HbA1c level 51mmol

[SheilaSalop]

Ok, I was diagnosed T2 about 6 months ago and have been working hard to bring my HbA1c levels down. I get my blood tested every couple of months and the Hb levels have consistently reduced and are now 51 mmol/mol. Now the test results say 'normal range : 20 - 42' but the green to red spectrum thing [which I have found on this site] puts 50 in green.

So, am I right in thinking that '50' is an OK reading or should I still be working to get my level down to the 'normal' range of between 20-42?

 

[Bluetit1802]

What you set as your personal target is up to you. These are the official ranges.

under 42 is non-diabetic
42 to 47 is pre-diabetic, or impaired glucose tolerance, or at risk of diabetes.
48 and above is diabetic.

If you are aiming for remission, then you need to be under 48 for a certain period of time, without medication.

 

[Guzzler]

I agree with @Bluetit1802 that your goal should be a personal one. My own goals are influenced by my HbA1c on diagnosis, how comfortable I am with my diet versus my present A1c and my overall well being (mentally as well as physically).

Well done on lowering your A1c, keep up the great work.

 

[SheilaSalop]

What you set as your personal target is up to you. These are the official ranges.

under 42 is non-diabetic
42 to 47 is pre-diabetic, or impaired glucose tolerance, or at risk of diabetes.
48 and above is diabetic.

If you are aiming for remission, then you need to be under 48 for a certain period of time, without medication.

OK, that is very helpful and thank you but who would decide on the 'without medication'? My GP wants me to double my does of Metformin [currently 1 tablet twice per day] and I did for a week or so but felt unwell. But why should I double my medication when I am clearly [I think] resolving my issues by diet? Heaven knows what she would say if I suggested stopping them all together!

 

[Bluetit1802]

OK, that is very helpful and thank you but who would decide on the 'without medication'? My GP wants me to double my does of Metformin [currently 1 tablet twice per day] and I did for a week or so but felt unwell. But why should I double my medication when I am clearly [I think] resolving my issues by diet? Heaven knows what she would say if I suggested stopping them all together!

You decide on the "without medication". All your doctor is supposed to do is advise. The rest is up to you. Your doctor seems to have great faith in Metformin, probably believing it is the Metformin that is the reason for your improved levels. I suspect your diet is the reason for that. Metformin is very mild and only helps to a very limited extent, mostly with morning fasting levels. Doctors do seem to regard it as a miracle drug. Really, it isn't. Diet is the key.

 

[SheilaSalop]

I agree with @Bluetit1802 that your goal should be a personal one. My own goals are influenced by my HbA1c on diagnosis, how comfortable I am with my diet versus my present A1c and my overall well being (mentally as well as physically).

Well done on lowering your A1c, keep up the great work.

Thank you Guzzler. I don't think I have had the diagnosis for long enough to get any level of stability - I am still very much learning. One of the things that drive me crazy is other people's attitude to my diet. For example, everyone seems convinced that a 'typical' breakfast eg toast and cereal if not actually good for you can't do you any harm. Consequently staying with friends can be a nightmare. And please don't get me on to what they think of the 'high fat' bit of my diet!

 

[SheilaSalop]

You decide on the "without medication". All your doctor is supposed to do is advise. The rest is up to you. Your doctor seems to have great faith in Metformin, probably believing it is the Metformin that is the reason for your improved levels. I suspect your diet is the reason for that. Metformin is very mild and only helps to a very limited extent, mostly with morning fasting levels. Doctors do seem to regard it as a miracle drug. Really, it isn't. Diet is the key.

Thanks Bluetit, all the GPs I see try really hard to get me to increase my medication - I shall continue resisting!

 

[Guzzler]

Thank you Guzzler. I don't think I have had the diagnosis for long enough to get any level of stability - I am still very much learning. One of the things that drive me crazy is other people's attitude to my diet. For example, everyone seems convinced that a 'typical' breakfast eg toast and cereal if not actually good for you can't do you any harm. Consequently staying with friends can be a nightmare. And please don't get me on to what they think of the 'high fat' bit of my diet!

I hear you, but you have your results to prove that what you are doing is paying dividends. What can't speak can't lie, as they say.

 

[Smallbrit]

What you set as your personal target is up to you. These are the official ranges.

under 42 is non-diabetic
42 to 47 is pre-diabetic, or impaired glucose tolerance, or at risk of diabetes.
48 and above is diabetic.

If you are aiming for remission, then you need to be under 48 for a certain period of time, without medication.

Hi @Bluetit1802,

I don't want to derail this thread, but does under 48 for a while really count as remission (at least in NHS eyes)? I would have thought that would be under 42?

I'm not particularly concerned either way, as life is low carb, no meds for me. It just piqued my interest as my HBA1C has been 48 and 48 three months later and it never occured to me that the GP might count me in remission if I continued to stay at those numbers (or at least if I lowered them by 1!).

 

[Bluetit1802]

Hi @Bluetit1802,

I don't want to derail this thread, but does under 48 for a while really count as remission (at least in NHS eyes)? I would have thought that would be under 42?

I'm not particularly concerned either way, as life is low carb, no meds for me. It just piqued my interest as my HBA1C has been 48 and 48 three months later and it never occured to me that the GP might count me in remission if I continued to stay at those numbers (or at least if I lowered them by 1!).

The criteria used by Prof Taylor et al, and the criteria used at my surgery, is under 48 for a certain period of time. However, the international standards are:

Following international standards [1,2] a person goes into diabetes remission when the following conditions are fulfilled:

1. Had a diagnosis of diabetes
2. Fasting Serum Glucose (FSG) is less than 100 mg/ml (5.6mmol/l)
3. HbA1c is less than 6.0% (42mmol/dL)
4. There is no active hypoglycemic therapy (either pharmacological or surgical)

We define three levels of remission:

• Initial. When the conditions are fulfilled for three months
• Complete. When the conditions are fulfilled for one year
• Operational cure. When the conditions are fulfilled for five years or mor

So take your pick. My GP has coded me as "diabetes resolved" and back dated this to June 2014 when I had my first HbA1c under 48. It was 46. I know he is wrong, with the coding (should be in remission), the 46, and the back dating. He did this without any discussion, but who am I to argue. I am still on the eye screening register and still see my nurse for annual reviews, and still have 6 monthly blood tests.

 

[T2#Me]

Thank you Guzzler. I don't think I have had the diagnosis for long enough to get any level of stability - I am still very much learning. One of the things that drive me crazy is other people's attitude to my diet. For example, everyone seems convinced that a 'typical' breakfast eg toast and cereal if not actually good for you can't do you any harm. Consequently staying with friends can be a nightmare. And please don't get me on to what they think of the 'high fat' bit of my diet!

Yes, the old "one piece of toast can't hurt" perception ... very trying ... I usually ask Would you offer an alcoholic one little drink? I shudder to remember my own misconceptions about diabetics before I became one ... forgive them, they know not what they do :smile:

 

[Daphne917]

Yes, the old "one piece of toast can't hurt" perception ... very trying ... I usually ask Would you offer an alcoholic one little drink? I shudder to remember my own misconceptions about diabetics before I became one ... forgive them, they know not what they do :smile:

However a piece of toast may be ok for some people - I have high protein bread about 3-4 times a week which is 10g carbs per slice and does not increase my BS. I have a slice toasted with my eggs or I make a sandwich with one slice but loaded with filling. @SheilaSalop are you testing your BS?

 

[Resurgam]

I was peeved to have my Hba1c come back as 42 when I got 41 the time before - I'm just that sort who has to get the gold star.
When under 42 is normal I have to aim for that, just not diabetic simply isn't good enough so it will niggle all year.
I do know that I am not spiking, so it is not an average with lows counteracting highs but a fairly straight line graph, as far as I can tell from using test strips, which is less concerning.
I do eat bread, but it is eithter the very low very strange Polish protein bread or the stuff I make myself with lots of extra fibre added to make my normal recipe as low carb as possible.