Second Hb1Ac result need a bit of help here!

[6cats]

Diagnosed 28th February 16 with an Hb level of 135, second test in late April 75 and results today of 48. Routine app to see GP first time since February, 4 weeks wait! My average BG test is 6.6 so how do I get an Hb level of 48? According to the 500 shades of diabetes with an average of 6.6 the Hb should be lower!?!? Will it continue to drop if I carry on as I am? How might this affect drugs - 1500 Met and 40 Gliclazide? Four weeks is a long time to wait! Any comments besides the appallingly long wait to see my GP!

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[Lamont D]

Diagnosed 28th February 16 with an Hb level of 135, second test in late April 75 and results today of 48. Routine app to see GP first time since February, 4 weeks wait! My average BG test is 6.6 so how do I get an Hb level of 48? According to the 500 shades of diabetes with an average of 6.6 the Hb should be lower!?!? Will it continue to drop if I carry on as I am? How might this affect drugs - 1500 Met and 40 Gliclazide? Four weeks is a long time to wait! Any comments besides the appallingly long wait to see my GP!

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I
The hba1c test is what has happened to your bloods for the past three months, that is why it is slightly higher than the fasting blood test average you are now showing.

If you continue to take the glicizide, then your bloods will keep dropping, ever down, you do need to talk about your meds to your GP! H will probably suggest you can stop taking the glicizide and lower your metformin.
Really good second hba1c test results!

And yes!
Four weeks is a joke!

If I thought complaining would help but it won't!
Bloody Tories!

 

[walnut_face]

I dont know too much but, there is a tollerance for accuracy of meters, search around and you will find folks using 2 different devices and getting readings >1.0 mmol apart. Depending on what you are doing diet wise the ball is in your court. If you carry on exactly then you BS will find their level, and you might already be there. So to go lower you may have to adjust diet again.

But give yourself a grand pat on the back 48 is the top end of pre-diabetic readings and to come down from 135 is truly remarkable in such a short time. I would also put a chat about reducing meds high I the agenda. (If your Dr is still alive )

 

[Bluetit1802]

Hi, that is a wonderful drop. You should be delighted. Well done. Please don't be disappointed with that.

What is your 6.6 an average of? Is it an average of all readings from fasting right through to bedtime, including before all meals and at half hourly or hourly intervals after each meal until you are back to where you started? I'm afraid that unless we test zillions of times a day our meter averages won't necessarily give you the equivalent HbA1c. An A1c of 48 is equivalent to an average of 7.7mmol/l so it could be you are missing your peak levels after meals.

There are also other reasons why an HbA1c is higher (or lower) than expected such as strange haemoglobin corpuscles, various forms of anaemia, high or low glycation rates to name a few.

What make of meter are you using? Some makes need converting to read the same as plasma blood (many meters only read the whole blood). The Codefree and Accu Chek Mobile read the same as plasma blood. If yours doesn't, then you need to use the converter because the HbA1c is plasma blood which is 12% higher than whole blood.

http://www.diabetes.co.uk/whole-blood-readings-to-plasma-converter.html

 

[6cats]

Thank you all, will have a look. X

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[sud5nala]

My average BG test is 6.6 so how do I get an Hb level of 48? According to the 500 shades of diabetes with an average of 6.6 the Hb should be lower!?!?

Because there are two aspects to excessive glucose: before a meal, and once eating or drinking starts. A person can have disparity between the two -- they are not expected to be on a par. It's possible to be too high in either one or in both.

By "average BG test" it's not certain that you meant fasting BG test, although that's what people usually mean.

Fasting BG of 6.6 mmol/L is not really disparate to A1c of 48 because the 48 is the lowest value for declaring diabetes, while the 6.6 is close to the threshold for declaring diabetes by that test (the criterion is >= 7.0).

Well done on reducing A1c from 135, to 75, to 48 within 6 months! A1c of 47 down to 42, and fasting plasma glucose (FPG) 6.9 or less, are defined as prediabetes.

 

[chalup]

My average reading has been about 6 and when I got my A1c results it was 6.7% WHAT???? Turns out my meter is reading a full mmol below what it actually is. Still better than the 10.4% that it was 3 months ago. Good job on bringing your numbers down.

 

[6cats]

I think we are all doing well. I still find it so hard at times. We have just broken up from school and I found it very difficult. All I wanted to.do.was snack! At least at school you can't do that. First long school holiday since diagnosis si another phase to get through In guess!!!!!

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[Jasperville]

6cats, you have done absolutely brilliantly!

I have always followed this conversion.................

Hba1c Average BG

6.0 (42) 7.0
6.5 (48) 7.8
7.0 (54) 8.6
7.5 (60) 9.4
8.0 (66) 10.2

Your Hba1c reading is mainly a reflection of your recent BG control, but will still reflect a little bit how you were 3-4 months ago. Best estimate is that of your Hba1c reading, about 50% of it is from the last month, 25% from the previous month, and 25% from 2-4 months ago.

Hba1c of 48 (6.5) suggests average BG of 8.0......................so that could be average of 6.6 for last 2 months, but about 12.0 before that.

Hope that makes sense.

Bear in mind that an Hba1c of 135 at the start meant that your average BG at diagnosis was 19.2, so you were probably swinging between 10 and 25 most of the time................you've been on a hell of a journey in just 2 months!

 

[6cats]

Thank for explaining this, all so complicated still. That makes much more sense, ask and somebody has an answer LOL. If I carry on the way I have been will I continue to reduce the Hb1 result? I am loosely doing LCHF? It has been difficult so much to give up but I confess to have odd treat now and again. Thank you so much for your explanation. X

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[Jasperville]

Hi 6cats,

I think if your "average" BG stays at about 6.6, and you don't go above 8 too often after meals, I would expect your hba1c to be around 42 (6.0) or even a little lower if you get it checked again in a couple of months time.

But 48 is still brilliant - most doctors are delighted with this. It is mainly the dedicated and experienced low carbers on these forums who are aiming much lower. Even if your Hba1c stays around 48, you will have dramatically reduced your risk of complications, but no harm aiming for even lower. I want to join the 5% club (Hba1c of 5 point something, or <42), but need to stop the little treats which have been creeping in.