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Disastrous results

D

DanW13

Well-Known Member
Messages
119
Hi,

Just had 6 month blood test results after being diagnosed prediabetic with Hba1c of 43 in Sept20.

I had an interim test at end of October that showed great results - Hba1c had dropped to 36, cholesterol up a bit to 5.6 but mostly due to higher HDL. Blood pressure had fallen also. Happy days.

Today’s results are therefore a kick in the teeth.

Hba1c back up to 40, so just about in normal zone still but up significantly compared to end of Oct.

Total cholesterol up to 7.6 (huge increase). HDL has gone up again from 1.8 to 2.3 but non HDL has soared from 4.0 to 5.3. Ratio is 3.3

Ive no idea what to do now to be honest, I’ve lost almost 2 stone, have a BMI just under 21, but all the effort for a paltry decrease in blood sugar and a huge increase in cholesterol. What the hell do I do now??

The weird thing is I used a Libre both end of Dec for 2 weeks and end of Feb for 2 weeks, average blood sugar was 5.7 on both and Hba1c prediction was 33!! So miles out, what’s going on??? Both libres came back with similar results.

Any thoughts appreciated, but clearly I need to cut out/down the high dairy fats & eggs but then how do I replace the lost calories and avoid further weight loss??
 
Do you have your full lipid panel results.. in weight loss mode cholesterol numbers can be quite misleading and are often mis interpreted by doctors.
Had you fasted before the blood was taken for the test too?
 
bulkbiker said:
Do you have your full lipid panel results.. in weight loss mode cholesterol numbers can be quite misleading and are often mis interpreted by doctors.
Had you fasted before the blood was taken for the test too?
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Yes it was done at 8am and hadn’t eaten anything since evening before, just a glass of water and coffee prior to it.

Don’t have any other info, they only checked cholesterol because I specifically asked them to, they were just only going to do blood sugar.
 

Do you have the triglycerides figure? Coffee can have an impact of cholesterol readings too so sorry to say that your reading could well have been skewed by the coffee.
The Trig/HDL ratio is thought to be the most important so those are the two most important numbers.
 
My Libres always return unrealistically low guesstimates for my HbA1cs. I do not consider the Libre useful for predicting HbA1cs, since my Libres always read between 1 and 1.5mmol/l lower than prick tests, so the discrepancy is easy to explain.

Cholesterol often rises with weight loss (the subcutaneous fat is released from the stores and transported via the blood as cargo on the things that are measured in a cholesterol test. So you will likely have a lot more of them during weight loss. Give it time (months) after the weight loss if over, for your true Chol levels to be revealed.

You may find this thread interesting:
https://www.diabetes.co.uk/forum/threads/struggling.180502/page-2#post-2378776
 
I’ll give them a call re:triglycerides.
 

Thanks will take a look at the thread. My worry with the Hba1c I guess is it was 36 at end of October, since then I’ve lost further weight and if anything are lower carb than I was back then yet it’s shot back up to 40. If Hba1c was still around 36 I’d be despairing far less but it feels like I’ve succeeded in making only a minor dent in blood sugar at great cost to my cholesterol levels.
 
DanW13 said:
Just called them, they don’t know. Just asked me to book an appointment with the Doctor due to the high cholesterol.
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They are I'm afraid talking nonsense..
Cholesterol is as dynamic as blood glucose (possibly more so) so a single reading after coffee should not be used to diagnose nor prescribe.
I'd seriously wait another 3 months and try and get a re-test before signing up for statins (which is what your doc will likely prescribe for you) and next time water fast for 12-14 hours before the blood is taken.

In the meantime you could try this thread..
https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/
Once you've read it and watched the videos you'll be better informed than 90% of GP's...
 
When I was using sensors, my recorded levels were always around 1-1.5 mmol lower than actual finger pricks, and the predicted HbA1c figures were far lower than both finger prick average predictions and actual HbA1c results.

For the last seven years my HbA1c results have generally varied within 3-4 points which I feel are perfectly acceptable limits, but occasionally have gone a bit higher due to issues other than my diet. I've learned that what goes up will go down again, so while I appreciate that you're unhappy with the increase you've seen I don't think, unless your HbA1cs continue to rise, that you have much to worry about. Just remember you're a person not some sort of robotic laboratory experiment, and you'll see variations as nothing can ever be 100% accurate, and as @Brunneria says it can take a while for your body to settle down and adapt to new routines.
 

I won’t take statins, my cholesterol has always been around 5.0 so if it’s shot up now, the root cause is fairly obvious (change of diet possibly combined with weight loss), so for me the change to make prior to a retest in say 3 months is to cut back on the eggs & dairy fats, I’ve been having cheese omelettes 4-5 times a week so clearly that’s likely a big factor. I’ll cut those out and see if that makes a difference. My only worry is chances are the weight decline starts again and as I said I’m BMI 21 already with low body fat so can’t really afford to lose any.
 

I don't really see your results as disastrous nor particularly see a need to change what you eat.

My results for comparison are these. So I've been higher and lower but am still pretty unconcerned. With my Trig/HDL at 0.77 my chances of CVD seem pretty low.

But as always it's your choice.

 
You do know the eggs/cholesterol assumptions were disproved a decade ago don’t you? And there’s no proven link with fats, dairy or otherwise. Whereas there is definitely a link between carbs and cholesterol. If your bmi is quite low the last thing you want is to cut beneficial foods and end up starving yourself or adding carbs.

Please read at least some of the info in @bulkbikers thread before you cut things you don’t need to cut. A retest without coffee and when weight is stable rather than falling is likely all you need to change.
 

Aren’t there some (circa 1 in 4 from memory) who are hyper responders and diet does impact cholesterol? Feels like I need to speak into a specialist in the area & get a full lipid profile to find out what’s going on.
 
Feel a bit happier now, just went on a heart health risk calculator, plugged all the figures in and came back with a heart attack/stroke risk in next 10 years of 2.8%, and average age I’d live before having one is 80, so I’m not a walking heart attack waiting to happen! Interestingly even if I reduced cholesterol to 4.6 it only dropped risk to 2%. Going full blown diabetic wound up the risk to 3.6% and LE to 75.
 
DanW13 said:
Aren’t there some (circa 1 in 4 from memory) who are hyper responders and diet does impact cholesterol? Feels like I need to speak into a specialist in the area & get a full lipid profile to find out what’s going on.
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There are (ldl) hyperresponders. They have very high numbers usually. That still hasn’t translated into higher poor cvd outcomes though. There’s links to this issue in the long thread linked to above.

Also note that ldl is calculated not measured and the assumptions used don’t fit low carb well. Also ldl could vary in protectiveness/damaging potential by particle size. They also rarely check this. Low carb encourages the protective large buoyant particles and lowers the small dense potentially harmful ones.

Or you can get a cac scan to see what level of damage you have if any in your arteries.

I see you found a calculator - was that Qrisk 2/3? My biggest gripe with those is there’s no accounting for control of diabetes and postcode makes big assumptions for an individual. A few 100m can give some quite different results.

these are specific cholesterol calculators you might find interesting
https://cholesterolcode.com/new-report-tool-launched/
https://www.hughcalc.org/chol-si.php
 

Thanks, it was a BHF calculator, one thing it didn’t include was exercise (which I do a lot of), on Bulkbikers thread there was a link there to high levels of exercise leading to high LDL levels, guess body running on high levels of blood cholesterol to manage the higher exercise levels? Feeling bit less stressed now, just wasn’t expecting such a leap in the cholesterol, or a Hba1c beginning with a 4 again!
 
A quarter of us do have cholesterol which is affected by diet. I'm one of them. It's genetic. Familial hypercholesterolemia. If I eat 200 mg of cholesterol a day my cholesterol levels are normal.

Your results aren't too disastrous. My total cholesterol was 10 mmol/l when I changed to LCHF. It's 5 nowadays was I count my daily total cholesterol. I'm not on any cholesterol medication. Your HbA1c is still in the same ball park. You may ask for a c-peptide and GAD antibody tests as your BMI is 21. It's low enough for a referral pathway to check for type 1 diabetes.
 
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Thanks for this, been reading up on stuff this afternoon and the Triglyceride reading is the missing piece of the puzzle, really need that figure as a low number there would suggest I’m a lean hyper responder, the description of which fits my profile (slim, low BMI, lots of exercise, high HDL, high LDL, low Trig).

So planned next steps for me - check Triglyceride figure. I’m going to get thyroid function checked just in case. Then yes given the increase in Hba1c I’m going to get checked for possible LADA, via those tests you mentioned. Anything else anyone would suggest?
 
Reactions: ert
Well that’s all quite a puzzle.

So if the tri’s are fine, you don’t have to worry about that? And if the insulin/gad is clear then you’re clear on late t1 and still in the managing t2 club?

Thyroid is a maybe given the weight loss, but it would be a coincidence if thyroid happened at the same time as your high BG and the weight loss that’s easily explained by a new diet.

I have no clue about cholesterol, I’ve just been hoping that it settles down in my case. Sounds like there are plenty of people who have been through it and understand it in this thread.

Relax mate, you’re not dying anytime soon. Plenty of time to get a handle on it. The wheels of medical diagnostics turn verrrry slowly.
 
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