HBA1C on a monthly basis?

[Prince4]

I think I know the answer, but is it permissible to have HBA1C on a monthly basis? I accidentally had my last one around 10 days from the previous one and saw a 13 point reduction, so keen to see what another month is at. I have been on Low Carb and my predictive MYSugar says that I trend in the 42 range, so would be keen to understand where I may be. Appreciate 8-12 weeks is the sweet spot but would be good to re-baseline..

I take a Accu Check several times a day and have a good grasp of my BG levels, but want it formalised through a HBA1C. I have been diagnosed with Treatment Induced Neuropathy and have also stopped taking Metformin since last test around a month ago, so keen to understand where I am at so I can understand how long these aches and tingles are going to last until. I also think my DN nurse only really takes HBA1C seriously as a metric and doesn't agree with constantly finger testing as she advised that HBA1C is the only measure that matters.

 

[ianf0ster]

If you are talking about paying privately for it, it's permissible but rather pointless since it isn't going to change much without a reason. The variability on an HbA1C test is said to be around 6%, so it is more accurate than a single finger-prick test, but less useful than a whole series of finger-prick tests.

Because of the 8 -12 weeks lifespan of red blood cells, HbA1C tests are useless for determining the effect on us of different meals, but with 2 finger-prick tests (before and 2hrs after the meal) we get personalised and immediate notification if our latest meal was good for our Blood Glucose control or if it was bad for it.

I would agree with your nurse IF you were just taking RANDOM finger pricks, But for example some factors can cause diabetics to go both quite high and fairly low during the same day much less a whole month! So their HbA1C might look perfect when the truth was that the Blood Glucose was all over the place!

 

[Prince4]

If you are talking about paying privately for it, it's permissible but rather pointless since it isn't going to change much without a reason. The variability on an HbA1C test is said to be around 6%, so it is more accurate than a single finger-prick test, but less useful than a whole series of finger-prick tests.

Because of the 8 -12 weeks lifespan of red blood cells, HbA1C tests are useless for determining the effect on us of different meals, but with 2 finger-prick tests (before and 2hrs after the meal) we get personalised and immediate notification if our latest meal was good for our Blood Glucose control or if it was bad for it.

I would agree with your nurse IF you were just taking RANDOM finger pricks, But for example some factors can cause diabetics to go both quite high and fairly low during the same day much less a whole month! So their HbA1C might look perfect when the truth was that the Blood Glucose was all over the place!

I think that's my point/question. Is it not possible to significantly impact HBA1C in 30 days?

 

[AndBreathe]

I think that's my point/question. Is it not possible to significantly impact HBA1C in 30 days?

Whilst A1c tests reflect the most recent several weeks, it is influenced by the most recent 2-3, so with significant to radical changes you could see a reflection in the numbers.

Several years ago, I bought a pack of 10 home A1c tests (which pretty much mirrored labe results for me). I bought 10 because at that moment, the additional costs from the smaller pack was very small. I did tests monthly with those.

Bearing in mind I was already in remission, the tests demonstrated my stability, rather than anything else.

In terms of the NHS testing you monthly? I doubt that would ever happen, unless there was a something compelling to drive that. By compelling, I am thinking about driving an HbA1c down in order to improve the safety of imminent elective, but necessary surgery.

 

[KennyA]

I think if you shifted from a carb-heavy to a low-carb or keto level you might see a change in A1c each month for the first few months. The result is skewed towards the recent month - Bilous and Donnelly reckon that 50% of the A1c value represents the 30 days prior to test, 40% the middle month and only 10% the initial month. And there's an assumption that your red blood cells live for 90 days. If yours live a bit longer, or not as long, all this might shift a bit.

Suppose you go from 500g carbs a day to 20g carbs/day on Jan 1st - you ought to see a "real" change in A1c for a test done at the end of January, because 50% of that test value is derived from your Bg in January.

Equally expect a "real" fall in February, because now 90% of the test value is taken from two low carb months. I wouldn't expect that much of a fall at the end of March, as you've only shifted the final 10% of the result (acceptable test error is 6% so it could cancel out)

I would not expect a significant change from end March at end April, because you're now working with a refreshed set of red blood cells that have never experienced the high BG levels you used to have. And the same would apply in following months.

Thing is, your fingerprick tests will be showing you all that progression anyway. I guess if you want to pay for it, it's your money, but lowering your A1c doesn't make you "not diabetic".

BTW The example above is pretty much my personal experience - I went from diabetic levels in January to low-normal by April. On countback, it's possible I was below the diagnostic threshold by the end of January. I was getting that sort of feedback from my fingerprick tests, and i don't see how taking further A1c tests would have helped or made a difference.

 

[Mrs HJG]

If you are spending your own money, or even my taxes I'd say investing in Libre would be more useful, less/no finger-pricking and a good view of the ups and down of your daily glucose - maybe not totally accurate to the mmol, but honestly nothing is that accurate anyway. HbA1c will not let you know if you are wildly swinging high to low or literally level as it's just an average.