Help making sense of blood sugar test results

[Bergy10]

Hi there everyone. Just had some weird results over the last few months I wanted to get some ideas about. Not sure if I am prediabetic or non-diabetic.

So as a background, I've never watched my sugar intake in the past, or anything related to it. I've had periods where I've cut carbs to lose some weight over the years but never for the purpose of blood glucose as I've only had fasting blood sugars taken and they'd always been in the 90s.

Anyways, back in December i requested some bloods from the clinic at my workplace, vitamin levels etc and they all came back normal but I noticed something called hb1ac which I never tested before that was aooarently outside the reference range at 5.8%. I only know this test because my mum had been diagnosed with type 2 in her 60s recently and she tests this every few months.

This 5.8 scared me but I wasn't fully surprised given I've never worried about diabetes before or ever watched out for what I ate outside of weight loss diets once every few years. Im usually in the 90s for weight and am 6'2".

Anyways, so after getting this shock I start reducing my sugar intake, completely cut out chocolate, sweets, and any of those super high carb, empty calorie foods to both lose weight and reduce my sugar intake. Also started playing football once a week for a few hours.

I went from 97kg down to about 90kg and on April 7th I had my annual checkup at work. The clinic took our regular bloods and everything and I asked them specifically to add the hb1ac test as it's not usually done. Expecting it to have gone down, turns out they said it's now 6.3%. I was gobsmacked, and believed I had full blown diabetes at this stage. Went home and changed my diet completely to chicken fillet and vegetable soup for a week.

I decided I needed a second opinion, I went to a hospital to see a doctor with the results. She couldn't understand why, after losing weight, exercising, and moderately reducing my sugar intake, that the numbers would go up. She checked the cbc and other blood tests and said if they were off it could affect the results but they were all normal. So she asked me to redo the hb1ac at the hospital. The result came back 5.5 on April 18th. I saw her again and asked if it was because of my diet the last week, and she said it won't have that big an effect as it is a 3 month average and that there must be something wrong with my workplace clinics test. She also said it lines up with my weightloss, change in eating habits and increased activity levels.

Went back to the workplace and asked them to repest the test to be certain (as they gave my my first 5.8 in december, and the latest 6.3 in April). They agreed, and the result came back 5.8 on April 22nd.

Now I have 4 test results, 3 from my clinic at my workplace, and 1 from a hospital. 3 of which came in the space of 2 weeks.

December (work clinic) - 5.8%
April 7 (work clinic) - 6.3%
April 18 (hospital) - 5.5%
April 22 (work clinic) - 5.8

So now I don't know whether I am prediabetic, not prediabetic, or what and which test is correct.

I subsequently bought myself a blood glucose meter (onetouch verio) and have been testing myself out. I been eating almost no carbs for the last few weeks and my sugar levels are between 75 and 95 during the day before I eat (I have been fasting for ramadan) and between 85 and 100 after meals at both the 1 hour and the 2 hour marks. When I eat a few more carbs, eg couple slices of brown bread, a slowcooked gourmet burger (with the buns and sauces included), i get upto around 120ish and back down to 105ish at the 1 hour and 2 hour marks.

I had a meal today, that was almost made completely of a large number of carbs and sugar (made completely of flour etc), I was at the following numbers following tests at:

30 mins after from first bite: 166
Repeat test at 35mins after first bite: 150
1 hour after first bite: 121
2 hours after first bite: 150,

The 2 hour test looked high so I repeated it 4 more time in the next 5-10 or so mins after washing hands each time:
1st repeat test 141,
2nd repeat 126,
3rd repeat 120,
4th repeat 126,
Final test at 2 hours 40 mins after first bite: 119

Anyways, after my hb1ac test at the hospital my doctor tell me not to bother testing and that I'm fine and as long as I manage my weight, stay active and reduce my carbs that I'm ok and that I don't need to reduce my carb intake as much as I did recently as for the last month I've eaten almost exclusively chicken breast fillet and vegetable soup. She told me to just continue what I was doing between December and April, which was a reduction in junkfood like chocolate, sweets etc, but I still had regular meals with pasta, rice, brown bread etc.

So my three questions, after this looooong post (sorry for the length) is the following:

1) Which of those Hb1ac tests do we thunk us correct and dies that make me non diabetic, prediabetic, or literally on the edge close to a diagnosis?
2) Do my test results after this carb and sugar loaded meal suggest there is a problem with my body to regulate sugar levels indicating insulin resistance/diabetes?
3) Should I keep testing on a regular basis, or is my doctor right and I should not bother and just wait every 3 months to redo thr ub1ac to check on progress (although this last question to me feels like I should do it in any case)?

Thanks again everyone

 

[jape]

Keep in mind that all tests have a measurement error factor (albeit relatively small).

I would consider the 6.3% on Apr 7th as a probable outlier. As the aic is an average measurement over 3 months, the drop of 0.5% over just 2 weeks seems tho be a little suspect from a statistical perspective.

 

[Dark Horse]

This American site says, "For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have prediabetes and a higher chance of getting diabetes. Levels of 6.5% or higher mean you have diabetes." https://www.webmd.com/diabetes/guid...t diabetes, the,higher mean you have diabetes.

However, it is generally best to look at the ranges quoted by the laboratory that did the tests as there can sometimes be some variation between laboratories.

 

[catinahat]

30 mins after from first bite: 166
Repeat test at 35mins after first bite: 150
1 hour after first bite: 121
2 hours after first bite: 150,

The 2 hour test looked high so I repeated it 4 more time in the next 5-10 or so mins after washing hands each time:
1st repeat test 141,
2nd repeat 126,
3rd repeat 120,
4th repeat 126,
Final test at 2 hours 40 mins after first bite:

Your poor fingers must have been so sore with all that jabbing but you didn't do the most important one. If you don't know what your level is before you eat its difficult to get any useful information from the post meal numbers.
For example. If pre meal you tested at say 85 (4.7mmol) and at 2 hours 150 (8.3 mmol ) then you would know that the meal had to many carbs for you to process.
If on the other hand the pre meal was something like 110 (6. 1 mmol) then a rise of just 40 (2.2mmol) at the 2hr mark would mean that you just about handled the carbs, maybe think about a smaller portion next time.
The other thing you need to be aware of is the accuracy of the meters, the industry standard is +/- 15%
If you look at the extra 4 tests you did they ranged from 141 to 126 (7.8 - 6.9 mmol) that's just 1mmol variance in UK units and can easily be explained by the +/-15. Even the HbA1c has a margin of error, 6% I think.
Whatever your final diagnosis, looking at your levels I would be avoiding high carb meals in the future.

 

[BravoKilo]

Hi there everyone. Just had some weird results over the last few months I wanted to get some ideas about. Not sure if I am prediabetic or non-diabetic.

So as a background, I've never watched my sugar intake in the past, or anything related to it. I've had periods where I've cut carbs to lose some weight over the years but never for the purpose of blood glucose as I've only had fasting blood sugars taken and they'd always been in the 90s.

Anyways, back in December i requested some bloods from the clinic at my workplace, vitamin levels etc and they all came back normal but I noticed something called hb1ac which I never tested before that was aooarently outside the reference range at 5.8%. I only know this test because my mum had been diagnosed with type 2 in her 60s recently and she tests this every few months.

This 5.8 scared me but I wasn't fully surprised given I've never worried about diabetes before or ever watched out for what I ate outside of weight loss diets once every few years. Im usually in the 90s for weight and am 6'2".

Anyways, so after getting this shock I start reducing my sugar intake, completely cut out chocolate, sweets, and any of those super high carb, empty calorie foods to both lose weight and reduce my sugar intake. Also started playing football once a week for a few hours.

I went from 97kg down to about 90kg and on April 7th I had my annual checkup at work. The clinic took our regular bloods and everything and I asked them specifically to add the hb1ac test as it's not usually done. Expecting it to have gone down, turns out they said it's now 6.3%. I was gobsmacked, and believed I had full blown diabetes at this stage. Went home and changed my diet completely to chicken fillet and vegetable soup for a week.

I decided I needed a second opinion, I went to a hospital to see a doctor with the results. She couldn't understand why, after losing weight, exercising, and moderately reducing my sugar intake, that the numbers would go up. She checked the cbc and other blood tests and said if they were off it could affect the results but they were all normal. So she asked me to redo the hb1ac at the hospital. The result came back 5.5 on April 18th. I saw her again and asked if it was because of my diet the last week, and she said it won't have that big an effect as it is a 3 month average and that there must be something wrong with my workplace clinics test. She also said it lines up with my weightloss, change in eating habits and increased activity levels.

Went back to the workplace and asked them to repest the test to be certain (as they gave my my first 5.8 in december, and the latest 6.3 in April). They agreed, and the result came back 5.8 on April 22nd.

Now I have 4 test results, 3 from my clinic at my workplace, and 1 from a hospital. 3 of which came in the space of 2 weeks.

December (work clinic) - 5.8%
April 7 (work clinic) - 6.3%
April 18 (hospital) - 5.5%
April 22 (work clinic) - 5.8

So now I don't know whether I am prediabetic, not prediabetic, or what and which test is correct.

I subsequently bought myself a blood glucose meter (onetouch verio) and have been testing myself out. I been eating almost no carbs for the last few weeks and my sugar levels are between 75 and 95 during the day before I eat (I have been fasting for ramadan) and between 85 and 100 after meals at both the 1 hour and the 2 hour marks. When I eat a few more carbs, eg couple slices of brown bread, a slowcooked gourmet burger (with the buns and sauces included), i get upto around 120ish and back down to 105ish at the 1 hour and 2 hour marks.

I had a meal today, that was almost made completely of a large number of carbs and sugar (made completely of flour etc), I was at the following numbers following tests at:

30 mins after from first bite: 166
Repeat test at 35mins after first bite: 150
1 hour after first bite: 121
2 hours after first bite: 150,

The 2 hour test looked high so I repeated it 4 more time in the next 5-10 or so mins after washing hands each time:
1st repeat test 141,
2nd repeat 126,
3rd repeat 120,
4th repeat 126,
Final test at 2 hours 40 mins after first bite: 119

Anyways, after my hb1ac test at the hospital my doctor tell me not to bother testing and that I'm fine and as long as I manage my weight, stay active and reduce my carbs that I'm ok and that I don't need to reduce my carb intake as much as I did recently as for the last month I've eaten almost exclusively chicken breast fillet and vegetable soup. She told me to just continue what I was doing between December and April, which was a reduction in junkfood like chocolate, sweets etc, but I still had regular meals with pasta, rice, brown bread etc.

So my three questions, after this looooong post (sorry for the length) is the following:

1) Which of those Hb1ac tests do we thunk us correct and dies that make me non diabetic, prediabetic, or literally on the edge close to a diagnosis?
2) Do my test results after this carb and sugar loaded meal suggest there is a problem with my body to regulate sugar levels indicating insulin resistance/diabetes?
3) Should I keep testing on a regular basis, or is my doctor right and I should not bother and just wait every 3 months to redo thr ub1ac to check on progress (although this last question to me feels like I should do it in any case)?

Thanks again everyone

Well done on the weight loss!
Re your question,
(1) All are “correct” …. but potentially inaccurate (“incorrect”! ). There are measurement errors in HbA1c, which are not well quantified; a quick search shows 5% variation not uncommon. So December and April measurements far enough apart to be different, but would expect April ones to be consistent, which they are ( 5.5 & 5.8 consistent from different labs, 5.8 & 6.3 from the same clinic (same lab? ) plausible but I would suspect the 6.3
Others have mentioned the cut off criteria - the labels are somewhat arbitrary - it’s a continuous spectrum, so you are straddling one of the boundary points ( with the 5.5 and 5.8)
On (3)
HbA1c is an average of haemoglobin over a number of weeks / months ( up to 3 but weighted to most recent weeks) , and can maps to average Bg in different ways in different people. You will get much more insight into your own blood sugar levels by measuring, eg when fasting/ waking, before meal, then 1, 2, hrs etc after a meal .
It will take a few weeks for any change in diet /exercise etc to be reflected in your HbA1c

 

[Ronancastled]

Now I have 4 test results, 3 from my clinic at my workplace, and 1 from a hospital. 3 of which came in the space of 2 weeks.

December (work clinic) - 5.8%
April 7 (work clinic) - 6.3%
April 18 (hospital) - 5.5%
April 22 (work clinic) - 5.8

There are certain blood conditions that can give false HbA1c results, anemia being one, perhaps look into that.
Nobody goes from 6.3 to 5.5 in the space of a week.

The home test you're doing all look fine.
Perfectly normal results.