Anaemia and HbA1c

[kentishmaid1234]

Hi

I was diagnosed about a month ago, along with a diagnosis of severe iron deficient anaemia. I had a very high HbA1c of 76. Very brief consultation with a diabetic nurse, which was along the lines of take metformin and have bloods tested in 3 months. Despite being told not to test blood glucose, I have been, and testing seems quite reasonable, on average just under 5 on waking to a max of 7 after meals. I have been following a lowish carb diet, as need to shift some weight.

It just seems that I would have expected my blood glucose level to have been worse, given that my HbA1c was so high at 76, and I have read some info that suggests that the HbA1c level can be artificially inflated by severe anaemia? Or is that just wishful thinking?

Thanks

 

[Rach612]

Im sorry to hear of your diagnoses. I’m no expert but I read that too and a private endro mentioned it to me as well. Did you test your levels before you started taking the metformin? Do you know did your GP do any other tests to confirm knowing of the anemia?

 

[EllieM]

Or is that just wishful thinking?

Not just wishful thinking. You could ask your doctor for a fructosamine test instead.
Type 2 diabetes diagnosis distorted through HbA1c due to anemia - Diabetes

ps And welcome to the forums.

 

[EllieM]

I have been following a lowish carb diet, as need to shift some weight.

Or it could just be that your lowish carb diet is low enough to normalise your blood sugars, and you are diabetic, though potentially with a level lower than 76 but still higher than a non diabetic's. What's your fasting bg like? That is often one of the first readings to go up if you become diabetic.

And weight gain can be a symptom of T2....

 

[kentishmaid1234]

My blood glucose on waking is generally between 4.8 and 5, which I thought was ok. I don’t know what it was before starting metformin, as I started immediately as I was so worried by the HbA1c of 76. The weight is a long long term problem, so not a symptom of T2, more the cause. I do think I’m in the diabetic range, but I do wonder if my HbA1c should be lower, and I could manage with my lowish carb diet alone. I guess I’ll wait until the 3 months, keep on the metformin, as it’s really killing my appetite, so silver linings I guess, which means I’m down a stone in a month.

 

[Resurgam]

Although my BG tests show normal levels, my Hba1c has remained at 43, even though I reduced my intake of carbs from 50 to 40 gm per day.
I have read that the correlation between Hba1c and typical blood glucose levels was not something absolute, but devised over a period of time by testing and checking - so for some people Hba1c might not be an accurate reflection of their blood glucose levels.

 

[EllieM]

I do think I’m in the diabetic range, but I do wonder if my HbA1c should be lower, and I could manage with my lowish carb diet alone.

A lot of people on these forums with hba1cs much higher than 76 have achieved normal bgs on low carb diet alone. Good luck.

 

[Oldvatr]

The HbA1c relies on your blood cells having a fairly constant lifespan, but there are other blood conditions where the lifespan is significantly less or more than the usual populace average of 3 months duration, and this affects the result too.

https://www.mlo-online.com/disease/...-red-blood-cell-lifespan-on-hba1c-measurement