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Blood Sugars up but HbA1C the same?

EllieM

Master
Retired Moderator
Messages
10,450
Location
New Zealand
Type of diabetes
Type 1
Treatment type
Pump
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hypos and forum bugs
When I saw my diabetic specialist in February she read me the riot act on hypos (had a bad night time one and an ambulance inducing one in the space of 6 months) and told me to keep my blood sugars between 6 and 12 or she'd take my driving license away (a bit mean I feel as I always test before driving but I did lose hypo awareness when I kept my blood sugars low during pregnancies so I do see her point.)

So, I've duly been keeping my blood sugars higher (mostly 6-12) and had only 4 readings under 4 (one 3.3 when I woke hypo and rest high 3s). Just had my latest hbA1C and confused because it's the same as the last one done by the nurse at the clinic (52 aka 6.9). Is this normal? Does having less hypos actually result in less spikes as well? I was definitely expecting a much higher reading....
 
I am not sure less hypos will directly mean less highs but I can imagine if you are keeping a closer eye on your BG to avoid going low, you are likely to be paying closer attention to all your levels.
I think the only way of really knowing is to wear a CGM or Libre to see what is happening when you are not pricking your finger.

Well done on what looks like better control.
 
Hi @EllieM There is great debate over the 'trustworthiness' of the HbA1c test as being an accurate way to gauge how well controlled a diabetic is over say 2-3 months, however it doesn't account for blood glucose variability. So some one who is say 6.5 mmol/l most of the time could get the same result as someone who is 4.2 25% of the time as an example.
 
It probably is just avoiding some of the highs as well as the lows. Are you feeling better and seeing less variation day to day?
 
It probably is just avoiding some of the highs as well as the lows. Are you feeling better and seeing less variation day to day?

Well, better in that I'm not getting hypos which make me feel like sh..t. :) And bad hypos tend to wipe me out for a day so avoiding them is definitely a plus. The thing is, I'm not really doing any more testing than I was before, it's just I'm aiming for slightly higher blood sugars, but I think the after meal raise has reduced.

I have one libre left which I will use some time, in the hope that I'll no longer be allergic to it and it will give me useable readings rather than a LO all night when I know I'm running at 5 or 6.....
 
HbA1C is frankly an utterly useless way of measuring how well you're doing because as has been pointed out it can easily be swayed one way or another by compensating for those lows with a couple of highs or regularly being slightly above your recommended range or vice versa. I had a great HbA1C myself according to the nurse back in December despite waking up low just about every single day for 6 months straight and feeling horrible on a daily basis, and I pointed out that the numbers don't really tell the same story once you actually analyse them, which she agreed with.
Until there is a way of keeping track of when and why we get our highs and lows, I expect we'll be stuck using these useless methods however. I'm working on my own theory to solve the problem, but it's not gonna be useful(if it works) for quite some time.
 
Until there is a way of keeping track of when and why we get our highs and lows
Well the "when" is solved by a working cgm, the "why" is the million dollar question.....:)
 
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