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A glitch in the matrix or something to be concerned over

G

gogobroom

Well-Known Member
Messages
73
Location
Hampshire
Type of diabetes
Type 2
Treatment type
Diet only
HI - Firstly its been a while since I visited, I was diagnosed prediabetic in 2014, not overweight, very active and still am, have had yearly HBA1c results each year since always between 42 and 45, had a few OGTT's and always come out ok. Diet is reasonable, generally fairly low carb with - I don't have a sweet tooth, though have probably been a little lazy this summer and have veered off slightly with food choices and red wine intake, but exercise wise is still 8 plus hours a week.

So I had my yearly HBA1c and its 52 so have been called back for a test 2 weeks later which is tomorrow ...

My assumption is that if when I get my results next week if the HBA1c is back to normal then it musty have been a glitch, but what could have caused this ? If it's not back down then I will be looking at next steps depending what doc says , possibly go full LCHF is my intention and reduce alcohol intake to battle this if it can be done without other intervention.

Are there glitches with the HBA1c and what causes then if so ?
Thanks
 
I believe glitches are pretty rare, but do happen, hence the repeat test.
gogobroom said:
but what could have caused this ?
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I think you’ve probably answered your own question here:
gogobroom said:
… have probably been a little lazy this summer and have veered off slightly with food choices
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Stick around the forum for inspiration and let us know how the retest goes.
 
I'm no expert in what causes HbA1C mis-readings, but certainly abnormal blood conditions could do so.

How low carb is 'fairly low carb'? - 130gms per day? or more than that. In my opinion Low Carb starts at under 130gms of carbs per day - though my BG meter tells me I need less than 40gms per day to stay in remission.

Red wine is something that many/most Low Carb Type 2's feel it's OK to drink in moderation - how many bottles per week have you been getting through in order to feel it's a problem? If you feel low carb restricts your alcohol consumption, then switch to spirits with a zero/low calorie mixer.
 
@gogobroom Hi there, have you been ill, had covid, or a booster jab, a course of antibiotics, steroids or anything in the last 2-3 months? This (anecdotally) can cause your BG to rise temporarily - good luck tomorrow and hope the 2nd result will push you in the right direction.
 
An HbA1c represents an average bood glucose level over 3 months. I can't understand why they want to see you in 2 weeks!
 
You did fall off the wagon a bit, more carb intake simply means higher blood glucose, so higher HbA1c readings. Cut them back down, and you can get them into the normal range. (Which I'd personally have preferred over settling for the prediabetic range: I was still fatigued when I was in that range for a bit, dunno about you though).

Glitches are possible, but with what you've said, not likely. Still, you can come back from this quite easily. And stronger than before, even.
Good luck!
Jo
 
Thanks all for the replies.

With regard to illness, nothing really of note, bit snotty for a couple of weeks but nothing else, no covid or flu jabs either. As I mentioned I do drink but over the years have switched to red win, on average a couple of glasses a night, throughout the summer probably most nights, now back to weekend s only. Carbs probably around 160gms a day, but given I do exercise a lot my calorie intake is regularly over 3000 per day to fuel that - but I tend to go higher percent protein and fats when looking at the macro splits. The second test I think is to verify the the first test result was correct, I haven't actually spoken to the doc yet, was just a message to say get 2nd test.

I don't check BS regularly but I go through phases every few months where I do check, generally the morning is high, over 7 and this hasn't really changed much since 2014 no matter whether I have gone fully carb free, heavy carb or even tried alcohol free for a month and nothing really changed. This time is slightly different as I have now checked for the last week or so with results of 7 through to 9.3 in the morning, even had a high of 18 over 2 hours post a high carb meal (one off fish, chips and mushy peas).

I have now started testing more regularly again and reducing carbs even more, will see what the results are next week and go from there.

Thanks again, just good to share and get my thoughts out.
 
CatsFive said:
Guidelines are to not diagnose from 1 result. This test is just incase the previous one was a glitch, not to see if the op has changed his lifestyle enough
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Thank you @CatsFive !
 
Results are back - and 2nd HbA1c is 51 so a reduction from the last one but not much, have been requested for a follow up consultation with GP ... however next available appointment is the end of November so some time to ponder in between. I will continue with the finger prick testing over the next month and see how things go along with watching/reducing the carb intake.

Any other tips for the next month until I have my review ? Anything I should be aware of ?
 
I think they'll confirm your T2 diagnosis when you see the doc. There's around a 5% allowable error in the test but it would be unusual for both to be off the same way - you'd have to have a "real" A1c of about 47/48 and both tests to be skewed high.

The important bit to my mind about fingerprick testing is that it shows you how efficiently your system deals with various foods. If after two hours you've not returned to within 2mmol/l of your starting point (and below 8) then there were too many carbs in that meal for you to deal with properly. That gives you strong information about what not to eat. I found it essential in getting a grip in the early weeks and in providing good feedback about what I was doing. You can (some luck and willpower needed) make significant changes in a matter of weeks.

There's absolutely no reason why you shouldn't continue with lowering your carb intake in the time before you see your doc. It's possible you'll be offered metformin - I was, with an HbA1c of 50 at dx, and I refused it. That's something you might want to read up about so you can make an informed choice if the offer is made.

best of luck.
 
Thank you, I will heed your advice re the testing - I think that is the most confusing thing to get used to. Testing itself is simple and recording the results, its the interpretation of the results that clouds things and ensuring you are timing the tests correctly.

A couple of years ago I was lucky enough to get access to the Supersapiens CGM and used it for about a year but I found it confusing to decipher the results and pinpoint exactly what was causing spikes - some days the same foods caused no considerable spikes others they did, some days exercise spiked, others it didn't. Generally I'd wake with high BS usually over 7 and rarely do I ever go under 6 even on next to zero carbs. (Note I understand Supersapiens is for sports not Diabetes monitoring and has its limitations but still utilises the abbots sensor. I compete in Ironman triathlon up to Ironman distance so regularly train 6 or 7 days a week with swim, bike and run - I was using the supersapiens to assist with my fueling for long distance events, but this was at a time when they had only just released the unit and app - it was very flakey.


I have lots of questions on what different things causes spikes but will have a look through the forum to see if I can see further info before posting.

Thanks
 
No problem. When you say spikes, do you just mean rises in blood glucose? My interpretation has always been that a "spike" is a sharp and sometimes unexpected rise to comparatively high levels. However I've seen people saying "I ate X and I spiked to 6"... for me, not a spike.

I've found that the more strenuous the exercise the higher my BG. I think this is caused by my liver dumping necessary glucose as extra fuel. It's hard to catch by fingerprick testing, as it's gone very quickly after I stop. CGMs are very good for this.

I totally agree about the interpretation of results. Just after diagnosis I was amazed to discover that some meals (with carb) seemed to lower my blood glucose. The issue (I eventually discovered) wasn't the food, but was the large glass of red wine that went along with it. Alcohol stops the liver adding glucose to the blood (much as metformin does) so a meal with wine does not show you what the food alone would do.
 

Does a glass of wine with a meal reduce the effects of carbohydrates or simply mask them?
 
For me it delays the effects of carbs but doesn’t eliminate them at all. I.e. if I eat more carbs than usual when having a glass or 2 of alcohol then I get very good numbers but once the alcohol has been dealt with by my liver then I see a rise in my BG (although slightly lower than I would get with carbs without alcohol) and they also stay higher for longer.

If I stay on keto and drink alcohol I see no difference in the numbers I have normally
 
Dancing Badger said:
Does a glass of wine with a meal reduce the effects of carbohydrates or simply mask them?
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As others have said, it doesn't actually do anything with the carbs you've eaten. It stops your liver trickle-feeding glucose. The carbs you ate are still there and are being digested to glucose and entering the bloodstream as always. You simply get a skewed reading that looks too good to be true, and that's what it is.
 
Hi - thanks for the reply and information. Re spikes it was more BG rising when I hadn't consumed anything in addition to the usual rises from food, exercise etc - Also as mentioned sometimes rising sometimes not after eating teh same thing.

Re the alcohol - that is very interesting, I am an avid red wine drinker, was most nights... and currently only drinking on a weekend prob 2 glasses a night, will be interesting to see what difference, if any this makes to the readings.


Yesterday I reduced carb intake a bit and tested fairly regularly - results were

Breakfast - scrambled eggs, avacado, plumb toms and cumberland sausage - 11gms carbs
Lunch - Chicken salad, Kvarg yoghurt and couple slices of Fruity five - 47g carbs
Dinner - bolognese with cauliflower rice, mixed nuts with greek yoghurt - 46g carbs (6.30pm)
Exercise I swam for 30 mins first thing

Total carbs for the day 103g - no snacking

#Pre lunch 5.3mmol after not eating for 4 hours. I had highs of 10.1 two hours post lunch and then 2hr30 post lunch 9.1
By dinner it had settled to 5.6, two hours post dinner 8.8 and by 9.45pm it was 8.1

Above for info only -


This morning upon waking at 5.55am I tested 7.5mmol and then tested again before breakfast at 8.32 and it was 9.3 - then 2 hours post breakfast was down to 6.6 (breakfast was poached eggs, sausage and toms)

My question regarding this is why would my reading continue to go up in the morning after waking and before breakfast? I know about the dawn phenomenon but assumed the reading would settle after you had got up.
 
Different for all of us, but my bloods go up and up and UP until I eat, and normally I don't eat until lunchtime. So I don't take any notice of it. I don't need to eat much to halt the rise, but my body is clearly in caveperson mode. My BG otherwise is in the non-diabetic range provided I stick with my keto diet regime, but lots of other people can eat more carbs than I can without spiking their bloods.

Edited for typo
 
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a lot of us find that the liver keeps on adding glucose until it's happy you don't need anything more - and that usually means eating something. IMy ex[perience is that my liver's happy if i have four almonds. If I don't eat, it will go on slowly adding glucose for at least six hours - it could be longer, but I got bored after six hours.

The numbers you're reporting would seem to indicate that there are more carbs in what you're eating than your system can readily deal with. The two hour reading will almost certainly not be the "high point" - that usually happens after about 20-40 minutes. So you will probably have been on the way down when you tested at +2 hrs.

If you want to see how this works for you, a Constant Glucose Monitor might give you some additional insight. I found some interesting things - eg that a small latte (milk, no sugar) will take me from low fives to over 9 inside half an hour, and back to low fives by one hour.
 
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