Reactive Hypoglycemia HbA1c of 31 and T2 Diabetic

[OranjeDan]

Good day All,

I have been diagnosed as Type 2 diabetic but my latest HbA1c is 31mmol/mol (5%).

Is this in any way possible? All I have read before is that a HbA1c of pre-diabetes is 42mmol/mol!

The diabetes diagnosis is from a OGTT after a 48 hr fast which they say went up to 12.8 mmo/L

I suffer from Hypoglycaemic incidents about 5 or 6 times per year.

Any advice, thoughts for a confused diabetic?

Kind regards to all,

Dan

 

[sally and james]

People eating a low carb diet are advised to "carb up" before an OGTT. If your body isn't expecting carbs/sugars, it won't be ready and primed to deal with them, giving a misleading high reading. You were on a 48 hour fast, which is, of course, very low carb. I wonder if this could have affected your result?
HbA1c is usually the way in which T2 diabetes is diagnosed. Your result is definitely not diabetic, unless you have some blood issues (anaemia) which can produce inaccuracies.
I would go back to the doctor and ask a few questions.
sally

 

[OranjeDan]

I have been back to my GP with a paper that details all of the above. My GP is also not convinced I am diabetic. The endocrinology Consultant is the one relegating the HbA1c second to the fasting OGTT and diagnosing Type 2 diabetes. I am not overweight (BMI of 23.7). It is puzzling.

 

[Member496333]

If you're having hypoglycaemic episodes then these will swing the HbA1c downwards. It's a mean average and cannot measure highs and lows.

Oh and welcome.

 

[Freema]

well, one can have an eating style that causes lower HbA1c because of eating low carb...

but if one does start to eat the usual way as one did before like at the time one was diagnosed one would most times end up just as diabetic as initially..

I did do all the things initially I could to get rid of diabetes; like losing excess weight, doing endurance exercises and resistance exercises and eating 1000 calories daily (kind of lower carb also)... and my lowest was HbA1c 34...

the last 4 month I did lose control and over the last year I.5 have gained almost all that I lost, I am now close to the prediabetic/ diabetic levels again..
I do believe that my ca. 8 kg gained muscle weight is the reason I am not fully diabetic again now... but well have once again started my low calory eating style to lose weight again.. .. but at least I didn't stop exercising

 

[Freema]

by the way many type 2 diabetics did have unstable blood sugar levels before their diagnosis. I had that problem even 15 years before becomming fully type 2 diabetic

 

[Freema]

Good day All,

I have been diagnosed as Type 2 diabetic but my latest HbA1c is 31mmol/mol (5%).

Is this in any way possible? All I have read before is that a HbA1c of pre-diabetes is 42mmol/mol!

The diabetes diagnosis is from a OGTT after a 48 hr fast which they say went up to 12.8 mmo/L

I suffer from Hypoglycaemic incidents about 5 or 6 times per year.

Any advice, thoughts for a confused diabetic?

Kind regards to all,

Dan

but there is also a chance that you are right and do not have type 2 ...

 

[Lamont D]

Hi and welcome to the forum.
A fasting test is normal procedure if the doctors are looking for anything other than T2 in a glucose tolerance test.
I have Reactive Hypoglycaemia, but I was not diagnosed from a two hour glucose tolerance test, or from a Hba1c test.
To get a true diagnosis of RH, there is a few elimination tests to show that it is not other conditions, including a extended OGTT, which can last up to five hours. It is what happens after the two hours that is important in diagnosing RH.
You can have Hypoglycaemic episodes as symptoms due to a number of factors, for instance, drugs that intentionally lower blood glucose levels.
Type two patients can have RH.
My Hba1c is normal, my fasting levels are normal. But because of intolerance to certain foods, my levels can become diabetic, if I lose control of my blood glucose levels. Symptoms of RH, will show diabetic levels when eating the wrong foods for quite a while. I was diagnosed with T2 Initially because I had high glucose levels, I also had high insulin levels. My blood glucose levels would swing from normal to high , then drop rapidly, then go high again after eating, then drop again. And so on.
For instance, after porridge in the morning, no milk just water, I could reach double figures easily, depending on portion size.
Have you had any other tests?
Are you on meds?
Have you any intolerance or allergies with food?
What dietary advice have you had?

We have a sub forum with great information about RH. Do read and ask questions if you want to.

Best wishes

Good day All,

I have been diagnosed as Type 2 diabetic but my latest HbA1c is 31mmol/mol (5%).

Is this in any way possible? All I have read before is that a HbA1c of pre-diabetes is 42mmol/mol!

The diabetes diagnosis is from a OGTT after a 48 hr fast which they say went up to 12.8 mmo/L

I suffer from Hypoglycaemic incidents about 5 or 6 times per year.

Any advice, thoughts for a confused diabetic?

Kind regards to all,

Dan

 

[OranjeDan]

Thanks all for your thoughts.

I am now taking Metformin which is helping level out my peaks (max I have seen 90mins after eating 9.3mmo/L before I started Metformin). Now maxing out at around 6.4mmo/L 90 mins after eating with Metformin.

Between meals it does drop to around 4.4mmo/L. I don’t know what is a normal range with Metformin.

Again, thanks for your response.

Kind regards to all,

Dan

 

[queenie 1957]

Thanks all for your thoughts.

I am now taking Metformin which is helping level out my peaks (max I have seen 90mins after eating 9.3mmo/L before I started Metformin). Now maxing out at around 6.4mmo/L 90 mins after eating with Metformin.

Between meals it does drop to around 4.4mmo/L. I don’t know what is a normal range with Metformin.

Again, thanks for your response.

Kind regards to all,

Dan

Hi OrangeDan I had a Hbca1c test done last Thursday the 5th and as yet have had no results do you or anyone know how long it usually takes for the results to come back please ?

 

[bulkbiker]

Hi OrangeDan I had a Hbca1c test done last Thursday the 5th and as yet have had no results do you or anyone know how long it usually takes for the results to come back please ?

Mine are usually online within a couple of days of having the blood taken.
I'm guessing it will depend on where the blood analysis is done. For me in Worthing its at the local hospital and they are pretty speedy. Your could maybe ring your surgery and ask although there's a chance the phone lines might be quite congested at the moment.

 

[queenie 1957]

Mine are usually online within a couple of days of having the blood taken.
I'm guessing it will depend on where the blood analysis is done. For me in Worthing its at the local hospital and they are pretty speedy. Your could maybe ring your surgery and ask although there's a chance the phone lines might be quite congested at the moment.

Thank you so much bulkbiker .. was thinking of phoneing GP but didn't want to appear needy as its my first test I think I can leave it a few more days and give them a call .. thanks again

 

[Bernie11064]

Good day All,

I have been diagnosed as Type 2 diabetic but my latest HbA1c is 31mmol/mol (5%).

Is this in any way possible? All I have read before is that a HbA1c of pre-diabetes is 42mmol/mol!

The diabetes diagnosis is from a OGTT after a 48 hr fast which they say went up to 12.8 mmo/L

I suffer from Hypoglycaemic incidents about 5 or 6 times per year.

Any advice, thoughts for a confused diabetic?

Kind regards to all,

Dan

Hi dan

That’s seems normal to me I’m having similar issues myself I’ve been fasting keto diet and stop taking metformin doc did annual check up and my fasting am blood sugar high 8.8 but I’ve been testing it and it’s normal during the day and 2hrs after food
This am 8.2 knocked breakfast back to 1pm 2 eggs 2 bacon 2 sausage 16.5 hours fast after 2hrs 6.5
I do keto and fast read this article but I’m struggling to convince my doctor

https://www.dietdoctor.com/the-dawn-phenomenon

Good luck

 

[bulkbiker]

Thank you so much bulkbiker .. was thinking of phoneing GP but didn't want to appear needy as its my first test I think I can leave it a few more days and give them a call .. thanks again

If you are in England you should be able to register to get test results online. Makes life much easier.

 

[Lamont D]

Thanks all for your thoughts.

I am now taking Metformin which is helping level out my peaks (max I have seen 90mins after eating 9.3mmo/L before I started Metformin). Now maxing out at around 6.4mmo/L 90 mins after eating with Metformin.

Between meals it does drop to around 4.4mmo/L. I don’t know what is a normal range with Metformin.

Again, thanks for your response.

Kind regards to all,

Dan

Hi again, what you have posted is not Hypoglycaemia even though you may naturally have an occasional hypoglycaemic episode.
Your Hba1c is normal! Your between meals reading is normal!

Metformin should not alter blood glucose readings by very much, if at all!

The more you test, the more understanding of what is going on will become clearer.
Having stable blood glucose levels is important as dietary advice is!
A low carb balanced diet is advised unless you have other issues or conditions!