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Advice

Tanmc

Well-Known Member
Messages
160
Type of diabetes
Type 2
I been to speak about my recent result of HBA1C of 38 nurse was full of praise and asked me how I got from 100 in three months. Truth is not a lot as nurse said didn't need to make changes on metformin. So she was baffled seems I have lost another 2 kilos in 3 weeks my cholesterol did not come down in line with blood sugars. We both decided I could dabble with reducing my metformin to 1 tablet a day as I had a hypo even thought I ate a lot of carbs that day! One interesting thing she noted I have had pernicious anemia for a few years and at diagnosis was due an injection she said that my red blood cell count would of been low at that point which would of meant less to carry the sugar. Does anyone have any thoughts
 
Contralto said:
I have this, too so when you find out how it affects diabetes, please send me a message
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Nurse told me with pernicious anemia your body has less red blood cells which means less red blood cells for sugar to attach to which could be what gives us a higher reading
 
Just conjecturing here, but you might be responding to the high carb intake with over production of insulin - possibly a misdiagnosis and you have reactive hypoglycemia?
I think that you do need to make the suggestion to your doctor.
As Metformin reduces the ability of the liver to release glucose, that might be a factor - when your BG drops you want your liver to respond and throw out glucose to compensate.
 
Tanmc said:
Nurse told me with pernicious anemia your body has less red blood cells which means less red blood cells for sugar to attach to which could be what gives us a higher reading
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Yes, you can see a falsely elevated HbA1c with pernicious anaemia (iron or B12 deficiency) but when on treatment for this type of anaemia, the HbA1c can become falsely low.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401751/

Agents altering erythropoiesis
Patients with anemia due to deficiency of iron and vitamin B12 have high HbA1c levels. This can be reversed with administration of the deficient factor. In some cases, administration of iron and vitamin B12can lead to falsely lowered HbA1c due to the preponderance of young erythrocytes in the circulation.[20] Treatment with erythropoietin has the same effect
 
Not to sound think but this is all so confusing. If it's falsely low I don't understand why a connection has not been made and instead the doctors are saying this is fab well done and keep up the good work. Whilst am over here having highs and then hypos
 

I have been on B12 injections for a few years now. If blood cells have a 12 week life span and HBA1C was measured at 100 then exactly three months later at 38 my impression is the blood cells measured would be of the same age as the first HBA1C. Do you agree (I sound like a doctor)
 

Maybe check your B12 injections are still necessary, or at too high a dose. Do you get B12 blood tests? If you are being overdosed on the B12 this MAY explain the very much reduced HbA1c. I'm no doctor either.
 
Bluetit1802 said:
Maybe check your B12 injections are still necessary, or at too high a dose. Do you get B12 blood tests? If you are being overdosed on the B12 this MAY explain the very much reduced HbA1c. I'm no doctor either.
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That would make sense but I always felt I wasn't getting enough B12 as at about 10 weeks would start feeling the effects again. Also I read that metformin depleted B12 so I thought maybe I am not getting enough xx
 
Tanmc said:
That would make sense but I always felt I wasn't getting enough B12 as at about 10 weeks would start feeling the effects again. Also I read that metformin depleted B12 so I thought maybe I am not getting enough xx
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Surely you get blood tests for the B12? I would have thought that was very important when on injections. Yes, Metformin can affect B12.
 
You need to get a current B12 test and results done.

No point conjecturing on 1/2 results now and what might be.

I was diagnosed with PA. A GP stopped them 3 years after they were started.
I thought, ok lets just wait for them to dive down and get a GP in England to sort out when we move back.

My readings were going higher and higher and higher. Ending up at 1598 (way increased) then it was found I had breast cancer.

Now both lots of cancerous cells gone then my levels have dropped right back to borderline and I am being monitored.. some of this will be from my diet though as I dont eat foods with fortified vitamins in them, as generally speaking my body cant handle those foods.

Please ask for current b12 and folate to be checked..
thinking you know whats happening inside and what actually is can be totally different.

My levels at stop of b12 methylcobalamin injections were still up in 800's at 10 weeks... this I guess was the reason the gp stopped them.

I still do not have injections but it is amazing how we dont always know what is happening in our bodies.

In 2013 research showed a link to high b12 and cancer.. certain cancers including breast. Pity I or my docs didnt pick up on it earlier but although yours may be low, you need to check that it is as you think...
 
Bluetit1802 said:
Surely you get blood tests for the B12? I would have thought that was very important when on injections. Yes, Metformin can affect B12.
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I do once a year but have never been told results
 

I think you are totally right and on my last visit nurse said they need to keep a check to make sure nothing else is going on. I am actually scarred of everything little thing now. Because I dropped so low I ate a carby dinner then peee d like a race horse from my bottom. I have no problem trying to control things if I know what's going on. Feel like sorting out my will xx
 
Tanmc said:
I do once a year but have never been told results
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Well there is an answer to that ...... ask!!! Never assume all is OK until you see it in black and white or straight from the horses mouth. You can ask for print outs, and I suggest you do this ASAP even if your last test was a long time ago. Knowledge is power.
 

When I have asked in the past they say they are fine and never thought anything bad of it. So I guess it's just another thing to learn and even when I get the readings how will I make head or tail of it still haven't even learnt all this diabetes stuff fully yet. I come on here for opinions, advice, piece of mind and I value what everyone has to say but sick of feeling like a school girl being told off. I am no medical professional but I have researched to within an inch of my life to the point that friends and family are telling me I am obsessed then get made to feel am not obsessed enough on here. Think I will just read posts from now on. Thanks for the help everyone xx
 

I am so sorry if I have upset you. It wasn't my intention at all, and apologise for being a bit heavy handed. Please keep posting. x

There has to be some reason for the substantial drop from 100 to 38 in 3 months, and your nurse was possibly on the right track thinking your pernicious anaemia has something to do with it. Whether it is the condition or the B12 injections causing the problems, whether these affected your levels at the beginning, falsely elevating them to 100, or whether they affected you 3 months later by falsely lowering them, is the thing to ask and to research. Knowing your actual blood B12 levels will help. On your print out, if you manage to get one, it will tell you the standard range for B12 (and also all the other red blood cell counts). On my print out it says the standard range for B12 is 160 to 1000. I hope this helps. x
 
That's fine I think I am just very sensitive and worried about all this. I have 2 girls and I am worried something serious is going to happen before they work it out xx
 
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