A1c Is Incredibly Misleading And Should Probably Not Be Used For Diagnosis ...

[John201832]

As the title says, A1C is incredibly misleading . My A1C was 5.4 on two occasions and recently dropped to 5.3 for no particular reason. Yet I have high fasting glucose from 5.6 to 5.9 mmol which is considered prediabetic . And I do not have anemia, abnormal hemoglobin or any other condition that would falsely decrease A1C. So confused and bizarre . Any doctor would look at my A1C and say I’m fine but my fasting glucose is abnormal .

 

[hankjam]

I don't think they would as your fasting test is just a snap shot in a day, while your HbA1c is an integration of 3 to 5 weeks of blood glucose. Fasting values are interesting but post eating values are equally informative.

The difference in 0.1 of a 5.3 is probably neither here nor there, given the variability of the measurement system.

 

[Antje77]

As the title says, A1C is incredibly misleading . My A1C was 5.4 on two occasions and recently dropped to 5.3 for no particular reason. Yet I have high fasting glucose from 5.6 to 5.9 mmol which is considered prediabetic . And I do not have anemia, abnormal hemoglobin or any other condition that would falsely decrease A1C. So confused and bizarre . Any doctor would look at my A1C and say I’m fine but my fasting glucose is abnormal .

An hba1c of 5.4 correlates to an average glucose of 6mmol/l. Seems consistent with your fasting glucose to me.
An A1c of 5.4 or 5.3 is basically the same.

 

[Rachox]

Do you check your blood sugar at any other times of the day? The reason I ask is that level is often higher first thing in the morning compared to later in the day. Having said that using this converter:
https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html even with an average blood sugar of 5.9 it gives an HbA1c of 5.3% which is what you got and is classed non diabetic.

 

[John201832]

I don't think they would as your fasting test is just a snap shot in a day, while your HbA1c is an integration of 3 to 5 weeks of blood glucose. Fasting values are interesting but post eating values are equally informative.

The difference in 0.1 of a 5.3 is probably neither here nor there, given the variability of the measurement system.

Hankjam, I’ve done a number of “experiments” with certain very high carb meals to see what is the problem . One time I ate Chinese food and drank a large Pepsi . Total carb content was ridiculous at 275-300 grams . I went from about 90 mg/dL (5 mmol) before eating up to 8.3 mmol at 1 hour. By 2 hours and 10 minutes, I dropped to about 6.9 mmol and by about 3 hours, close to 5.5 mmol. I normally don’t eat like that and with more reasonable, healthier meals, I might go up to 6.9 mmol at 1 hour. So, overall, my postprandials aren’t that bad but my fasting definitely is despite my normal A1C.

 

[John201832]

And the high fastings are the morning readings . If I eat a meal in the morning and then test 8 hours later after not eating anything, my sugar drops to 4.7 mmol . The other readings are fasting too but not morning ones. Only the morning fasting is 5.6 to 5.9 mmol.

 

[hankjam]

Sounding pretty sorted to me.
One thought, do you have any spare reserves that your liver might use to get a dump going to start your day?

 

[John201832]

Sounding pretty sorted to me.
One thought, do you have any spare reserves that your liver might use to get a dump going to start your day?

Hankjam, if by reserves you mean some weight to lose, then, yes, I still go. I am 32 years old male, 1.75 meters (average height), and weighed 93 kilograms in January. Since then, I’ve shed weight and am now about 80 kilograms . I am significantly leaner and much closer a healthy weight for my height - maybe need to lose another “stone” as you guys say before I’m no longer considered overweight. Maybe that is contributing to high fasting glucose , at least I hope so . Still over my weight and liver producing too much glucose .

 

[hankjam]

Hankjam, if by reserves you mean some weight to lose, then, yes, I still go. I am 32 years old male, 1.75 meters (average height), and weighed 93 kilograms in January. Since then, I’ve shed weight and am now about 80 kilograms . I am significantly leaner and much closer a healthy weight for my height - maybe need to lose another “stone” as you guys say before I’m no longer considered overweight. Maybe that is contributing to high fasting glucose , at least I hope so . Still over my weight and liver producing too much glucose .

As you can see from my sig I kicked off at 52 and 95 kg....

Sounding not too much unlike myself, -30 years...... I'm now down to 70 kgs and I'm fine with that. My FBG tend to 5.2. Tried some fasting, missing lunch and this did move 3 kg off and had an amazing affect on my fastings, 4.5's though this does appear to be a response rather than permanent, now back to 5.0 - 5.2.
It's a long road.

 

[John201832]

As you can see from my sig I kicked off at 52 and 95 kg....

Sounding not too much unlike myself, -30 years...... I'm now down to 70 kgs and I'm fine with that. My FBG tend to 5.2. Tried some fasting, missing lunch and this did move 3 kg off and had an amazing affect on my fastings, 4.5's though this does appear to be a response rather than permanent, now back to 5.0 - 5.2.
It's a long road.

I just hope shedding the rest of the pounds will drop my fasting . Hoping it’s just because I’m still overweight and not because I’m headed towards diabetes . Only time will tell I guess .

 

[hankjam]

I clearly missed the signals my GP was hinting at... repeated Glucose testing, referred to a dietician, who said I should eat more fruit and then a nurse, who was going to tell me about my high levels of cholesterol told me I was a T2 with a HbA1c of 52. I had been feeling really out of sorts for the previous 4 months and most nights was up to visit the loo....

but I never made the connection and so it came to pass.

Glad to hear you're one step ahead.

I wish you well.