Concern?

I don't think there is any need to panic since your test would be classed as a random test and the qualifying level is 11. Having said that she could well be pre diabetic so if she is up for it she should get an Hba1c test done.

About 25% of the population get glucose spikes after eating high carb meals. These people may not have diabetes. Glucose spikes can lead to many illnesses including heart disease, strokes, cancer and alzheimers. So, it is good to be aware of glucose spikes and take appropriate action to avoid them. Google glucose spike and you will find a Japanese documentary which gives a lot of details on this.

I suggest your friend gets a glucose meter to check their fasting glucose levels and post meal levels. If the fasting levels are high, then get a HbA1C test to see if they are type 2 diabetic.

Speedbird said:

Thank you @Squire Fulwood and @Art Of Flowers

Just an update. Since we did the test a couple of weeks ago, she has been on very low carb and following a “Blood Type”diet.
( Not the Blood sugar diet ). She has lost 10ibs in 2 weeks. She saw her nurse yesterday where she had another blood prick test and was told she is normal although I don’t know what figure the nurse told her. So, should she still go for the HbA1c?
She is also complaining of pain in her foot, which may not have nothing to do with diabetes but just a coincidence.
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If she has any concerns then an Hba1c test will put her mind at rest or let her know exactly where she stands. The pain in her foot is doing nothing to give her peace of mind.

One difficulty might be that since she has taken corrective action the test will show an improved result whereas it might not have done before.

Never mind all that. Losing 10lbs in 2 weeks is quite a result. Congratulate her for me.

eating low carb is a powerful suppressant of diabetes symptoms.
Your friend could be in the prediabetic stage, but possibly might never show up as such if she keeps on with the same diet - I was in full blown diabetes but not have no symptoms

I happened to find out that someone close to me had a 5.7 (39) A1C result three years ago and her doctor said nothing about it at the time. Earlier this year, she had an instantaneous glucose test (part of a routine medical) which was totally unremarkable, bang in the normal range. The doctor did not order an A1C this time, apparently because the insurance company here in America has changed the rules (the A1C is now only ordered if the instantaneous BG is out of whack).

The only thing I said to her is that I am diabetic, recently diagnosed, and that a few years ago my A1C was 5.5 (lower than hers is now). She does not seem concerned, and frankly, I don't want to sow what would almost certainly be totally unnecessary alarm. Right?

Speedbird said:

I agree @Grateful. I don’t want to cause alarm. The fact that she is losing weight is a good start. Her BMI is 32 but she is working on it.
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Thanks. It's a fine line.

I do happen to know that the person I mentioned is having a full routine medical in February. What I might do is gently suggest that she ask the doctor to do an A1C then (she did actually say to me that it's a pity she didn't have an A1C at her last medical). I am pretty certain it will be a waste of time, but there is always a chance that the 5.7% (39) reading three years ago was some kind of precursor.

I never had T2 symptoms and was diagnosed as the result of a routine medical. That was several years after registering a 5.5% (37) at the previous medical.

My son did a prick test and showed a reading of 10.1, but soon went down to normal as the process that should kick in actually did.

Art Of Flowers said:

About 25% of the population get glucose spikes after eating high carb meals. These people may not have diabetes. Glucose spikes can lead to many illnesses including heart disease, strokes, cancer and alzheimers. So, it is good to be aware of glucose spikes and take appropriate action to avoid them. Google glucose spike and you will find a Japanese documentary which gives a lot of details on this.

I suggest your friend gets a glucose meter to check their fasting glucose levels and post meal levels. If the fasting levels are high, then get a HbA1C test to see if they are type 2 diabetic.

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Hello and then what after testing, both tests finger testing, and A1C cut offs are Arbitrary figures set by experts acknowledged as such as random at whim, at choice, they lower as and when they decide not supported or backed up by medical evidence, or clinical evidence, only based on presumptions as I understand, that by lowering levels here and there accordingly, are to capture the disease earlier?????????? yet in between,normal people become pre or diabetic, and possibly by the one number adjustment, may be provided medicines unnecessarily, and or falsely diagnosed.

The Diabetes world has to come to grips, focus on putting a cut off level for the world to follow a strict medically approved cut off and not aribitrary, even the experts in America, the ADA and its so called specialists cannot agree on the cut off for A1C so my question is how can anyone trust the cut offs currently todate, I FOR ONE DO NOT TRUST THE NUMBERS, AS I FEEL THEY ARE DECIDED UPON FOR POLITICAL AND BUSINESS PURPORSES AT THE END OF THE DAY AND IF THAT PROVES TRUE AND CORRECT, THEN AT THE END OF THE DAY AND ULTIMATELY, ITS THE PHARMAS WHO DECIDE ONES DIAGNOSIS NOT THE DOCTORS YES OR NO IS THE FRIGHTENING AND CONCERN QUESTION?

MALLORCA

Speedbird said:

I had lunch with a colleague recently. She has not been tested for diabetes.
We both had the same food except that she had some flatbread with hers.
We then both did a finger prick test about 2 hours after eating, mine was 6.4, but hers was 9.2. Should she be worried?
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Even a non diabetic can have those levels after eating starchy carbs it doesn't mean they have diabetes or are even prediabetic I do not expect many of us ever tested our levels before we had diabetes we may have been amazed at the results if we had done. Even non diabetics do not have low levels all the time a starchy meal can shoot them up it is normal

Grateful said:

Thanks. It's a fine line.

I do happen to know that the person I mentioned is having a full routine medical in February. What I might do is gently suggest that she ask the doctor to do an A1C then (she did actually say to me that it's a pity she didn't have an A1C at her last medical). I am pretty certain it will be a waste of time, but there is always a chance that the 5.7% (39) reading three years ago was some kind of precursor.

I never had T2 symptoms and was diagnosed as the result of a routine medical. That was several years after registering a 5.5% (37) at the previous medical.

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I PRESUME YOU ARE IN AMERICA, re the cut offs, this shows how frightening the world diabetes is different cut offs in different countries, depends where you are time of diagnosis, and is appalling. In New Zealand an aA1C is 6.7% cut off to be diagnosed Diabetes, and one has to have classic symptoms also! and two tests. 6.6% is pre diabetes.

So your saying in America 5.5 % 37 is diabetic diagnosis range? with no symptoms??

Here in MALLORCA for example a person with 5.7% A1C is classed as NORMAL.

This is why everyone should get a 2nd and 3rd opinion at all times when they receive their tests, due to the arbitrary and inconsistent world differences of cut offs for diagnosing diabetes.

Hope this helps.

Mallorca

Art Of Flowers said:

I suggest your friend gets a glucose meter to check their fasting glucose levels and post meal levels. If the fasting levels are high, then get a HbA1C test to see if they are type 2 diabetic.

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I do not think we should be suggesting that those who have not had any tests to confirm if they have diabetes or prediabetic get a meter and start testing their blood. I think this could make some people very paranoid about their levels which may be perfectly normal. We all know a finger prick is not a diagnosis by any means and is only a result for that moment in time and it could make some people worry unnecessarily. If people are worried they should see their doctor for a proper blood test

pollensa said:

So your saying in America 5.5 % 37 is diabetic diagnosis range? with no symptoms??

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Not at all. It is not even "pre-diabetic" under the U.S. definition. Maybe I worded my post badly, so here are some more details.

Yes I am in America.

In 2009, during a routine medical, I had an A1C of 5.5% (37). My doctor, quite rightly, said nothing about it.

I then skipped my annual medicals (bad idea) until early this year (2017) when it was 8.3% (67) when I had the routine medical in February and the doctor diagnosed T2 diabetes. I had no obvious symptoms of diabetes and subsequent visits to specialists have shown that I do not yet have any complications of the disease, either.

At diagnosis, I also had a very high instantaneous glucose reading (I think this number is supposed to be around 100 to 125, mine was above 200). In fact this is what prompted the doctor to order the A1C.

pollensa said:

Here in MALLORCA for example a person with 5.7% A1C is classed as NORMAL.

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Again, if you look at my original post, the 5.7% (39) is not my reading, but that of someone close to me. That reading is from three years ago. Here in America, that level is exactly the point where "pre-diabetes" begins (to see the official ADA recommendation, click on the attachment icon at the bottom of this post).

BTW I did not say this to the person I am talking about -- it is not my role to play God, or rather, to play Doctor. Having seen her 5.7% (39) reading, I merely encouraged her to ask for an A1C at her next medical which happens to be three months from now.

Edited to add: at the time, three years ago, the doctor said nothing to this person. That is his right and he is in charge.

I agree that the cutoff levels set by the ADA, and other national authorities, are somewhat arbitrary. Especially at diagnosis, multiple tests are a good idea (and these were conducted, when I was diagnosed). Furthermore, there is a margin of error, which means tests that are only just in the diabetic range should be repeated to make sure.

But we have to start somewhere. (Edited to add: If you look at the graphic I posted below, it is explicitly stated that diabetes risk is a continuous spectrum, which is in effect a warning not to get too obsessed with arbitrary cutoffs.)

Again, I apologize if my post was badly worded, or if you got the impression that I interfere in other people's lives throwing around bogus data about diabetes.

Pinkorchid said:

Even a non diabetic can have those levels after eating starchy carbs it doesn't mean they have diabetes or are even prediabetic I do not expect many of us ever tested our levels before we had diabetes we may have been amazed at the results if we had done. Even non diabetics do not have low levels all the time a starchy meal can shoot them up it is normal

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About 25% of people suffer from blood glucose spikes. Most of these people have normal HbA1C and normal fasting blood glucose levels and don't have diabetes. However, frequent glucose spikes increase the risk of heart disease, strokes, cancer and alzheimers.

Art Of Flowers said:

About 25% of people suffer from blood glucose spikes. Most of these people have normal HbA1C and normal fasting blood glucose levels and don't have diabetes. However, frequent glucose spikes increase the risk of heart disease, strokes, cancer and alzheimers.

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Out of interest what defines a spike?

This still eludes me and confuses me.

Personally my fasting, pre and post readings are all fairly well maintained. I do check in between eating and the 2 hr post eating to see if spiking.

Definitely higher but still unclear if if constitutes a spoke or not ?

Looseboy said:

Out of interest what defines a spike?

This still eludes me and confuses me.

Personally my fasting, pre and post readings are all fairly well maintained. I do check in between eating and the 2 hr post eating to see if spiking.

Definitely higher but still unclear if if constitutes a spoke or not ?

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A spike is generally thought to be anything above 2mmol/l higher than before you started to eat.