Upcoming HBA1C

[Dupont]

Hello, I was diagnosed type 2 in January with a hba1c of 55 and GTT of 7.2 fasting and 13.2 after two hours.

I have lost 25 lbs and cycle most days. Since then all of my fasting self tests are usually below 5 and whatever I eat I am usually down below 6.5 within two hours.

Was my diagnosis hba1c bad and should I expect a drop in my hba1c next week and if so what should I be aiming for?

 

[Squire Fulwood]

Your initial Hba1c and OGTT were just a little high but not too bad at all. The readings you took yourself are excellent so I don't know what's going on there.

Hba1c gives a reading which indicates what your sugar levels have been for the last three months and if the whole three months was like the readings you took yourself I would expect the Hba1c to be lower than the one at diagnosis.

 

[Dupont]

So, if my hba1c comes back as normal and my weight is normal and all my self test readings are normal will I still be a diabetic?

 

[Squire Fulwood]

You will still be diabetic since you have to take measures to control your sugar levels. If you can get an OGGT result like the one you initially got there is some problem somewhere.

You could be classed as pre-diabetic but I don't think you are off the hook.

 

[toomanyairmiles]

I was diagnosed a year and a half ago and worried a great deal about this. GP's, Nurses and Endocrinologists gave me a lot of contradictory advice and in the end I spent some serious cash going to see a well respected private Endocrinologist. Well worth it! Here are a few things he told me (doesn't apply to type 1 at all).

Your portable meter has a margin of error of around 20% (the lower the size of the blood sample the bigger the margin of error). That's a very big gap and often produces uneven results. Treat the readings as guidance, this isn't a maths test, you're not getting marks! Look at your weekly/monthly averages rather than hour to hour results to get a better picture.

You can have high meter readings and still have a good HBA1C. HBA1C is plotted on an exponential curve by which risk is judged. High HBA1C puts you at risk of serious long term side effects, too low, and you risk serious short and long term side effects. The sweet spot is 6.5 in old money 48 in new money, aim to be around there.

In short there isn't a medically exact relationship between finger stick tests and HBA1C, they are actually measuring different things in your blood. For example my meter readings average 7.3, my HBA1C is now 6.5.

Different meters produce different results (slight panic ensued when I got a new meter and my readings went up - HBA1C was unaffected).

The more you worry about finger stick tests the harder you will find managing the condition - take them seriously but don't worry about them, they shouldn't cause you anxiety, concentrate on diet.

Medically the practical/friendly definition of type 2 is anyone who has had a blood sugar reading over 11. You are diabetic, there isn't a cure in the strictest sense of the word. Some people phase in and out, Steve Redgrave for example, but medically you will always be diabetic short of having a gastric bypass.

GP's for the most part issue all kinds of threats/predictions of doom and talk about things like 'mild' or 'borderline' diabetes - don't listen. Keep your A1C around 6.5/48 and you're in the lowest risk category for just about everything.

One bad HBA1C result isn't a bad thing, just keep working on the diet and exercise, you're playing a years long game to avoid the worst effects of the condition and manage risk. Monthly/three monthly readings don't matter, you want to be looking at up/down trends in your results.

Take the drugs, they do help manage your risk of long term side effects.