confused...high readings at home, low HbA1cs

[goji]

I'm confused as there seems to be a big discrepancy between my home testing and my Hba1cs. I just got my recent HbA1c back for October at 6.1%. In June I had one done that was 5.9%.

I know I should be happy with these results but I'm finding it difficult to take them seriously as my blood results at home are often quite high and I rarely have hypos.

For example, I just took my blood on two different machines (Freestyle lite and Accuevue Touch) and it was 10.1 and 9.8 respectively. These are not exactly the low readings that would go with low HbA1cs. The other day I had a reading of 16.2 post-priandal. :shock:

Is there something that could be making my HbA1cs artificially low? It's hard to know whether to trust my meter or the HbA1c. The two HbA1cs were done in different labs in different countries so I can't think it's the lab at fault.

Thanks
Goji :?

PS. I take Benfotiamine but only a low dose (150mg per day). Do you think that could be doing it?

 

[Katharine]

Could you have anaemia? This and many other things can affect the glycation of red blood cells.

If you are really concerned there is another test called fructosamine which a hospital consultant may agree to.

 

[JJ4]

My husband is Type 2 and often has similar going on. We've argued with his GP about it as they don't believe he can have such regular high readings but such a good HbA1c. We don't get it either.

 

[janabelle]

Hi, this post interested me as I have often questioned the real value of Hba1c tests.
I've been type-1 for over 20 years and on insulin. When I was on Lantus I had daily fluctuations between 2-15mmol/l, and sometimes higher. My highest Hba1c over the 4 years on Lantus was 7.1, which sounds ok, but my control was certainly not. Despite begging my consultant for help as I was feeling so lousy, I recently found out that she had written that I had "good glycaemic control" in my notes! This was despite me telling her about the daily fluctuations, and of my efforts to try to get things under control. She actually told me it was ok to have a BG of 15 as long as it comes down again-now I know better :cry:
I've since changed insulins and now have great daily control of my BGs.
So are Hba1c tests really worth their salt, if daily BG levels are all over the place? Most type-2s are relying on this test and many not prescribed testing strips for home testing.
After my experience, I have serious doubts about it.
Jus

 

[FordPrefect]

Obviously I dont know about the eating and testing schedule but remember that hba1c is an average so if for example you eat 2 meals a day and then test an hour after you get high readings but the rest of the time you are gonna be lower?

 

[totsy]

could u possibly be having unknown hypos where youre body liver dumps after??

 

[janabelle]

HI again Goji,
your post highlights the importance of type-2s being given the tools to check their own BG at home.Clearly, for you (and me, previously) the Hba1c result is not giving an accurate picture of your daily blood suagar activity.

It's not good for type-1s to have regular swings from high-double figures to very low single figures, so I can't see any reason why a doctor should find such fluctuations acceptable in a type-2 patient. Surely the likelihood of long-term complications due to poor control would be the same for both type-1 and 2?

Your doctor should acting on the information you are telling him, and looking at your home BG test results,rather than relying solely on the Hba1c test; even if the result is within the acceptable range. As previous poster said,it's only an average.

hope you get it sorted
Jus

 

[goji]

Hi everyone

Thanks for all your suggestions. It is so confusing as all the doctors are happy that my control is 'good' but I keep getting these high peaks. Sorry to hear that others of you are having the same problem. It makes it hard to know whether to trust your meter or not!!

Katharine, I'm not anaemic in the 'low Hb' sense, however I have been supplementing with a lowish dose of iron (40mg per day) for about 9 months as my ferritin level is on the lowish end of the scale at 24 [23-120]. I did wonder if lowish ferritin or taking iron could affect the Hba1c test?

I do tend to have good fastings with most in the 4s but I tend to go to bed on around 7 or 8. I still have good hypo awareness so I think I would be waking up if I was hypoing at night. It just seems that whenever I test in the day, I get these elevated readings like 10,11,12. Maybe it all averages out somehow like FordPrefect says.

I'll ask about the Fructosamine test next time i go to the hospital though that's not for a while.

Goji

 

[janabelle]

Sorry Goji,
don't know why I presumed you were a type-2,prob the hba1c thing, should have read the posting more closely.
I hope your doc listens to your concerns more than mine did, and your control improves. Trust your meter more than the Hba1c,. As far as I'm aware your pre-meal BG should be between 4-6 and should peak no higher than 9, two hours after.
Best of luck
Jus

 

[lilibet]

I think its a physiological thing for each of us. My last was in the low 5's but I too get the horrendous spikes that us T1's just cant seem to blinking well tackle without eating NO carbs (or maybe its just me....)

I think people might 'glycate' their cells differently which might just be genetics and some anaemias do give low hba1c's but its often puzzled me too. I know what you mean re docs though., If I complain about spikes of 10 or so, I get told that 'non' diabetics get this too and not to worry. I wish they would do a proper study of spikes because there is some 'notion' that they might cause damage but no real commitment to look at it. As long as we rely on the hba1c which I never find to be an average on my meter (though appreciate there are hours in between) we will ignore the grey areas that impact on our lives. Still, suppose NHS need some kind of barometer

Still, Ive yet to test any non diabetic friend/family who get over 7. Ever