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Newly diagnosed - big change in HBA1c

B

Barneymarney

Member
Messages
13
Hi

My HBA1c (is that right?) has gone from 46 last august to 107 this month. I have been described as atypical type 2.

I am monitoring and seem to have got the levels under control...

However - the doctor still hasn’t got an answer on how 46 becomes 107 in 8 months...

I have an ultrasound to check the pancreas on Friday, but I am anxious it’s something nasty... particularly given how health care professionals seem incredulous about the move from 46 to 107.

Anyone had similar experience?
 
Have they done any tests for T1?
 
How often are you monitoring your BG levels? Unless that result is wrong (& bloods do get muddled up!) then you must be having results in the teens more regularly than not.
 
Mine was similar. Something has caused your blood sugars to spike out of the park. But if it were a very low c-peptide (3-month average insulin), like mine, then chances are that you would struggle to normalise your HBa1c with just diet, which you appear to have done?
 
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What is a typical days food for you?

If you are a type 2 - not a misdiagnosised type 1 or LADA - then the answer may well lie in what you eat
 
Circuspony said:
How often are you monitoring your BG levels? Unless that result is wrong (& bloods do get muddled up!) then you must be having results in the teens more regularly than not.
Click to expand...

Since the diagnosis I have been doing BG pre/post meals every day (around 6 times). Since changing my medication I have over the last 4-5 days frequently had single-digit readings, so we seem to have that under control. I wondered about wrong result, but I have also had a 107 from a 2nd test
 
HSSS said:
What is a typical days food for you?

If you are a type 2 - not a misdiagnosised type 1 or LADA - then the answer may well lie in what you eat
Click to expand...

My diet is good (though too much alcohol which I have pretty much cut out). I weigh 78 kg, around 12st 3 (but have lost 1st this year, 6kg, unexplained as I wasn’t trying).
 
ert said:
Mine was similar. Something has caused your blood sugars to spike out of the park. But if it were a very low c-peptide (3-month average insulin), like mine, then chances are that you would struggle to normalise your HBa1c with just diet, which you appear to have done?
Click to expand...

Yes, this is my concern, my doctor seems baffled, I saw a nurse yesterday, she was baffled; so I am deeply concerned they’re looking for something much more sinister by doing ultrasound on the pancreas; the pancreatic cancer signals (unexplained weight loss and recent diabetes diagnosis - though I don’t have juandice) is scaring the beejesus out of me
 
Barneymarney said:
My diet is good (though too much alcohol which I have pretty much cut out). I weigh 78 kg, around 12st 3 (but have lost 1st this year, 6kg, unexplained as I wasn’t trying).
Click to expand...
Good by what standard? Typical nhs recommendations are often really poor for type 2. Do you eat bread, rice, potatoes, pasta, cereals, oats, flour, lots of fruit and juices? These all are “recommended “ but are terrible for blood sugar levels for many of us.

And not all type 2 are fat lazy slobs as the media portrays. Though rapid unexplained weight loss could indicate type 1.

Barneymarney said:
Since the diagnosis I have been doing BG pre/post meals every day (around 6 times). Since changing my medication I have over the last 4-5 days frequently had single-digit readings, so we seem to have that under control. I wondered about wrong result, but I have also had a 107 from a 2nd test
Click to expand...
Do you mean diagnosed this month or last August? What figures were you getting before the meds change?

What meds were you on and which now? It would be helpful to finish completing your profile to add the meds as it helps people consider your situation accurately.
 
If one subscribes to the glucose overflow hypothesis championed by Dr. Fung, this apparent sharp rise probably isn’t all that surprising. 46 is already elevated and could easily have been rising quickly at that time. It’s not impossible to imagine it reaching triple figures in 8-9 months. Particularly if bad dietary advice had been given to counter the first test.

Or of course it could indicate an insulin deficiency.
 
Jim Lahey said:
If one subscribes to the glucose overflow hypothesis championed by Dr. Fung, this apparent sharp rise probably isn’t all that surprising. 46 is already elevated and could easily have been rising quickly at that time. It’s not impossible to imagine it reaching triple figures in 8-9 months. Particularly if bad dietary advice had been given to counter the first test.

Or of course it could indicate an insulin deficiency.
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Thanks Jim

There was no particular change in lifestyle. Given that my numbers are better since including medicine to stimulate the pancreas to produce more insulin I wonder if it's the latter.
 
Barneymarney said:
Thanks Jim

There was no particular change in lifestyle. Given that my numbers are better since including medicine to stimulate the pancreas to produce more insulin I wonder if it's the latter.
Click to expand...
how did they confirm it was type 2 not type 1? Did they do c peptide and gad tests? If not are your drs intending to do more tests regarding insulin insufficiency? Ie establish if you are type 1/LADA or not? Id be asking for them if not in your shoes so they could direct the appropriate long term treatment with certainty not guesses.

I understand that in the short term at least pancreas stimulating drugs will effect lower numbers exactly as intended - until they don’t. Because more insulin for a type 2 can make the fundamental problem of insulin resistance worse in the long term.

Are you able (willing) to give us some idea of your diet? This could help rule it in or out as a factor and as I keep saying in type 2 it is the biggest factor we can control. As Jim said if you were given poor advice last year then a rise, potentially a large one, is almost to be expected.
 
Sorry I will start again
Inflammation can cause rise in BG levels, have you had any infections/ colds/ fever or other bugs, just before your last test
 
HSSS said:
how did they confirm it was type 2 not type 1? Did they do c peptide and gad tests? If not are your drs intending to do more tests regarding insulin insufficiency? Ie establish if you are type 1/LADA or not? Id be asking for them if not in your shoes so they could direct the appropriate long term treatment with certainty not guesses.

I understand that in the short term at least pancreas stimulating drugs will effect lower numbers exactly as intended - until they don’t. Because more insulin for a type 2 can make the fundamental problem of insulin resistance worse in the long term.

Are you able (willing) to give us some idea of your diet? This could help rule it in or out as a factor and as I keep saying in type 2 it is the biggest factor we can control. As Jim said if you were given poor advice last year then a rise, potentially a large one, is almost to be expected.
Click to expand...


Hi

Diet is good - cereals for breakfast, lunch invariably something fresh, dinners home made from scratch.

Since diagnosis - refined further - only wholewheat cereals (no sugar), all the usuals on food - wholewheat pasta, brown rice, no sugars outside fruit, never had sugar in tea/coffee... snacking on unsalted nuts, boiled eggs.

From a diet perspective beer was an issue - cut out almost completely.

In terms of c-peptide - yep, had the result this week - ‘normal’
 
HSSS said:
Good by what standard? Typical nhs recommendations are often really poor for type 2. Do you eat bread, rice, potatoes, pasta, cereals, oats, flour, lots of fruit and juices? These all are “recommended “ but are terrible for blood sugar levels for many of us.

And not all type 2 are fat lazy slobs as the media portrays. Though rapid unexplained weight loss could indicate type 1.


Do you mean diagnosed this month or last August? What figures were you getting before the meds change?

What meds were you on and which now? It would be helpful to finish completing your profile to add the meds as it helps people consider your situation accurately.
Click to expand...

Hiya

Will do profile now... diagnosed this month.

Typical numbers (before change in meds):

Pre breakfast - low teens
2hrs Post breakfast - high teens
Before evening meal - probably 10-ish
Post - v. High teens

Since change 13/5 (last 6 days):

Pre Breakfast - high 9.6, low 7.3
Post b/fast - high 17, low 7.0 (7, 8.2, 9.5 last 3 days)
Pre-lunch - low 4.6, hi 7.6
Post lunch - hi 12.6, low 8.6
Pre evening - hi 12.8, low 4.8
Post eve - hi - 15.7, low 8.3

meds before change (from 3/5/19):

- metformin - 500MG after breakfast / after evening meal

Meds after (from 13/5/19)

- 2 x 1000mg modified release - with evening meal
- 1 x 25mg Alogliptin daily
 
Barneymarney said:
Hiya

Will do profile now... diagnosed this month.

Typical numbers (before change in meds):

Pre breakfast - low teens
2hrs Post breakfast - high teens
Before evening meal - probably 10-ish
Post - v. High teens

Since change 13/5 (last 6 days):

Pre Breakfast - high 9.6, low 7.3
Post b/fast - high 17, low 7.0 (7, 8.2, 9.5 last 3 days)
Pre-lunch - low 4.6, hi 7.6
Post lunch - hi 12.6, low 8.6
Pre evening - hi 12.8, low 4.8
Post eve - hi - 15.7, low 8.3

meds before change (from 3/5/19):

- metformin - 500MG after breakfast / after evening meal

Meds after (from 13/5/19)

- 2 x 1000mg modified release - with evening meal
- 1 x 25mg Alogliptin daily
Click to expand...
 
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