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Reliability of HbA1c results

Wurst

Wurst

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1,129
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Germany
Type of diabetes
Type 1
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Insulin
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Not one to brag but I've got 4.9 % HB1AC again , last one (3 months ago) was 4.9 %. Previous to that I've been 5.0 % most of the time.

For first 4.9% result 3 months ago, I put lots of effort in i.e. extra exercise careful with everything I ate , very low carb etc etc. This time around I've done the opposite, In fact I would not class myself as a low carber anymore and have been eating all kinds of **** in evening, when I'm more sensitive to insulin.

So how accurate are these HB1AC results ? Our meters/ test strips have a 80 - 90 % accuracy rate in most cases is the same for HB1AC tests?
 
Provided your bg levels are still under control when you eat '****' in an evening then it would have little effect on your Hba1c result, perhaps the reason why your a1c hasn't gone up is because you are more knowledgeable now and know how to adjust your insulin accordingly, this happens when you pay close attention to your diabetes over a time and you learn what effect particular types of food have on your bg levels.
 
Of course I attempt to control my levels when eating '****' (smarties, chocolate bars etc), it would be suicidal otherwise . I was always led to believe a good HB1AC was unattainable unless a strict low carb diet was followed so I am surprised more than anything.

I was actually going to quit the '****' and go back to a strict low carb (< 30 gramms per day) if my HB1AC was over 5.5 % after today's appointment, but no need now.
 
Wurst said:
Of course I attempt to control my levels when eating '****' (smarties, chocolate bars etc), it would be suicidal otherwise . I was always led to believe a good HB1AC was unattainable unless a strict low carb diet was followed so I am surprised more than anything.
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Well we have members on this forum who have type 1 diabetes and don't follow a low-carb diet and have Hba1c's in the 5's & 4's, I do think if you know what effect food has on your bg levels and you know how to bolus around it then you can include carbs in your diet without them being detrimental to your overall bg control.

Like you when I first came to the forum I went low-carb but gradually increased them as I began to pay closer attention to my bg levels and after receiving some good advice on this forum, from the net/books and from education course that I attended, I don't eat high carb but keep things in moderation but I don't eat sweets unless they are to treat a hypo, but well done Wurst and hope your good progress continues.
 
Hi. Don't forget that be it T1 or T2, your own insulin proudction can vary from person to person and over time. If it's not too low then it is easier to achieve a good Hba1C without injecting too much.
 
Wurst said:
Of course I attempt to control my levels when eating '****' (smarties, chocolate bars etc), it would be suicidal otherwise . I was always led to believe a good HB1AC was unattainable unless a strict low carb diet was followed so I am surprised more than anything.

I was actually going to quit the '****' and go back to a strict low carb (< 30 gramms per day) if my HB1AC was over 5.5 % after today's appointment, but no need now.
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And that's why it's important people understand that there is NOT just one way to eat. It particularly concerns me when new members are bombarded with advice all weighted towards low carbing. I have absolutely no problem with low carbing. But I DO have a problem with people who say it's the only way to control Type 1. It may be for THEM, but one size doesn't fit all and other people can control their diabetes in different ways.

I don't low carb and my HbA1C is 28 (4.7). I too try to limit the '****' for health reasons, but I eat cake and chocolate in moderation, and carbs like cereal, rice, pasta, etc.

Congratulations on your great HbA1C result :)

( and I've had diabetes for more than 20 years so I doubt I'm making much insulin of my own now sadly)
 
azure said:
I don't low carb and my HbA1C is 28 (4.7). I too try to limit the '****' for health reasons, but I eat cake and chocolate in moderation, and carbs like cereal, rice, pasta, etc.
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Nice HBA1C result Azure. I was strict low carbing for almost 3 years so now it's good to know I don't have endure that diet for the rest of my life :-)
 
I think its pretty reliable. You can try to check yourself by averaging your meters readings - when i make a 'report' on my Freestyle Insulinx meter it spits out an 'estimated HbA1c' from the readings it has in its memory, and that has always been very close to what the Lab tells me.

I personally do not follow a 'diet' - I try not to get fat, and i try to keep my sugars in the target range - but you can eat whatever you want in any quantity as long as you keep control of your sugars. You could do a 3 month Cake diet and get an A1c in the 5's if you injected properly.

I think the biggest factor in a low A1c is how quickly a person corrects for high sugars. If you test before and after a meal, and you spike but correct it in 2 hours then you will likely have good numbers on your A1c. If you don't correct until your next meal 4 or 5 hours later, and then go high after that meal too you will have terrible numbers. This

is what a lot of people do - They test and inject, then end up going high but don't test again until the next meal and realize it so they correct and eat and inject again, but still end up above target but don't test until bed time or 5 hours later and are still high so they correct, and go low, and then over correct the low and end up high again. Which ends with an A1c thats high, obviously.

Small post meal spikes that last 1-2 hours, don't effect your A1c as much as you might think because if you spend the other 20 hours in target range, over 3 months that has less and less effect.
 
That isn't always so, Diamattic. My A1c just went up over three months in which two different kind of figs I kept, including a CMG, showed a consistent fall in mean BG. So I really do know my mean BG has fallen by about 0.5 mmol. But the A1c went up by two points. Admittedly not a lot.

As to why, one reason could be that hemoglobin cells apparently live longer if they're not heavily glycated, so they might have had more time to glycate.

Another possibility is that some people glycate at a lower or higher level than most. That would be more worrying for me.
 
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