Annual Hba1c and cholesterol blood test

[KELI]

I've had a letter inviting me for my annual review. It says I do not need to fast for the hba1c and cholesterol blood test. Surely this will affect the readings. What difference does it make if I fast or not? Any advice would be appreciated. Thanks.

 

[pavlosn]

My understanding is that one should always fast for 12 hours before giving a sample for a lipid(cholesterol & triglycerides) count so that the results are not affected by a recent meal.

Unlike an HbA1c, which gives you a measure of average glucose levels over a period of three months and therefore does not require fasting, lipid counts give you a snapshot of your lipid levels at the point of time when the blood sample is taken.

You can read more about cholesterol blood samples here:

http://www.diabetes.co.uk/diabetes-complications/cholesterol-screening.html

 

[Ruth B]

HBA1C doesn't necessarily need to be a fasting test, but I thought cholesterol was better to be one. When I get the letter for my review (they do tend to check kidney, liver etc. functions as well) it normally says that it is better to be a fasting test, unless the diabetes is sever enough that fasting is dangerous.

My best suggestion would be to ask when you book the blood test and confirm that it does not need to be a fasting one, either that or if you don't mind fasting, fast regardless and tell the nurse who draws the blood that it is a fasting one, they always ask me when they do mine.

 

[Enclave]

Ages ago I read an article that the cholesterol dose not need to be fasting.. But as in the past it has always been .. Most medics do still want a fasting test.. I asked my Drs about this and they said its a load of rubbish .. But they also said testing my sugar levels and a LCHF diet is a load of rubbish.
Sadly I have lost the article that I read .. Think it was a bmj or something like that.. I no longer have my tests fasting..and the results are great !

 

[tim2000s]

My last Cholestrol test was not fasted due to an early morning hypo. The nurse taking the test was a little grumpy about this, but accepted it. The readings came out suitably low anyway, so it didn't really matter!

 

[KELI]

Thank you both for confirming my suspicions.
The letter states you do not need to fast, but I thought that would affect the cholesterol reading. They do check kidney function too yes and I always get them to check thyroid as well as its in my family.
I will be fasting for my bloods. They are probably trying to catch me out! Been nagging at me for years to get on statins and I keep refusing!

 

[KELI]

Enclave... My diabetes nurse sent me to the dietitian last year who told me if I went below 130g of carbs a day she would stop seeing me!

 

[Enclave]

Enclave... My diabetes nurse sent me to the dietitian last year who told me if I went below 130g of carbs a day she would stop seeing me!

I have on my notes that I am not managing my condition ... this is due to my LCHF diet .. that has helped me loose 4st and got all my bloods in to the normal for everything !!!! I get the feeling that if you want good control you must do it alone as most DBS's will not support what works..

 

[Enclave]

Thank you both for confirming my suspicions.
The letter states you do not need to fast, but I thought that would affect the cholesterol reading. They do check kidney function too yes and I always get them to check thyroid as well as its in my family.
I will be fasting for my bloods. They are probably trying to catch me out! Been nagging at me for years to get on statins and I keep refusing!

Just had my statins reduce with a view to stopping them .. all my blood tests now are not fasting ..

 

[CollieBoy]

Enclave... My diabetes nurse sent me to the dietitian last year who told me if I went below 130g of carbs a day she would stop seeing me!

Clearly this dietician is incapable of working with clients so my retort would be " I understand if you are incapable !now refer to someone who understands nutrition!"

 

[KELI]

Just had my statins reduce with a view to stopping them .. all my blood tests now are not fasting ..

Well done! That's great.

My cholesterol has been in the 5's for years. Personally I don't consider this high enough to warrant staton therapy, but that's just my opinion.

 

[KELI]

I have on my notes that I am not managing my condition ... this is due to my LCHF diet .. that has helped me loose 4st and got all my bloods in to the normal for everything !!!! I get the feeling that if you want good control you must do it alone as most DBS's will not support what works..

Well done on the weight loss, that's amazing.

Since diagnosis 9 years ago I have lost two stone. Been stuck at this weight now for a year and can't seem to shift the last two stone I want to lose. Any advice regarding LCHF would be appreciated.

 

[KELI]

Clearly this dietician is incapable of working with clients so my retort would be " I understand if you are incapable !now refer to someone who understands nutrition!"

[thumbs up].

She said the brain can only concert sugar to energy and can't use fat for energy!

 

[noblehead]

Thank you both for confirming my suspicions.
The letter states you do not need to fast, but I thought that would affect the cholesterol reading. They do check kidney function too yes and I always get them to check thyroid as well as its in my family.
I will be fasting for my bloods. They are probably trying to catch me out! Been nagging at me for years to get on statins and I keep refusing!

Sounds like they are just going to give you the Total Cholesterol figure when you get your results, as Pavlosn says earlier, if they were doing a full lipid breakdown then they would ask you to fast for the test.

 

[Kezzer4321]

I've had a letter inviting me for my annual review. It says I do not need to fast for the hba1c and cholesterol blood test. Surely this will affect the readings. What difference does it make if I fast or not? Any advice would be appreciated. Thanks.

Hi Keli,

I have never been asked to fast for the test either. I think it is now becoming common practice to do these tests as non-fasting.

Kezzer

 

[KELI]

Sounds like they are just going to give you the Total Cholesterol figure when you get your results, as Pavlosn says earlier, if they were doing a full lipid breakdown then they would ask you to fast for the test.

Ah thanks for that.

My previous GP surgery used to do cholesterol, HDL and ratio along with trig and LDL. I'm of the understanding that testing LDL is not done often for various reasons so the ratio is usually "total cholesterol/HDL" instead of "total cholesterol/LDL". That will answer why I used to fast before.

I suppose it costs less to do just the total cholesterol... Not much use for us though!

 

[forty six]

Ah thanks for that.

My previous GP surgery used to do cholesterol, HDL and ratio along with trig and LDL. I'm of the understanding that testing LDL is not done often for various reasons so the ratio is usually "total cholesterol/HDL" instead of "total cholesterol/LDL". That will answer why I used to fast before.

I suppose it costs less to do just the total cholesterol... Not much use for us though!

My surgery still insists on fasting as it gives a better picture for liver and kidney function.

They have never tested for LDL or triglycerides as it costs too much and by that I mean a hell of a lot too much. Therefore the breakdown that you are given at the GP's only has 2 correct figures in it out of 4 and the rest are just a guess. Although when I pointed this out to my DB nurse she said it wasn't a guess but a 'scientific estimate' - I said how can it be scientific and an estimate as science is based on evidence?

Anyway she has now told me that they are now being told to advise cutting carbs again! Hooray, hooray, hooray. Why can't we have some consistency in the treatment of diabetes across the country? Everyone seems to get a different level of service!

 

[KELI]

My surgery still insists on fasting as it gives a better picture for liver and kidney function.

They have never tested for LDL or triglycerides as it costs too much and by that I mean a hell of a lot too much. Therefore the breakdown that you are given at the GP's only has 2 correct figures in it out of 4 and the rest are just a guess. Although when I pointed this out to my DB nurse she said it wasn't a guess but a 'scientific estimate' - I said how can it be scientific and an estimate as science is based on evidence?

Anyway she has now told me that they are now being told to advise cutting carbs again! Hooray, hooray, hooray. Why can't we have some consistency in the treatment of diabetes across the country? Everyone seems to get a different level of service!

Hi Forty six,
My previous GP's was abroad (southern Ireland) and private so the more they did, the more they got paid! Test strips etc were all private prescriptions so I'm used to paying for them.
Now that I'm back in the UK (my home country) it's all gone to pot! Only had one diabetic review in two years, they won't prescribe lancets or test strips and they've just diagnosed me with background retinopathy. I'm a diet controlled type 2 btw. Dietitian refused to allow me to go below 130g carbs a day. Nothing like getting help when you need it is there! I'm so grateful to get everyone's input on this.
I will fast before the bloods because I know they will be doing kidney function test. Thanks for that.

 

[tim2000s]

If you are now under the NHS, you can insist on your diabetic review with your GP/etc.

 

[cold ethyl]

If you are now under the NHS, you can insist on your diabetic review with your GP/etc.

Can you? My practice DN retired and they don't appear to have bothered replacing her so blood tests are done by whichever phlebotomist is on and everything else is just the nurse assistant and a follow up phone call by GP which I don't think constitutes appropriate diabetic care as there's like opportunity for any in depth discussion about medication or latest advice.