What would cause persistently elevated Glucose levels but a perfectly normal HbA1c???

[calumcco]

My last 4 Glucose Fasting test results were 6.7mmo/l, 6.8mmo/l, 7.3mmo/l and 7.9mmo/l.
However I had my 1st HbA1c test taken last month and I gave a result of 27mmo/l.
What on earth does this indicate? Anyone think this is a bit strange???
Why am I producing elevated Glucose levels indicative of diabetes yet my HbA1c suggests completely the opposite???

 

[Deleted member 83869]

My last 4 Glucose Fasting test results were 6.7mmo/l, 6.8mmo/l, 7.3mmo/l and 7.9mmo/l.
However I had my 1st HbA1c test taken last month and I gave a result of 27mmo/l.
What on earth does this indicate? Anyone think this is a bit strange???
Why am I producing elevated Glucose levels indicative of diabetes yet my HbA1c suggests completely the opposite???

6 and 7 isn't high though????

 

[Randburg]

Hi a HbA1c of 27mmol/L, is not even on the chart, its so high, are you Shure it is correct ?

 

[Squire Fulwood]

Hi a HbA1c of 27mmol/L, is not even on the chart, its so high, are you Shure it is correct ?

I think that OP means the IFCC chart and 27 is off the low end, not the high end.

 

[calumcco]

6 and 7 isn't high though????

Hi I thought anything over 5.5mmo/l was considered Impaired Glucose Tolerance and anything over 7.0mmo/l was indicative of diabetes?

 

[calumcco]

Hi a HbA1c of 27mmol/L, is not even on the chart, its so high, are you Shure it is correct ?

Hi HbA1c is 27mmo/l not the Glucose Fasting!

 

[Bluetit1802]

Do you mean an HbA1c of 27mmol/mmol rather than 27mmol/l? Huge difference between the two measurement units.

Your fasting glucose levels are still normalish and are probably affected by the liver dump people have when their bodies are expecting food but don't get any. Your liver probably is dumping glucose in your system to keep you going until you eat.

 

[Deleted member 83869]

Hi I thought anything over 5.5mmo/l was considered Impaired Glucose Tolerance and anything over 7.0mmo/l was indicative of diabetes?

Are you T1??? If so then target's are between 4 and 8! those are perfect reading's what you have there! I am not too sure if I have done a fasting glucose test! Is that the same as a basal rate test?

 

[Squire Fulwood]

My last 4 Glucose Fasting test results were 6.7mmo/l, 6.8mmo/l, 7.3mmo/l and 7.9mmo/l.
However I had my 1st HbA1c test taken last month and I gave a result of 27mmo/l.
What on earth does this indicate? Anyone think this is a bit strange???
Why am I producing elevated Glucose levels indicative of diabetes yet my HbA1c suggests completely the opposite???

I have often had doubts about the fasting blood test. If it's not reading a liver rush then it has to wait until the appointment happens and that could be any time of the morning.

Do you test at other times, after meals for example?

 

[Squire Fulwood]

Hi I thought anything over 5.5mmo/l was considered Impaired Glucose Tolerance and anything over 7.0mmo/l was indicative of diabetes?

Yes, close enough for cash but it is not indicative of your Hba1c which includes many periods of not fasting ...and non eating.

 

[Randburg]

My last 4 Glucose Fasting test results were 6.7mmo/l, 6.8mmo/l, 7.3mmo/l and 7.9mmo/l.
However I had my 1st HbA1c test taken last month and I gave a result of 27mmo/l.
What on earth does this indicate? Anyone think this is a bit strange???
Why am I producing elevated Glucose levels indicative of diabetes yet my HbA1c suggests completely the opposite???

Hi on checking I think your Hb1Ac reading was possibly 27 mmol/mol, and that would be 4.6% and that is an excellent figure, most of us would love results like that.
As the previous post from Nicholanne indicated your spot checks are also within a Diabetic range (5 to 7.8) depending what you read
Look at
http://www.bloodsugar101.com/

 

[phoenix]

What do you mean by fasting?
Is it a home test done immediately upon waking, Is it when you have got out of bed and done a few things ?
Are they lab tests when you have been awake for two hours before the test takes place?
'Fasting levels' vary between time of day and also things like stress effects them. So might a long walk to the test lab.

To see if you have persistent high glucose you would need to look at other times of day

Although the HbA1c is a good measure over time, the bonding process ie the joining of glucose to the red blood cell is a relatively slow reaction and so if you are only at that level for a brief time it won't occur. (which is why non diabetics can regularly have brief periods with higher glucose but still have quite normal HbA1cs)

There are though some conditions that can result in shorter than normal red cell life so artificially lower HbA1c .
If you have had some blood loss or have donated blood recently, that could lower HbA1c
. If you have an African, Mediterranean or SE Asian heritage then this could be relevant : http://diabetes.niddk.nih.gov/dm/pubs/traitA1C/index.aspx
also this interview mentions other reasi
http://asweetlife.org/feature/interview-dr-zachary-bloomgarden-on-the-hba1c-assay/

 

[andy1971]

My understanding is a T1 shouldn't have a fasting test? My doctors have all insisted I eat and inject as normal on the the day before and indeed on the day of a Hba1c

Sent from the Diabetes Forum App

 

[phoenix]

No-one needs to fast for an HbA1c since it is a measure over time.
Many people including T1s get asked to fast for a cholesterol test . I certainly have fasting cholesterol but I've read of some T1s that don't. If you are on a MDI or use a pump though there is no reason not to fast for 12 hours, indeed people do that for basal testing. Personally, I find that if I miss breakfast for a fasting test my glucose rises a bit ( I have a half hour drive and a walk to get to the lab so that's understandable).
Some people with T2 or prediabetes (or suspected diabetes) may have laboratory fasting glucose tests.

 

[NickiH]

Hi, I have a similar situation, but my hba1c is higher - 41. It's still considered ok, I believe 42-47 is considered pre-diabetic in the U.K., and 48 and above would be diagnosed with diabetes?? But, I also have high fasting glucose, 7.3 on my blood tests through the gp, regularly 7.0-8.5 which I test first thing in the morning at home. My GP has said I am type 2, but can stay diet controlled. I worry though about the morning highs and any big meal or too many carbs can also send my sugars up, so I have to be really careful. 2 slices of toast would put my sugars up in the 9.0s. And even if my bm is 5.5 (which is rare) before bed, it's guaranteed still above 7.0 in the morning. I would also appreciate advice from anyone!

 

[bulkbiker]

Hi, I have a similar situation, but my hba1c is higher - 41. It's still considered ok, I believe 42-47 is considered pre-diabetic in the U.K., and 48 and above would be diagnosed with diabetes?? But, I also have high fasting glucose, 7.3 on my blood tests through the gp, regularly 7.0-8.5 which I test first thing in the morning at home. My GP has said I am type 2, but can stay diet controlled. I worry though about the morning highs and any big meal or too many carbs can also send my sugars up, so I have to be really careful. 2 slices of toast would put my sugars up in the 9.0s. And even if my bm is 5.5 (which is rare) before bed, it's guaranteed still above 7.0 in the morning. I would also appreciate advice from anyone!

Hi Nicki
You are seeing evidence of the dawn phenomenon which causes blood sugars to go up when we wake up to almost literally make us "rise". Eventually after a few months of low carbing they start to come down (it took about 6 months before mine got to "normal" levels and I still get the odd blip especially when under the weather). Not really something you can do much about. However at other times of the day bloods are far easier controlled by eating fewer carbs (things like bread, pasta, root veg, rice) are best avoided by Type 2's or those with pre-diabetes. Have a read round on the forum and you'll find this out pretty quickly. Hope that helps a bit.

 

[eggs11]

What do you mean by fasting?
Although the HbA1c is a good measure over time, the bonding process ie the joining of glucose to the red blood cell is a relatively slow reaction and so if you are only at that level for a brief time it won't occur. (which is why non diabetics can regularly have brief periods with higher glucose but still have quite normal HbA1cs)

Fascinating about the bonding process - do you know how long it takes for the sugar to start bonding to the cells?

 

[NickiH]

Hi Nicki
You are seeing evidence of the dawn phenomenon which causes blood sugars to go up when we wake up to almost literally make us "rise". Eventually after a few months of low carbing they start to come down (it took about 6 months before mine got to "normal" levels and I still get the odd blip especially when under the weather). Not really something you can do much about. However at other times of the day bloods are far easier controlled by eating fewer carbs (things like bread, pasta, root veg, rice) are best avoided by Type 2's or those with pre-diabetes. Have a read round on the forum and you'll find this out pretty quickly. Hope that helps a bit.

Thank you I'll definitely try and cut the carbs!

 

[bulkbiker]

Fascinating about the bonding process - do you know how long it takes for the sugar to start bonding to the cells?

This is quite an old thread and Phoenix hasn't posted since January so you may not get an answer anytime soon..

 

[NickiH]

Thank you I'll definitely try and cut the carbs!

Can I just ask - do you self test every day? My doctor said its not necessary, but I have been checking 4 times a day...