.

 

[mikej1973]

The difference between venous and capillary BS, is larger in normoglycemic persons than diabetics, since the cells in the normoglycemic body are better at absorbing sugars. The capillary BS is the same as the arterial, while the venous is lower after sugar has been absorbed in the capillaries.
In the diabetic, the cells doesn't absorb as much sugar and consequently the difference is smaller.

Hey. Do you have a reference for this? I'm not arguing with you! Just trying to get as much information together as I can before seeingmy gp next week

 

[Galathea]

7.3 and 6.8 were the fasting readings taken by the doctor using blood from my veins..... His rationelle for leaving it three months was because he said no harm would happen in three months and he wanted to see if .... Err.... Dunno.( maybe He just wanted to see if I stopped bothering him? )

I think I will change practices. I have nothing to lose......

In the meantime..... If I am diabetic then what can I do apart from exercise. ( I am a gardener so I move around a lot every day). and stick with the low carb?

I suspected I wasnT right about 7 years ago and my doctor gave me a fasting glucose tolerance test...... She said the results were ok.... I never thought to find out what they were.... But on the way home I felt absolutely dreadful. I was grey by the time I got home and had to sleep it off for two days. I wonT be volunteering for a GTT anytime soon....... II cannot cope with feeling that bad again.

G

 

[Spiker]

Eat a bag of sweets and go to A&E? That should get you diagnosed fast.

Same as a GTT I suppose. It won't be pleasant but it might get you taken seriously.