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[Foligno]

I understand HbA1c gives an average reading of blood sugar levels over 2 to 3 months. If someone doesn't eat while at work 9 to 5, and then eats in the evening to compensate. And their HbA1c results are 48 . Does it mean blood sugar levels are controlled well, or is the result misleading. KR M

 

[Melgar]

@Foligno The HbA1c is a straightforward test. It doesn't differentiate what time of day you eat. If, for example, you are eating 150 g of carbs a day, even if it is in a single meal, you are still eating 150 g in a day. If you are eating roughly 150 g per day and your HbA1c result is 48 mmol/l mols then you are eating too many carbs for your lifestyle. That is how I see it. I often skip lunch, but I don't make up for the missed lunch. Others may have a different view.

 

[lovinglife]

I sort of agree & disagree with @Melgar, my HbA1c is 47 never been able to get it lower in 16 years and I’m diet only, I consider that I do have good control, I eat 3 meals a day but less than 20g carb in my whole day. Never more than 8g in any one meal, I have no more wriggle room other than to go full carnivore which I don’t think I could do and I really don’t think it would bring my numbers down much more

But @Melgar is correct in what the HbA1c is, you can’t cheat it.you don’t say how many carbs you are eating in that meal but if you are eating a lot of carbs in that one meal, (not eating between 9 & 5 or even longer is fine, lots of people eat OMAD way - one meal a day) then then you have much more room to reduce your HbA1c by reducing your carbs in that meal. If like me you eat a minimal amount of carbs then it will be harder to reduce your HbA1c

Do you test with a meter before and after meals to see if what you are eating your body is coping with?

The holy grail of remission or reversal isn’t doable for many many people and all you can do is your best to be the best you can be

 

[ianf0ster]

@Foligno An HbA1C of 48 is the internationally recognised cut off level for Diabetes, so it should not be thought of as the target for Blood Glucose. Where we can, it is better, if possible, to get the HbA1C below 48 or even 42 which in the UK is considered the starting level for pre-diabetes (but the USA standards have this at 37).
HbA1C measures the amount of red blood cells which have had glucose attached to them and so gives an approximation for how high the blood glucose is on average, but since this can be influenced by both too high and too low blood glucose, it has its limitations.

In my opinion having long(er) gaps between meals is beneficial, even if the same quantity of carbs is consumed, because that gives the body a break from high levels of insulin which also reduces hunger and allows the use of body fat for energy.
So, whether I have 1 or 2 meals per day I still consume around the same amount of calories and carbs.

 

[KennyA]

I understand HbA1c gives an average reading of blood sugar levels over 2 to 3 months. If someone doesn't eat while at work 9 to 5, and then eats in the evening to compensate. And their HbA1c results are 48 . Does it mean blood sugar levels are controlled well, or is the result misleading. KR M

It's not an average. It counts the number of glycated red blood cells at the point of test - cells that have had a glucose molecule attached. As the cells live around three months, this gives an estimate of what the level of blood glucose has generally been in the last few weeks, with a huge skew towards the most recent month. There's also a level of error in the test (as there is for all such tests) and the true figure could be a bit higher or lower than 48.

If someone has had an HbA1c result of 48 that is a long way out of normal range and at the point where that person would be diagnosed as diabetic, although a second test would probably be need to be done as confirmation. See the attached graph, which relates to people who are not diabetic. Almost everyone is between 35 and 41.

The times when people eat are to my mind probably less important than what people eat. Skipping lunch, but eating loads of carbs in the evening, doesn't make the evening carbs vanish. What those of us who are restricting carb aim for is restricting overall intake, usually calculated daily, rather than reducing a single meal.

 

[Foligno]

@Foligno An HbA1C of 48 is the internationally recognised cut off level for Diabetes, so it should not be thought of as the target for Blood Glucose. Where we can, it is better, if possible, to get the HbA1C below 48 or even 42 which in the UK is considered the starting level for pre-diabetes (but the USA standards have this at 37).
HbA1C measures the amount of red blood cells which have had glucose attached to them and so gives an approximation for how high the blood glucose is on average, but since this can be influenced by both too high and too low blood glucose, it has its limitations.

In my opinion having long(er) gaps between meals is beneficial, even if the same quantity of carbs is consumed, because that gives the body a break from high levels of insulin which also reduces hunger and allows the use of body fat for energy.
So, whether I have 1 or 2 meals per day I still consume around the same amount of calories and carbs.

Thank you for detailed and helpful response. KR Michael

 

[Foligno]

It's not an average. It counts the number of glycated red blood cells at the point of test - cells that have had a glucose molecule attached. As the cells live around three months, this gives an estimate of what the level of blood glucose has generally been in the last few weeks, with a huge skew towards the most recent month. There's also a level of error in the test (as there is for all such tests) and the true figure could be a bit higher or lower than 48.

If someone has had an HbA1c result of 48 that is a long way out of normal range and at the point where that person would be diagnosed as diabetic, although a second test would probably be need to be done as confirmation. See the attached graph, which relates to people who are not diabetic. Almost everyone is between 35 and 41.

The times when people eat are to my mind probably less important than what people eat. Skipping lunch, but eating loads of carbs in the evening, doesn't make the evening carbs vanish. What those of us who are restricting carb aim for is restricting overall intake, usually calculated daily, rather than reducing a single meal.

Thank you for detailed and helpful response. KR Michael