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Bit lost

Paul113

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1
Hi guys.
Looking for a little bit of guidance/advice if possible please.
I’ve not been diagnosed but have all the classic symptoms. Excessive urination, thirst, fatigue, blurred vision at times, slower healing wounds etc. I had covid in August and was luckily well throughout but afterwards I have took 3 funny turns where I ended up in a and e due to palpitations, confusion and chest pains. Checked out all fine on each occasion and then within the last 2 weeks I have started developing the classic symptoms listed which have been gradually getting worse. Urine test and antibiotics for potential infection but came back clear. Sent for blood tests fasting which was after 13 hours came back at 6 and hb1ac has come back at 37. Not sure what these mean but been told they are fine. Whilst waiting for the results I picked up a glucose monitor as I’m desperate to get to the bottom of what’s causing my symptoms. My fasting reading each morning for the last 5 days has been 7 to 7.8. My highs have been between 11 and 13 with an average of 9.2mmol. I’m mid 30s, slim, active, non-smoker, don’t drink alcohol and rarely drink caffeine. I guess my question is how quickly can diabetes come on? If it has only come on in the last few weeks then my average hb1ac will reflect the previous 3 months so will reduce my score I presume? Is there anything else I can ask my gp to do test wise to get to the bottom of this? Sorry for the long winded post guys. Any advice will be greatly received!
 
Hi @Paul113 , and welcome to the forum.
I guess my question is how quickly can diabetes come on? If it has only come on in the last few weeks then my average hb1ac will reflect the previous 3 months so will reduce my score I presume?
Yes, that's correct.
And diabetes can come up quickly, depending on type.
Diabetes after covid is all new terrain, but it seems to happen. Of course, some of those cases are coincidental, those people would have developed diabetes at this moment anyway, and I guess many who've had undiagnosed diabetes for a while are diagnosed because they see a doctor for the covid, but it looks like some develop diabetes due to covid as well.

Is there anything else I can ask my gp to do test wise to get to the bottom of this?
Keep testing would be my first advice, that way you know to sound the alarm bells if you start to see higher numbers.
Apart from that, I'd inform your doctor on your current numbers and see if you can get another hba1c in a month or so.
While your fasting of 6 and hba1c of 37 sound good, like your doctor said, seeing unfasted numbers up to 13 are a reason to look a bit further.

Good luck, and let us know what happens!
 
I started having problems a long time ago that I thought were diabetes, and so I self-funded (£99) an Hb1AC test in September 2018 that showed me at 35. A few months later, around February 2019 the GP send me for tests, I came back a 47, and then the time after that 48. So the limits are arbitrary, and maybe if you have had highs of 13 on the fasting blood sugar, and the Hb1AC is 37 it could easily rise into the 40s next time. If only the pathologists had told in 2018 to take immediate action to stop the figure from going over 48....
 
Your lab fasting level which I take as 6mmol/L would be considered pre-diabetic.
Your last A1c of 37 would be considered slightly higher than normal but not far off the population average.

The worry is your self-measured postpriandials & fasting levels, so what to do.
Weight & lifestyle seems good so low carb is the real tool in your arsenal.

You are luckier than most that you have detected this before rolling into a full blown diagnosis.
The fact you have your own meter is also encouraging.
Low carb should yield good results but if things continue to deteriorate then request a C-peptide & antibody check on your next lab panel.

Good luck
 
Your lab fasting level which I take as 6mmol/L would be considered pre-diabetic.
Your last A1c of 37 would be considered slightly higher than normal but not far off the population average.

The worry is your self-measured postpriandials & fasting levels, so what to do.
Weight & lifestyle seems good so low carb is the real tool in your arsenal.

You are luckier than most that you have detected this before rolling into a full blown diagnosis.
The fact you have your own meter is also encouraging.
Low carb should yield good results but if things continue to deteriorate then request a C-peptide & antibody check on your next lab panel.

Good luck
Have I missed something? Surely an A1c of 37 is towards the bottom end of normal range?

https://www.diabetes.co.uk/hba1c-test.html
 
Have I missed something? Surely an A1c of 37 is towards the bottom end of normal range?

What I was trying to get across is that although 37 is nearer 40 than 20 it's about average for a western population.
Here's a 10 year old Dutch study that measured the A1c of nearly 3k of the non-diabetic population across various ages.
https://pure.rug.nl/ws/portalfiles/portal/14502679/01c1.pdf

DUTCH.PNG
As you can see the average A1c was 38 which is about where the OP stands atm.
 
What I was trying to get across is that although 37 is nearer 40 than 20 it's about average for a western population.
Here's a 10 year old Dutch study that measured the A1c of nearly 3k of the non-diabetic population across various ages.
https://pure.rug.nl/ws/portalfiles/portal/14502679/01c1.pdf

View attachment 52105
As you can see the average A1c was 38 which is about where the OP stands atm.
So the really good news for the OP is that the reported A1c of 37 is below average for the non-diabetic population, let alone the diabetic population.
 
According to Dr Bernstein all cause mortality is J shaped with the minimum equivalent to average blood glucose 83mg/dl. So I think that translates into 83/18 approx 4.6mmol/l blood glucose. With HbA1c around 26mmol/mol.
How hard you work towards this target is up to you but how close you get to this target will vary from person to person ... its all OK until you get to 42mmol/mol is not the whole truth :(
 
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