Normal HbA1c,high blood glucose.

[gillytee31]

I am confused. I was told by my GP on Friday that my HbA1c was 44 and therefore normal which I find odd as since the beginning of January my blood sugars have never been below 9.5. Up until the end of December 2020 my waking BG was always below 7. I have also put on a stone in weight since Christmas 2020 despite not changing my diet. The previous year ie from December 2019 I had lost 3 stone in weight - this possibly was because I stopped taking steroids in June that year and my husband died in October 2019. My weight was then stable from Christmas 2019 until Christmas 2020.
If anyone has any helpful thoughts I would be grateful - I do not understand how HbA1c could be normal when my blood sugars have been consistently between 9 and 14

 

[EllieM]

If anyone has any helpful thoughts I would be grateful - I do not understand how HbA1c could be normal when my blood sugars have been consistently between 9 and 14

Several possibilities that I can think of
1) Inaccurate meter (out of date strips?) . Did they do a spot glucose test along with the hba1c? If that is high then you can probably rule out meter error.

2) Error when processing your hba1c result. You could ask for another test.

3) You have a condition that artificially lowers your hba1c result. Read the link below and if you think it applies then I'd ask your doctor for a fructosamine test instead.
Could Your Hemoglobin A1C Test Be Wrong? - GoodRx

Honestly, in your position I'd believe my blood test results rather than an hba1c. Go back to your doctor, tell him or her about your readings and get a repeat hba1c and/or a fructosamine test.

Good luck.

ps and high insulin levels plus high glucose levels cause weight gain, so that is also consistent with your levels being too high...

 

[Roggg]

weird. How many readings have you had between 9 and 14? Are they fasting or non-fasting readings? Are you checking at regular times relative to meals? Most common is just before eating, and 2 hours after the first bite.

Your readings sound odd, but it's hard to say more than that without a bit of info on how and when you are testing.

 

[Goonergal]

Well 44 is officially in the pre-diabetic range, so I’d suggest that needs to be addressed. For me, pre-diabetes should be treated the same way as type 2 - i.e reduce carbohydrate intake to lower blood glucose. Very often a side effect of that will be weight loss.

I’d suggest looking at dietdoctor.com for information about carb content of foods, recipes etc. And stick around here to ask questions!

As others have said, it depends how many readings you’ve been taking and when as a few finger prick readings won’t correlate to an HbA1c score.

 

[ianf0ster]

As @Goonergal says, 44 isn't normal. ! It sounds like your Doctor thinks that anything he can't treat (= prescribe for) must be 'normal'.

Although 9.5 mmol is high, BG meters have a + or - 15% accuracy, so if that is just a Fasting BG and you suffer from Dawn Phenomenon, it need not be a concern.

What would matter more is if that level persisted throughout the day i.e. before lunch and before dinner.
Also if you're attempting to control your BG by a 'way of eating', then a concern would be if the difference between a pre-meal BG and that 2hrs after 1st bite rose by over 2.0 mmol.

 

[gillytee31]

Well 44 is officially in the pre-diabetic range, so I’d suggest that needs to be addressed. For me, pre-diabetes should be treated the same way as type 2 - i.e reduce carbohydrate intake to lower blood glucose. Very often a side effect of that will be weight loss.

I’d suggest looking at dietdoctor.com for information about carb content of foods, recipes etc. And stick around here to ask questions!

As others have said, it depends how many readings you’ve been taking and when as a few finger prick readings won’t correlate to an HbA1c score.

I have been classed as diabetic since 2015 and was on insulin from then until December 2019 when my HbA1c went very low after I stopped having to take steroids. I have always tried keeping my blood sugars steady by eating a low carb diet and it worked until I had to start taking amitryptiline last December because of diabetic neuropathy. I lost 3 stone in weight between December 2019 Nd December 2020 and then put on a stone in 2 months between end December 2020 and February 2021. It really is not as straight forward as you think.

 

[gillytee31]

Several possibilities that I can think of
1) Inaccurate meter (out of date strips?) . Did they do a spot glucose test along with the hba1c? If that is high then you can probably rule out meter error.

2) Error when processing your hba1c result. You could ask for another test.

3) You have a condition that artificially lowers your hba1c result. Read the link below and if you think it applies then I'd ask your doctor for a fructosamine test instead.
Could Your Hemoglobin A1C Test Be Wrong? - GoodRx

Honestly, in your position I'd believe my blood test results rather than an hba1c. Go back to your doctor, tell him or her about your readings and get a repeat hba1c and/or a fructosamine test.

Good luck.

ps and high insulin levels plus high glucose levels cause weight gain, so that is also consistent with your levels being too high...

Thank you. That is really helpful. I have asked my GP about another HbA1c test but he won't do it for another 2 months and in the meantime I have to increase my metformin.

 

[gillytee31]

weird. How many readings have you had between 9 and 14? Are they fasting or non-fasting readings? Are you checking at regular times relative to meals? Most common is just before eating, and 2 hours after the first bite.

Your readings sound odd, but it's hard to say more than that without a bit of info on how and when you are testing.

I check my BG levels just before each meal and just before I go to sleep. Since just before Christmas it has been between 9 and 14, whereas before then it had always been 5 and 8 both while on insulin and when I was taken off insulin and put on metformin In December 2019. I am also putting on weight, a stone in the last 2 months which seems odd when I had lost 3 stone in the previous 2 years

 

[Lamont D]

I have been classed as diabetic since 2015 and was on insulin from then until December 2019 when my HbA1c went very low after I stopped having to take steroids. I have always tried keeping my blood sugars steady by eating a low carb diet and it worked until I had to start taking amitryptiline last December because of diabetic neuropathy. I lost 3 stone in weight between December 2019 Nd December 2020 and then put on a stone in 2 months between end December 2020 and February 2021. It really is not as straight forward as you think.

Are you on any meds other than the metformin?
What symptoms are you getting since you stopped the insulin?
You are right, it is not straight forward, as you are not using your glucometer to give yourself the best use. As has been suggested, a pre meal reading and the two hours reading will give you an idea, which foods are causing the high glucose levels.
This food diary, which includes what you eat and the before and after results, this will help you and your doctor understand what is happening. Also, if it is unusual blood glucose levels, you should ask your doctor for a referral to a specialist endocrinologist.
Can you give us an idea of what you have eaten regularly for your low carb diet?

Type two diabetes can be caused by steroids.

Stay safe