HbA1c normal

[rebowe1308]

Hi
Just wondering if anyone can offer some advice?
I was diagnosed type 2 middle of January with HbA1c of 96 !
Was put on 4 x metformin slow release and was due my 1st blood test and review in april. Obviously with covid this never went ahead.
When diagnosed I found this group and still use it for guidance on a daily basis. I have been on a very low carb diet had no bread pasta rice ever since diagnosis. Make all my own low carb alternatives etc.
Anyhow, 5 weeks ago I finally had my blood test and have been calling my surgery weekly to be told the results hadn’t come back and that a diabetic nurse would call me when they had as to arrange a review.
I test my blood sugars throughout the day every day and my estimate HbA1c is between 5.6/5.7
Today I had a call from the receptionist to say that my results were back and said they were normal, I asked her to elaborate to which she told me I could go and collect a print out. I have just collected the print out which states I am 39 mmol and says non diabetic range.
I asked if I could book and appointment with diabetic nurse to be told that she is inundated at the moment and working through all the reviews.
I gradually stopped taking my metformin back at the end of May due to the sickness etc that it was causing and didn’t feel I could call my gp surgery as they haven’t been the best. I haven’t taken any metformin since the first week of June.
Anyhow, after that long story, I was someone would be able to give some advice on whether I would now be considered as non diabetic as that is what it says on the print out ?
Thanks
Becky

 

[ianf0ster]

Hi rebowe1308,
Firstly huge congratulations!

This probably isn't a big issue for you but the standard for diagnosis of Diabetes in the UK is 2x Hba1C tests of over 48 mmol.
Did you have 2 tests (about a month apart) or just the one?
If you had 2 then you were officially T2D and since it is generally accepted to be incurable even though it can be kept in permanent remission by lifestyle, then a diabetic always a diabetic!
The advantages of being diabetic (but in remission) are:
1. free prescriptions.
2. Free annual tests for diabetic retinopathy and neuropathy ( eye and foot checks).

If you had the 2 HbA1C tests reading of over 48 mmol and you care about the 'benefits' of being classed as diabetic, then you should contact your GP surgery about getting/keeping you classified as such.

 

[Andydragon]

Hi rebowe1308,
Firstly huge congratulations!

This probably isn't a big issue for you but the standard for diagnosis of Diabetes in the UK is 2x Hba1C tests of over 48 mmol.
Did you have 2 tests (about a month apart) or just the one?
If you had 2 then you were officially T2D and since it is generally accepted to be incurable even though it can be kept in permanent remission by lifestyle, then a diabetic always a diabetic!
The advantages of being diabetic (but in remission) are:
1. free prescriptions.
2. Free annual tests for diabetic retinopathy and neuropathy ( eye and foot checks).

If you had the 2 HbA1C tests reading of over 48 mmol and you care about the 'benefits' of being classed as diabetic, then you should contact your GP surgery about getting/keeping you classified as such.

congratulations @rebowe1308

You do not get free prescriptions if you are diet only. I would also say there are no advantages to being diabetic. At all

as you say, You are always diabetic, you have just controlled to keep your levels under control. Reverse the way of living and it will come back

I also am surprised you have to have 2 hba1c readings. Surely one significantly high enough will mean you have some form of diabetes? I was diagnosed over a decade ago but it was definitely on the basis of a single test

 

[Alexandra100]

I have just collected the print out which states I am 39 mmol and says non diabetic range.

Yes, 39 is considered "normal" in the UK. From 42 to 47 is classed here as pre-diabetic. 48+ diabetic. However, in the US pre-diabetes starts at 38.8. Some people here have managed to get their A1cs down from diabetic to well below 38 and I wish I could emulate them. Sadly, despite eating VLC (20-30g carbs daily) I can't. You will have to decide for yourself what numbers to aim for. Most GPs just blindly follow the WHO guidelines.

 

[sno0opy]

Depends on surgery. Most require at least two tests at lower then 42. Mine said two annual tests so it would be two years for me. I have had three tests this year at 33 or below and they won't even "let me" drop the Metformin heh

 

[Resurgam]

I am officially in remission after bouncing along the top edge of normal Hba1c for a couple of years. I only had one test to be declared diabetic, at a level of 91 there was little point in a retest.
I think it very much depends on your surgery and GP as to how you are treated.

 

[HSSS]

Hi rebowe1308,
Firstly huge congratulations!

This probably isn't a big issue for you but the standard for diagnosis of Diabetes in the UK is 2x Hba1C tests of over 48 mmol.
Did you have 2 tests (about a month apart) or just the one?
If you had 2 then you were officially T2D and since it is generally accepted to be incurable even though it can be kept in permanent remission by lifestyle, then a diabetic always a diabetic!
The advantages of being diabetic (but in remission) are:
1. free prescriptions.
2. Free annual tests for diabetic retinopathy and neuropathy ( eye and foot checks).

If you had the 2 HbA1C tests reading of over 48 mmol and you care about the 'benefits' of being classed as diabetic, then you should contact your GP surgery about getting/keeping you classified as such.

Two tests are not required if there are clear diabetic symptoms and the second could also be a blood glucose test.

Free prescriptions (only after receiving applying for and receiving an exemption card) only applies if you are a medicated diabetic. Diet treatment alone does not qualify. Annual checks such as hb1ac, feet and retinopathy should continue when in remission.

 

[Nicole T]

I've recently received my exemption card. I understand it's valid for 5 years, regardless of whether I continue to be prescribed diabetes medicine. I didn't even have to ask for it. The form was part of the bundle that the diabetes nurse gave me, along with the Metformin prescription that I never filled.

So if you have the card, you can continue to use it until the expiry date. If you never got one, then you'll probably struggle to get one now, if you don't have any diabetes meds on prescription.

 

[HSSS]

I've recently received my exemption card. I understand it's valid for 5 years, regardless of whether I continue to be prescribed diabetes medicine. I didn't even have to ask for it. The form was part of the bundle that the diabetes nurse gave me, along with the Metformin prescription that I never filled.

So if you have the card, you can continue to use it until the expiry date. If you never got one, then you'll probably struggle to get one now, if you don't have any diabetes meds on prescription.

Well if you feel ok doing that it’s your call. Personally I wouldn’t if I never took the medication, especially if I never even filled the prescription . The nhs is cash strapped enough as it is even if this is legal

 

[Nicole T]

Well if you feel ok doing that it’s your call. Personally I wouldn’t if I never took the medication, especially if I never even filled the prescription . The nhs is cash strapped enough as it is even if this is legal

And me saving a tenner on antibiotics twice a year is going to make all the difference? Furthermore, the NHS has been ripping me off for years on my antibiotics. They're about £7 a course retail (probably £5 to the NHS) but inaccessible over the counter to me, so I've no way of getting them without paying whatever the current prescription fee happens to be. I'm lucky in that my prescriptions are now 56 tablets. There was a time when I used to get 14 or 28 for the same money.

And let's not get started on the fact that NHS negligence back in 1968 is why I need regular antibiotics in the first place.

So I'm happy to use (but not abuse) this with a perfectly clear conscience. I think I've been out of work for a total of 3 weeks in the last 32 years. I put my fair share into society, and HMRC takes every penny it thinks it's entitled to from me. I don't think I should be paying the "Ha-ha, you live in England" tax in the first place. If I lived in Northern Ireland, Scotland or Wales, I'd be getting free prescriptions without needing an exemption certificate.

 

[HSSS]

And me saving a tenner on antibiotics twice a year is going to make all the difference? Furthermore, the NHS has been ripping me off for years on my antibiotics. They're about £7 a course retail (probably £5 to the NHS) but inaccessible over the counter to me, so I've no way of getting them without paying whatever the current prescription fee happens to be. I'm lucky in that my prescriptions are now 56 tablets. There was a time when I used to get 14 or 28 for the same money.

And let's not get started on the fact that NHS negligence back in 1968 is why I need regular antibiotics in the first place.

So I'm happy to use (but not abuse) this with a perfectly clear conscience. I think I've been out of work for a total of 3 weeks in the last 32 years. I put my fair share into society, and HMRC takes every penny it thinks it's entitled to from me. I don't think I should be paying the "Ha-ha, you live in England" tax in the first place. If I lived in Northern Ireland, Scotland or Wales, I'd be getting free prescriptions without needing an exemption certificate.

I can see your points and the fact that it’s hard to argue with many of them.

 

[rebowe1308]

Hi rebowe1308,
Firstly huge congratulations!

This probably isn't a big issue for you but the standard for diagnosis of Diabetes in the UK is 2x Hba1C tests of over 48 mmol.
Did you have 2 tests (about a month apart) or just the one?
If you had 2 then you were officially T2D and since it is generally accepted to be incurable even though it can be kept in permanent remission by lifestyle, then a diabetic always a diabetic!
The advantages of being diabetic (but in remission) are:
1. free prescriptions.
2. Free annual tests for diabetic retinopathy and neuropathy ( eye and foot checks).

If you had the 2 HbA1C tests reading of over 48 mmol and you care about the 'benefits' of being classed as diabetic, then you should contact your GP surgery about getting/keeping you classified as such.

Hi
I had 2 test 2 weeks apart in January 1st was 96 2nd was 88

 

[rebowe1308]

Depends on surgery. Most require at least two tests at lower then 42. Mine said two annual tests so it would be two years for me. I have had three tests this year at 33 or below and they won't even "let me" drop the Metformin heh

Thanks for the reply. Hopefully I will get to speak to diabetic nurse soon about the results.
May get in trouble for stopping the metformin 3 months ago !

 

[HSSS]

May get in trouble for stopping the metformin 3 months ago !

Your body your choice. You are not a child. They are not your teacher or mother!

 

[Robbity]

You do not get free prescriptions if you are diet only. I would also say there are no advantages to being diabetic.

You do if you're an OAP: all prescriptions are actually free then regardless of whether you are a diabetic on meds or not.... One of the main advantages of being an ancient, decrepit, diet only T2, IMO.

 

[Andydragon]

You do if you're an OAP: all prescriptions are actually free then regardless of whether you are a diabetic on meds or not.... One of the main advantages of being an ancient, decrepit, diet only T2, IMO.

Well yes, there are free prescriptions if you are on certain benefits, live in certain parts of the UK, are a certain age etc. Where NHS prescriptions apply and you are diet only diabetic as your only condition then you do not get free prescriptions.

 

[KK123]

And me saving a tenner on antibiotics twice a year is going to make all the difference? Furthermore, the NHS has been ripping me off for years on my antibiotics. They're about £7 a course retail (probably £5 to the NHS) but inaccessible over the counter to me, so I've no way of getting them without paying whatever the current prescription fee happens to be. I'm lucky in that my prescriptions are now 56 tablets. There was a time when I used to get 14 or 28 for the same money.

And let's not get started on the fact that NHS negligence back in 1968 is why I need regular antibiotics in the first place.

So I'm happy to use (but not abuse) this with a perfectly clear conscience. I think I've been out of work for a total of 3 weeks in the last 32 years. I put my fair share into society, and HMRC takes every penny it thinks it's entitled to from me. I don't think I should be paying the "Ha-ha, you live in England" tax in the first place. If I lived in Northern Ireland, Scotland or Wales, I'd be getting free prescriptions without needing an exemption certificate.

Hi Nicole, I understand exactly where you are coming from and I sympathise greatly BUT you are either entitled to free prescriptions or you are not regardless of whether you have an in date exemption card. Every time you pick up your prescription and present that card or sign the form you are telling them you are entitled to free prescriptions. If a person is not then it's fraud pure and simple. I mention this not as a rebuke to you (only you can make a decision as to whether you think you are entitled) but as info for anyone else tempted to defraud the NHS. x

 

[bulkbiker]

and you are diet only diabetic as your only condition then you do not get free prescriptions.

That's kind of logical as you won't use any prescriptions in your scenario anyway?

 

[Nicole T]

Hi Nicole, I understand exactly where you are coming from and I sympathise greatly BUT you are either entitled to free prescriptions or you are not regardless of whether you have an in date exemption card. Every time you pick up your prescription and present that card or sign the form you are telling them you are entitled to free prescriptions. If a person is not then it's fraud pure and simple. I mention this not as a rebuke to you (only you can make a decision as to whether you think you are entitled) but as info for anyone else tempted to defraud the NHS. x

Morally, or legally entitled?

Morally, like I say, this government takes every penny it feels it's entitled to from me. I have no qualms in taking back what I'm allowed. The fact that only people in England pay prescription fees (and people in Northern Ireland, Scotland and Wales do not) is also a hideously unfair system. Morally, speaking.

So that just leaves legally...

Sadly, I didn't keep the covering letter, but someone has kindly scanned it and posted it here: https://www.diabetes.co.uk/forum/th...ming-off-meds-for-diabetes-temporarily.76453/

It expressly states that the certificate is valid for 5 years, even if the holder's medical condition changes. My NHS treatment plan for my condition is Metformin. The fact that I've chosen not to take the medication doesn't negate the fact that it was prescribed. I did not even request the certificate. The application form was given to me by the nurse, as part of a whole bundle of diabetes related documentation, and I was advised that free prescriptions were one of the (few) perks of being diabetic.

So I do not believe I am committing any kind of fraud by using this certificate to obtain free prescriptions, up to its expiry date. It was not obtained under false pretences (I was intending to use the Metformin at the time I completed the form) and it seems there is no mechanism for it to be revoked before its expiry. If, in 5 years time, I'm still controlling my diabetes by diet alone, there's a good chance my GP will not be prescribing me diabetes meds and I will have to start paying again.

Of course I could fill my Metformin prescription and lie to my GP that I'm using it. But I think I would feel guilty about that.

 

[KarenGG]

Hi
Just wondering if anyone can offer some advice?
I was diagnosed type 2 middle of January with HbA1c of 96 !
Was put on 4 x metformin slow release and was due my 1st blood test and review in april. Obviously with covid this never went ahead.
When diagnosed I found this group and still use it for guidance on a daily basis. I have been on a very low carb diet had no bread pasta rice ever since diagnosis. Make all my own low carb alternatives etc.
Anyhow, 5 weeks ago I finally had my blood test and have been calling my surgery weekly to be told the results hadn’t come back and that a diabetic nurse would call me when they had as to arrange a review.
I test my blood sugars throughout the day every day and my estimate HbA1c is between 5.6/5.7
Today I had a call from the receptionist to say that my results were back and said they were normal, I asked her to elaborate to which she told me I could go and collect a print out. I have just collected the print out which states I am 39 mmol and says non diabetic range.
I asked if I could book and appointment with diabetic nurse to be told that she is inundated at the moment and working through all the reviews.
I gradually stopped taking my metformin back at the end of May due to the sickness etc that it was causing and didn’t feel I could call my gp surgery as they haven’t been the best. I haven’t taken any metformin since the first week of June.
Anyhow, after that long story, I was someone would be able to give some advice on whether I would now be considered as non diabetic as that is what it says on the print out ?
Thanks
Becky

By any chance did you have a full blood count too? My hba1c is ‘great’ but I’m anaemic so you can forget the a1c till that is sorted! My last a1c was 47 after a hospital one of 72 but now I have other issues they are trying to sort anaemia is giving the false result but I’m under care of specialist diabetic team at the hospital because my diabetes followed DKA, sepsis and being very unwell. Can you try and get FBC that will help