HbA1c and diagnosis

[Hendie]

Hi, if one has been on a very low carb diet and 0 sugar for about 4 years their HbA1c results will be normal. So how would you be able to get a diagnosis ? and what would the treatment be ?

Whenever i eat sugars and carbs i get quite high spikes 10+ my symptoms worsen i need to pee alot ect ect but then they come back down again and then i dont eat sugars/carbs for as long as possible.

Thanks

 

[borofergie]

You probably wouldn't

A Glucose Tolerance Test would show it, but I don't know how many GPs would send you for one of those if your BG and HbA1C readings check out.

But then lots of 10+ mmol/l spikes would adversely influence your HbA1C too.

 

[Hendie]

You probably wouldn't

A Glucose Tolerance Test would show it, but I don't know how many GPs would send you for one of those if your BG and HbA1C readings check out.

But then lots of 10+ mmol/l spikes would adversely influence your HbA1C too.

Well this is the situation i am at at the minute, but i got my GP to send me for a GTT result which came back as follows

Fasting 5.4
30 Min after solution 12.5
1 hour after solution 10.5
1:30 hour after 10.0
2 hours later 7.4

I've not been to my follow up appointment yet as its only in one weeks time (gp went on holiday for 2 weeks) So im just wondering what medication to ask for, i guess metformin and diet ? and also i would like to try and figure whats going on!

The 10+ spikes are very rare as i have yeast infection aswell as diabates and the symptoms are just too much if i eat carbs/sugars.

Thanks

 

[RussG]

HbA1c is not recommended for diagnosing diabetes. The current criteria are:

Diabetes symptoms (ie polyuria, polydipsia and unexplained weight loss) plus

a random venous plasma glucose concentration › 11.1 mmol/l
or
a fasting plasma glucose concentration › 7.0 mmol/l (whole blood › 6.1mmol/l)
or
two hour plasma glucose concentration › 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).

2. With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting or random values are not diagnostic the two hour value should be used

Impaired Glucose Tolerance (IGT)* is a stage of impaired glucose regulation (Fasting plasma glucose ‹ 7.0 mmol/ and OGTT two hour value › 7.8mmol/l but ‹ 11.1 mmol/l).

Source: http://www.diabetes.org.uk/About_us...ations/New_diagnostic_criteria_for_diabetes_/

 

[Hendie]

So it seems i have Impaired Glucose Tolerance or very close as mine was 7.4 and it says 7.8> possibly from insulin resistance.

How would i go gettng a diagnosis for inslulin resistance ?

 

[Hendie]

I just found this about insulin resistance
http://en.wikipedia.org/wiki/Insulin_re ... #Diagnosis

If anybody has any expierence about it, would be appreciated.

 

[Sanober]

Hi Hendie,

I'm in a similar HbA1c range as you this is what happened.

Last year I started to need to pee a lot, but more so in the night I thought my Interstitial Cystitis had returned. I always had the need to drink water more than people I know, and when I got hungry I just HAD to eat or I would become very moody and listless...I did have the 'foggy head' but ignored it because I thought it was from getting up at night to pee so I was tired.

They did a urine test in Nov and said my glucose was slightly raised and asked if there Diabetes in the family (both parents are T2) They told me I would needed to be checked out further. My GP wrote to me to come in and the nurse did a fasting glucose test and an HbA1c in Dec, my GP also took blood for everything because I told him I was just generally feeling under the weather.

And they did fasting glucose and Hba1c in March. Because I was over the 6 mark both times this was their basis for a diagnosis of Diabetes.

You can see my HbA1c results and dates below.

A c-peptide test can be done regarding insulin (but it can come up normal) BUT it just tells you that you're producing insulin - it doesn't confirm how much of it is being used up. I had this done and it was normal.
I don't think this is a standard test they offer to all people that they're testing for Diabtetics, they did it to me as I don't fit the 'standard criteria for T2' i.e normal BMI, weight and age is 34. If someone has extra weight it's assumed that there's fat around the internal organs and this contributes to insulin resistence - this is what the specialist has told me.

So it still doesn't tell me why my insulin is not helping my glucose get into my cells, but at this stage I'm not overproducing insulin so I suppose because my overall control is regarding as good control...I don't know, they don't really know. It's a waiting game for me.

I too have looked to see what other tests they do to tell you're Diabetic the above two sets of the above two glucose ones are routine (I live in Scotland so don't know if it's different elsewhere).

I don't personally understand the GTT test to be honest. I've never been offered it and I've never asked. Through self testing I know how my glucose changes before and after eating.