Poor 6 Monthly Results & Very Worried

johnoo

Well-Known Member
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125
Where do you want to be? That is the question. Personally it would be a concern. It isn't telling me you have control. A deterioration from 42 to 55 is what it is, a deterioration. Your problem now is to turn this round or your next test may be even worse. Something you are doing is not helping you. Do you know what this "something" is?
Two points:-
1 BOO1979, great link thanks. Shows 48/58 are desired levels
2 Bluetit1802, Thanks again, I realize I've "gone backwards", what's caused it, possible relaxation of diet/eating too much chocolate. This said only a few squares of dark chocolate 3 times a week.But now I must cease!
Now off on holiday to a "Rum Producing" country, which will now help, but after that I'll see my great nurse & discuss
 

Bluetit1802

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25,216
Type of diabetes
Type 2 (in remission!)
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Two points:-
1 BOO1979, great link thanks. Shows 48/58 are desired levels

I think you have misread the link. This is the important bit:
NICE note that for type 2 diabetes (1):
  • for adults with type 2 diabetes managed either by lifestyle and diet, or by lifestyle and diet combined with a single drug not associated with hypoglycaemia, support the person to aim for an HbA1c level of 48 mmol/mol (6.5%)
    • for adults on a drug associated with hypoglycaemia, support the person to aim for an HbA1c level of 53mmol/mol (7.0%)
  • in adults with type 2 diabetes, if HbA1c levels are not adequately controlled by a single drug and rise to 58 mmol/mol (7.5%) or higher:
    • reinforce advice about diet, lifestyle and adherence to drug treatment and
    • support the person to aim for an HbA1c level of 53mmol/mol (7.0%)
    • and intensify drug treatment
In other words, 48 is acceptable for those not on particular drugs. 53 is acceptable for those on certain strong drugs that can cause hypos. 58 is not acceptable and requires additional medication.
 

johnoo

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Messages
125
I think you have misread the link. This is the important bit:
NICE note that for type 2 diabetes (1):
  • for adults with type 2 diabetes managed either by lifestyle and diet, or by lifestyle and diet combined with a single drug not associated with hypoglycaemia, support the person to aim for an HbA1c level of 48 mmol/mol (6.5%)
    • for adults on a drug associated with hypoglycaemia, support the person to aim for an HbA1c level of 53mmol/mol (7.0%)
  • in adults with type 2 diabetes, if HbA1c levels are not adequately controlled by a single drug and rise to 58 mmol/mol (7.5%) or higher:
    • reinforce advice about diet, lifestyle and adherence to drug treatment and
    • support the person to aim for an HbA1c level of 53mmol/mol (7.0%)
    • and intensify drug treatment
In other words, 48 is acceptable for those not on particular drugs. 53 is acceptable for those on certain strong drugs that can cause hypos. 58 is not acceptable and requires additional medication.
OK, understood but as I recorded 55 & admit I've slacked off I think I can get back to the previous 48 after me holiday!
 

Bluetit1802

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Type of diabetes
Type 2 (in remission!)
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OK, understood but as I recorded 55 & admit I've slacked off I think I can get back to the previous 48 after me holiday!

Good luck. You can do it, but you need to keep a food diary and test regularly for the best results.
 

Bluetit1802

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Type of diabetes
Type 2 (in remission!)
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Yes, agree I do test regular & monitor results/food

Good. If you are doing this regularly it should have thrown up a warning that your HbA1c might have increased. Not to worry, keep going and really analyse your self testing results to see how they can be improved. An HbA1c of 55 means your average daily levels has been 8.9mmol/l so you are spending a lot of time too high.
 

johnoo

Well-Known Member
Messages
125
Good. If you are doing this regularly it should have thrown up a warning that your HbA1c might have increased. Not to worry, keep going and really analyse your self testing results to see how they can be improved. An HbA1c of 55 means your average daily levels has been 8.9mmol/l so you are spending a lot of time too high.
I thought a Hba1c of 55 equated to about 7.2 not 8.9?
If I take a total average of all of my last 3 months tests, Morning/Afternoon/night the average has been 7.13
 

Brunneria

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I thought a Hba1c of 55 equated to about 7.2 not 8.9?
If I take a total average of all of my last 3 months tests, Morning/Afternoon/night the average has been 7.13

Have a look at this chart

hba1c-chart.jpg


Your 55 (the blue numbers at the top of the arc) equates to 8.9 in mmol/l (prick tests) the white numbers at the bottom of the arc.

I would suggest that your prick tests are not catching your real highs.
Do you test before each meal and snack, then 2 hours after each one? And if your numbers are high, are you doing additional tests to work out why, and how long it takes to get back to your starting level?

Unfortunately it takes intensive testing like this to provide enough info to predict where your HbA1c is going to be - and even then the predictions are often inaccurate.
 

johnoo

Well-Known Member
Messages
125
Have a look at this chart

hba1c-chart.jpg


Your 55 (the blue numbers at the top of the arc) equates to 8.9 in mmol/l (prick tests) the white numbers at the bottom of the arc.

I would suggest that your prick tests are not catching your real highs.
Do you test before each meal and snack, then 2 hours after each one? And if your numbers are high, are you doing additional tests to work out why, and how long it takes to get back to your starting level?

Unfortunately it takes intensive testing like this to provide enough info to predict where your HbA1c is going to be - and even then the predictions are often inaccurate.
OK, I was referring to my Hba1c of 55 being equivalent to 7.2% & this agrees with my overall percentage figure over 3 months of 7.13%
I tend to test every 3 days AM fasting then 2 hours after B/Fast, before Supper & then 2 hours after.
 

Bluetit1802

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OK, I was referring to my Hba1c of 55 being equivalent to 7.2% & this agrees with my overall percentage figure over 3 months of 7.13%
I tend to test every 3 days AM fasting then 2 hours after B/Fast, before Supper & then 2 hours after.

That is nowhere near enough testing to estimate an HbA1c I'm afraid.

Have a look at this - type in your 55 in the IFCC box.
https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

The box on the left is where you get the 7.2 from. This is not the same measurement units as our meters. It is the old way of measuring the HbA1c and is expressed as a percentage. The box on the right is in mmol/l (the same as our meters) and says 8.9. As this is an AVERAGE it is high and means you are missing a lot of peaks, and not accounting for how long you are high after a meal. Depending on what we have eaten, we can peak at any time from an hour after first bite to 4 hours later, and sometimes we can spike to 8 and still be at 8 an hour or two later. I think you need more intensive testing (and acting on it when necessary) if you are to get back under 48.
 

johnoo

Well-Known Member
Messages
125
That is nowhere near enough testing to estimate an HbA1c I'm afraid.

Have a look at this - type in your 55 in the IFCC box.
https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

The box on the left is where you get the 7.2 from. This is not the same measurement units as our meters. It is the old way of measuring the HbA1c and is expressed as a percentage. The box on the right is in mmol/l (the same as our meters) and says 8.9. As this is an AVERAGE it is high and means you are missing a lot of peaks, and not accounting for how long you are high after a meal. Depending on what we have eaten, we can peak at any time from an hour after first bite to 4 hours later, and sometimes we can spike to 8 and still be at 8 an hour or two later. I think you need more intensive testing (and acting on it when necessary) if you are to get back under 48.
Points taken & I will investigate.
 

johnoo

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Messages
125
Your help please!!
My regular Blood Sugar tests are showing an average of 7.75mmol/l what would this translate to when as a HbA1c reading when I go for blood test?
 

bulkbiker

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19,576
Type of diabetes
Type 2
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Your help please!!
My regular Blood Sugar tests are showing an average of 7.75mmol/l what would this translate to when as a HbA1c reading when I go for blood test?
Probably something like 48 mmol/m but if you are still only testing every 3 days than I'm afraid the figures may not be representative of much..

https://www.diabetes.co.uk/hba1c-units-converter.html

If you put 48 into the IFCC mmol/m box it gives an average of 7.8 mmol/l
 

johnoo

Well-Known Member
Messages
125
Probably something like 48 mmol/m but if you are still only testing every 3 days than I'm afraid the figures may not be representative of much..

https://www.diabetes.co.uk/hba1c-units-converter.html

If you put 48 into the IFCC mmol/m box it gives an average of 7.8 mmol/l
Many thanks.
I've tried to download the "Free Hba1C to mmol/l chart that is stated on thisd page of the web site, but nothing arrives.
Is there a problem or is it me?
 

Brunneria

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hi @johnoo

If you scroll up this page to my post above, you will find an easy conversion chart that you can copy and paste if you want.
 

bulkbiker

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Many thanks.
I've tried to download the "Free Hba1C to mmol/l chart that is stated on thisd page of the web site, but nothing arrives.
Is there a problem or is it me?
It doesn't give you the info you are looking for anyway. It is just a DCCT to IFCC conversion table nothing about average blood glucose levels.
 

Prem51

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Your help please!!
My regular Blood Sugar tests are showing an average of 7.75mmol/l what would this translate to when as a HbA1c reading when I go for blood test?
If you have a smartphone you can download the MySugr app which gives you an estimated HBa1c if you input bg readings.
 
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