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Bit confused with my readings vs HbA1c results

C

crista.

Newbie
Hi all,

I had gestational diabetes in 2023. So since, I’ve had HbA1c tests and the results were 34mmol in 2023 after giving birth and 35 mmol in 2024. Fast forward this year, something made me start taking my readings after meals. Surprisingly, my 1h readings were ok, but my 2h readings were over 7.8 mmol ( 8 and 10 mmol on 2 occasions)
So I decided to get a Dexcom cgm as I used one when I had GD. My fasting readings are below 5.2 mmol and my average glucose is 5.6mmol. I followed a low card diet (for about 3weeks) cause I was getting scared but when I do have more carbs, I see glucose going up after 45 mins. If the glucose goes above 7.8 mmol I noticed it takes 25 minutes for it to return below 7.8 mmol in most cases. My higher reading was 10 mmol on cgm .
Now, because I was concerned I contacted GP and the doctor was not worried at all and he just said he doesn’t believe I had diabetes but booked me for a HbA1c anyway. My results came today and it’s 31mmol - shocking for me being less than 7 months ago

I am 1.65 and 65 kg. I been on a diet to loose weight for about 1 months now anyway.
So now I’m confused and I am not sure if I should continue a low carb diet, or if it’s normal to spike like that as long as my insulin brings it down in 25 minutes. GP can’t be bothered to even explain me this

Thank you x
 
Hi and welcome to the forum @crista. I can understand your concern because you were diagnosed with gestational diabetes, but not everyone who develops gestational diabetes during pregnancy goes onto develop diabetes. During pregnancy, your hormones cause your body to become less sensitive to the effects of insulin, so your blood sugars rise. If they rise too much and stay elevated then you can develop gestational diabetes, but in most cases it is temporary.

Your blood sugars look great now. Your HbA1c looks great at 34. In fact your blood sugars look normal. Certainly not in the diabetic range, neither are you close to being prediabetic, the latter starts at 42. Everybody’s blood sugars rise after eating. The pancreas releases insulin in the presence of foods to bring blood sugars back down. It is what the pancreas does. There is usually a rise, by how much depends on what you have eaten. A carby, starchy, or sugary meal will send your blood sugars higher. That is to be expected and is perfectly normal. Looking at your fasting blood sugars, they look great. . I hope that helps. Crista, please don’t hesitate to ask questions. Mel
 
I would just like to add to @Melgar 's reply, with which I fully agree. About 40 years ago my mother-in-law asked me to test her blood sugar, out of fascination, half an hour after finishing a carb-heavy meal. She was 10.6 which is the equivalent of 92 now. She lived for another 26 years and never had diabetes. Rather than restricting yourself, I would adopt the Ancient Greek motto "Nothing in excess". I wish you continued good health.
 
Hi

I think your blood glucose looks to be bang normal. Your HbA1cs are well below average (most non-diabetic people are clustered around 38). BG should rise 45 minutes after eating, because that's about how long it takes the carbs in food to be digested to glucose and to be arriving in your blood. And coming down after 25 minutes is also what you'd expect, and nothing to be concerned about.

This bit of research below shows how non-diabetic people react to meals containing varying amounts of carbs. It was sponsored by one of the CGM makers because there was (amazingly) not a lot of information about how non-diabetic people reacted to eating carbs. You'll see they do not have "flat" blood glucose levels at all.

Continuous Glucose Profiles in Healthy Subjects under Everyday Life Conditions and after Different Meals - PMC

This study investigated continuous glucose profiles in nondiabetic subjects. Continuous interstitial glucose measurement was performed under everyday life conditions (2 days) and after ingestion of four meals with standardized carbohydrate content ...
pmc.ncbi.nlm.nih.gov

And this one tracks non-diabetic people using a CGM and shows ups and downs as well

Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study - PMC

Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation ...
pmc.ncbi.nlm.nih.gov

[Edited as originally posted incompletely]
 
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G'day Crista, and welcome to the forum.

I have to say I'm surprised your GP won't or can't elaborate on
your condition. Is it possible for you to see the clinic's diabetes
nurse educator instead? It's important that we develop a rapport
with our treating doctor(s), and if you're—apparently—dissatisfied
with yours, then it might be time to see a different practitioner.

And your questions have prompted me to ask the wider forum as
to why some people—who are are not diabetic—choose to
use a real-time continuous glucose monitor (such as the Dexcom).

As a newly-diagnosed T2 I'm using a blood glucose monitor
and strips—AM fasting and 2-hour post meal x once a day. Or
should I consider a GCM?
 
Hi,

Thank you for your message.

I was told I have Gestational Diabetes at 27 weeks and that’s the first time o considered a GCM. Firstly and probably a bit silly was because my fingertips were in so much pain 2 weeks after stating to use a glucose monitor. I was testing 4 times a day because I was required to. So I signed up for Freestyle Libre 2 sensor which had a free trial of 14 days. I felt like all my problems got solved After the free trial I continue purchasing the Libre 2 sensor until I gave birth. I must say, it was just easy, I knew if I spiked within the 2 hours (and sometimes it did happen) and by the time I was supposed to actually test the glucose, it had returned to normal. So it can catch spikes that we aren’t aware of, you can see how the glucose raises and falls during nighttime and overall I felt more relaxed having that on my arm knowing 24/7 what’s happening with my glucose. You can set alarms and if the glucose is too high or too low, the phone alerts you.

Now, my concerns drove me towards CGM and I went for Dexcom. I will tell you now I would choose Dexcom over Libre anytime. With Libre I had a faulty sensor once and a had to call customer service for replacement. Also, Libre takes 24h once you activate it to start reading accurate. Therefore out of the 14 days trial, you are left with 13. Another disadvantage is that you have to scan the sensor when you want to see your glucose level.
On the other side, I loved Dexcom because it gave me an average of glucose for 3,7,14 and 30 days which I found it useful. The sensor sends the readings every 5 minutes to the app which again, it makes it easy for us.

They both are pain free.

I can not recommend you enough a CGM. Personally, I found it useful. Both Dexcom and Libre offer free trial. Libre sensor lasts 14 days and Dexcom’s 10. Have a look on their websites. Hope this helps
 
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