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Which Readings to Drop First? If any?

Discussion in 'Type 2 Diabetes' started by Rachox, Jul 15, 2017.

  1. Art Of Flowers

    Art Of Flowers Type 2 · Well-Known Member

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    If you get consistent readings every day, then you don't need to test that often. Only when you are eating something different. Testing only first thing can be a bit disappointing as the number can be higher due to the dawn effect, so maybe just have a morning and evening test.
     
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  2. badcat

    badcat Type 2 · Well-Known Member

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    Ive been retesting some foods to guage impact progression - I have started to use mysugr (free app from app stote) to record my readings / foods etc - lot easier than the spread sheet method I was using before
    Once youve inputed enough data, it gives you an estimated hba1c - no idea how accurate the estimate is, only time ( and my next diabetic review blood tests) will tell.
     
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  3. Bluetit1802

    Bluetit1802 Type 2 · Master

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    I can't do this. It just doesn't work. My last HbA1c was 44, which equals an average mmol/l of 7.3.
    As I spend all day and all night in the 4s and 5s other than post lunch and post evening meals where my levels rarely rise above 7, and that is a brief rise, how on earth can my average be 7.3?

    This is according to 2 different meters with 8 to 10 tests a day and also according to my Libre sensors (after adding 1mmol/l to the Libre readings as they tend to read about 0.5mmol/l low on me, so I am being hard on myself with this) I estimated my last HbA1c to be around 35 to 38.

    This also happened on all my previous review HbA1c tests.
     
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    #23 Bluetit1802, Jul 16, 2017 at 2:06 PM
    Last edited: Jul 16, 2017
  4. Robbity

    Robbity Type 2 · Well-Known Member

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    I'm like @Bluetit1802 with this - my HbA1c results are always a bit higher than those calculated from my meter averages. And my Libre fairly consistently reads lower and its estimates would put me well into normal levels.

    And well done @Rachox on your excellent results! :)

    Robbity

    PS My post meal levels were the first to show a drop, and my wakeup/fasting levels the last...
     
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  5. Rachox

    Rachox Type 2 · Well-Known Member

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    Maybe mine was just a fluke! I try it again in 9-10 weeks when I get my next test!
     
  6. Rachox

    Rachox Type 2 · Well-Known Member

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    I'll have a look at Mysugr, I currently use the app Glucose Companion for my weight and blood sugars and an Excel spreadsheet for my food diary. I like that Mysugr works out an HbA1c estimate.
     
  7. Bluetit1802

    Bluetit1802 Type 2 · Master

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    Maybe a lucky fluke. Without a continuous monitoring system you have no idea what happens overnight, what your levels are between tests, how high the actual peak is, how long you stay higher than your base after eating, whether your choice of food in a particular meal peaks later or even twice, and so on. (We can and do peak twice with certain meals). Your 8 tests consist of only 3 post meals when you would expect to be higher, and 5 pre-meal/fasting/bedtime tests when you expect to be lower. That isn't averaging like with like. To get an average close to your HbA1c you would have to test half hourly at least!

    Some members here do report they can estimate HbA1c from meter tests, but how they manage this I have no idea.

    Me? I have learnt to take very little notice of my HbA1c and wouldn't care if I never had another one. My red blood cells just do not comply with the accepted norm. I just rely on my self testing and part time Libres, watching for upwards and downward trends.
     
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  8. Goonergal

    Goonergal Type 2 · Well-Known Member

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    I am one of those whose meter testing aligned with my HbA1C - almost exactly. 3 month meter average was 6.3 and my HbA1C was 38. However, my first re-test I had not been using a meter long enough to compare so this is a once-off event for my second re-test. It could have been a fluke as @Bluetit1802 suggests, so I will be interested to see whether this trend continues.

    Agree that the meter tests give a much clearer idea of spikes and provide more guidance around whether diet is positively impacting diabetes management.
     
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  9. ringi

    ringi Type 2 · Well-Known Member

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    Research is starting to say that the last few weeks BG has more affect on HbA1c then the BG from 12 weeks ago. So taking an average over 12 weeks is likely to overestimate HbA1c if your BG is going down. Therefore doctors are starting to do HbA1c after 8 weeks.

    As some peoples blood cells last longer then others, a HbA1c can only be converted to a BG reading for the "average person". For Type2, HbA1c is most useful as a "fire alarm" when it increases or does not decrease when expected.
     
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  10. ringi

    ringi Type 2 · Well-Known Member

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    I now mostly just test my BG after the evening meal, as that is the meal that tends to have the most risk and a reading that is higher then normal tells me I need to investigate what is going on.

    My readings are still dropping about 0.5 every few weeks, but I have now worked out what food I intend to eat and will only reconsider my meals if my readings start going up. However I do test more if I have a meal I don't often eat.
     
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  11. Rachox

    Rachox Type 2 · Well-Known Member

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    My GP is obviously going for the middle ground then testing approx. every 10 weeks!
     
  12. Brunneria

    Brunneria Other · Moderator
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    Exactly how I feel.
    I have no interest whatsoever in having my HbA1c done by the surgery on a regular basis, since my prick tests and Libre show a very different (lower) average number.
    I am also happy to accept that those prick tests and the Libre are not particularly accurate either. lol.

    However, I just use them for trends and to track any long term rises and falls (and to force myself to see the consequences of unwise food choices, so that I don't make those choices too often!). This has the result of me feeling that I am 'on top of things' and confident that my particular combo of diet, gluten free, dog walks and food timings are not causing long term damage.

    (I kind of feel the same about my cholesterol tests too, but that is a whole other thread! :D)
     
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  13. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    Not sure I understand what you mean. You say "taking an average over 12 weeks or 8 weeks" as though there is some sort of calculation involved. They could measure your HbA1c every 2 weeks it wouldn't make any difference. The point is the reading reflects what has occurred over the last 8-12 weeks so if you have had a change (or not) of diet or medication, then to find the full effect you need to wait until all the blood cells have renewed under the new regime.
     
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  14. Bluetit1802

    Bluetit1802 Type 2 · Master

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    I agree. It isn't the frequency of the tests that matter, it is the way the labs analyse the HbA1c that matters, and that analysis looks at the past 12 weeks with the calculation being weighted towards the previous 3 to 4 weeks. If a person has a lot more old haemoglobin that the average person, there will be more glucose attached to these old cells and the HbA1c will be higher than expected. If a person has a lot more new haemoglobin than the average person there will be less glucose attached and the HbA1c will be lower than expected.
     
  15. ringi

    ringi Type 2 · Well-Known Member

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    Higher up in the thread people where talking about predicting their HbA1c based on their own BG readings.
     
  16. Rachox

    Rachox Type 2 · Well-Known Member

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    Yes, I tried it, last week was my first HbA1c since diagnosis. This is how I described what I did:
    "I didn't know if it would work as my daily readings are just eight snapshots and I didn't know what my sugars were doing inbetween, however my calculation was fairly close.
    The maths: I took eight readings a day, then each day I worked out the average (add all eight together and divide by eight). I then worked out weekly averages using the daily ones, then I calculated an overall average of the 12 weeks using the weekly averages (In my case I had three weeks missing, but converted my old HbA1c using the calculator on the page I've link below for those weeks). I then used the second part of the calculator to convert my grand average into an approximate HbA1c reading! Ta daa! Hope that makes sense, told you I'd become a number cruncher!"
    I'll try it next time with a 'full set' of readings and see how close it comes.
     
  17. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    Sorry, I misunderstood. You're correct, if people are averaging their own readings then they need to do it over 8/12 weeks if their readings are changing. If as you say the HbA1c is biased towards later weeks then it is not a simple relationship between average BG and HbA1c and not surprising if it is not accurate. My HbA1c is 37 which the calculator says equates to an average BG of 6.2 which seems reasonable as my BG is consistently about 6 before meals and about 7 after 2 hours.
     
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  18. keitjones

    keitjones Type 2 · Well-Known Member

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    Hi Rachox, that makes perfect sense. Thank you
     
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  19. keitjones

    keitjones Type 2 · Well-Known Member

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    By the way Rachox have you looked at Libre? It will do all this for you. Bit pricy though. I am still thinking about it.sure others on the forum use it.
     
  20. Rachox

    Rachox Type 2 · Well-Known Member

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    I have looked at it but my bank balance says no, it's so expensive!
     
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