HBA1C up from 38 - 54 in 9 months

knowlestr

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nice and easy one. been feeling particularly low for a number of months - sore throat, achy eyes, lack of energy. Approached my GP and pushed for a blood test -. my last HBA1C came back as 38 (Jan 2019), this last was 54, the GP says that no action is required, but surely that is not the case. I have no improved over the last few weeks - unable to complete basic physical exercise, always tired
 

Goonergal

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I’m an unmedicated type 2 so can’t offer any direct experience, but if you give some more information others might be better placed to help.

Has anything else changed? Your profile mentions metformin and sitagliptin. Are those still your medications? Has the dosage or anything else changed? Have you changed your diet?

If none of these have changed, have you explored with the GP/nurse about further investigations that might shed light on your symptoms in case they’re not diabetes related.

I would have thought that kind of rise in HbA1c in a relatively short period would warrant at least some further investigation.

Hope you get to the bottom of it.
 

DJC3

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nice and easy one. been feeling particularly low for a number of months - sore throat, achy eyes, lack of energy. Approached my GP and pushed for a blood test -. my last HBA1C came back as 38 (Jan 2019), this last was 54, the GP says that no action is required, but surely that is not the case. I have no improved over the last few weeks - unable to complete basic physical exercise, always tired

That does seem a fairly quick rise if nothing about your diet or lifestyle has changed much. You say you pushed your GP for a blood test, but was it just HbA1c? I’d go back and explain your symptoms again and ask for further tests.
Hope you feel better soon though.
 

Antje77

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You have your information set as T1.5. Does that mean you are a confirmed T1 (LADA)? If so, I would want to see an endo, as GP's are usually not well versed in treating T1.
 

Daibell

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What medication if any are you having? What is your BMI? May be you have another undiagnosed medical condition?
 

Diakat

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Are you testing blood sugars yourself? Have you seen a rise?
 

knowlestr

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Type of diabetes
Type 1
Treatment type
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all.

thanks for the comments.

Taking some of the comments in reverse order.

Diakat - yes i am self testing - finger pricking- every morning, it has been rising but the GP is not interested, he comments that these are only indicators and that the only true test is the HBA1C, which is why we pushed for it. Today (13 Nov) i had 14.1mmo/l

Daibell - i am on Metformin - 4 tablets per day (200mg) and Sitagliptin (1 x 500mg). Vitality Corporate Health care reported 25.9 for the BMI. this last few weeks I have had a cold and blocked sinuses, and yes I have had my Flu vaccine.

Antje77 - they settled on T1 LADA as they are certain it was not T2 (my HBAIC at that point was 38). Now it is 54 but in the words of the GP - 'you are still in the range ' so there is nothing to worry about. he has T1 's and T2's on his books but has never mentioned T1 LADA. Great bed side manner but....

DJC3, Goonergal -he says that he discussed the blood test results - had a range taken - with colleagues and that there were no issues of concerns noted in the results. so to there mind - no further action.

as noted above, my finger prick test hit a high of 14.1 today - has been in double figures for a week now.
 
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Diakat

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I’d be testing more than just the once a day and making an appointment to ask for insulin.
 

Antje77

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they settled on T1 LADA as they are certain it was not T2 (my HBAIC at that point was 38). Now it is 54 but in the words of the GP - 'you are still in the range ' so there is nothing to worry about.
As a LADA it is fully expected to need insulin at some point. This sounds like a good moment to start looking into that.
 

knowlestr

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Messages
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Type of diabetes
Type 1
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As a LADA it is fully expected to need insulin at some point. This sounds like a good moment to start looking into that.
that was my thought but I have a resistant GP who has no interest in that approach - wants only to review again in the New Year
 

knowlestr

Member
Messages
18
Type of diabetes
Type 1
Treatment type
Insulin
I’d be testing more than just the once a day and making an appointment to ask for insulin.
tried the multi testing - not helped the inability of the local pharmacy (within the GP surgery ) to provide test strips - keep supplying beta ketone not Optium. - last ketone test (not today) was 0.2 so will need to check that also. I have contacted the diabetes specialist at the local NHS trust (no the one that the GP surgery is associated with)
 
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Millie74

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Hi. Sorry. Didn’t know how to start a new thread. I am having the GAD and C peptide test next week. I haven’t been told to fast or come off metformin, but forgot to ask the GP. Does anyone have any idea? It’s to see if I am LADA. Thanks.
 

Antje77

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Hi. Sorry. Didn’t know how to start a new thread. I am having the GAD and C peptide test next week. I haven’t been told to fast or come off metformin, but forgot to ask the GP. Does anyone have any idea? It’s to see if I am LADA. Thanks.
No need to fast. For GAD it doesn't make a difference, for C-peptide they take in account it's a non fasting test. Metformin shouldn't affect either test.

To start a new thread, click on 'Forums', select the forum you'd like to post in, for instance 'Ask a question' and use the green 'Post new thread' button at the top (right).
This works on PC or phone, but not sure if you use the app.
 

Millie74

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217
No need to fast. For GAD it doesn't make a difference, for C-peptide they take in account it's a non fasting test. Metformin shouldn't affect either test.

To start a new thread, click on 'Forums', select the forum you'd like to post in, for instance 'Ask a question' and use the green 'Post new thread' button at the top (right).
This works on PC or phone, but not sure if you use the app.
 

Antje77

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Thanks. I use my phone. Thanks for the information regarding the test. Will be good to have a firm diagnosis.
I hope yours will be firmer than mine!
I had my GAD come back negative and my C-peptide inconclusive (slightly below low-normal). My internist and I debated testing further for other antibodies, as GAD are not the only ones, but in the end we decided to go for a T1 stamp based on 'circumstantial evidence'.
Good luck!
 
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Millie74

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I hope yours will be firmer than mine!
I had my GAD come back negative and my C-peptide inconclusive (slightly below low-normal). My internist and I debated testing further for other antibodies, as GAD are not the only ones, but in the end we decided to go for a T1 stamp based on 'circumstantial evidence'.
Good luck!
 

Millie74

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Messages
217
Interesting. The GP told me if not LADA I will be sent back to the diabetic nurse to try more T2 drugs. If LADA will be referred to a consultant at the hospital for possible insulin. Not sure what to expect. Will wait and see. Was diagnosed in Jan with HBA1C of 96mmol. Only got it down to 52 mmol, then 56mmol on low carb (under 20g). I am 44 years, slim and active as teach dance. The nurse keeps telling me she doesn’t think I produce enough insulin. So asked GP for this test before trying all type 2 drugs. I tried Jardiance, but it’s not suitable on low carb so stopped.
 
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Antje77

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The nurse keeps telling me she doesn’t think I produce enough insulin. So asked GP for this test before trying all type 2 drugs.
The C-peptide test will tell you if you have an absolute shortage of insulin, regardless of positive or negative GAD test. I think that's the most important part.

My history is a bit different, as I started insulin under my GP care very soon after diagnosis, and had been on a basal/bolus regime with very good results for 2 years before even asking for a test and a switch to hospital care by a specialist.
So the test didn't have an impact on my treatment. Even if they had decided I wasn't T1, anybody would have had a hard time takin my insulin away from me, as it obviously works very well for me.
I have been on gliclazide for a short time, and in combination with lowering my carbs it never gave me a number below 10 so I practically begged for insulin after a month
 
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Millie74

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The C-peptide test will tell you if you have an absolute shortage of insulin, regardless of positive or negative GAD test. I think that's the most important part.

My history is a bit different, as I started insulin under my GP care very soon after diagnosis, and had been on a basal/bolus regime with very good results for 2 years before even asking for a test and a switch to hospital care by a specialist.
So the test didn't have an impact on my treatment. Even if they had decided I wasn't T1, anybody would have had a hard time takin my insulin away from me, as it obviously works very well for me.
I have been on gliclazide for a short time, and in combination with lowering my carbs it never gave me a number below 10 so I practically begged for insulin after a month