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Estimated HbA1c

BPF

Member
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24
Just curious. Over the last few weeks since being diagnosed I've been working hard on my diet and my BG levels are generally within a non-diabetic range. Though I did break on Thursday and had a curry sausage supper from the chippy (which is what caused my 1 hyper)

The estimated HbA1c is showing 35.

Whilst I know this is relative to how often I'm testing but was wondering how accurate this is?

I'm using the accru chek instant tester.

Cheers.
 
Hi @BPF - those are generally excellent numbers, good work..!!

And that's a great set of numbers to get from the tester. I never used that particular brand.
But - to answer your question, they measure different things, so it really is just a mathematical estimate, given the current results.
As you probably know, testers measure the amount of glucose molecules in your blood or interstitial fluid, but an HbA1c measures the amount of glycated haemoglobin in your blood.

What that means is, there is a certain amount of glucose in your blood at any time. There are also blood cells that live on average for three months. So - randomly one will bump into the other all the time, and the effect of a glucose molecule hitting a blood cell is that it will be glycated - if you measure the amount of glycated cells in a sample, you can determine the amount of glucose that's in the entire blood stream on average over the previous three months.

So - if nothing is changing over those three months, your tester will be very accurate, regardless of how often you test (at estimating HbA1c) - but if you are changing the amount of glucose in your blood (or other things are affecting how long your blood cells live) - then the results may not be quite so accurate.
 
I found it impossible to estimate an HbA1c based on blood glucose fingerprick data. The two tests are testing for different things in different ways: fingerprick tests are measuring (with a 15% allowable inaccuracy) how much glucose there is in your blood at that moment. Although you've got 63 data points, these might (I have no way of knowing) be skewed in some way - for example, I know from experience that my daily BG is generally lowest at around 4-5pm, higher in the mornings: by predominantly testing at one point or the other, I could skew it either way.

The HbA1c (with a 5% allowable inaccuracy) is counting how many glycated red blood cells there are at the point of test, and from that estimating what your blood glucose has been like over the last three months or so, and it's heavily skewed towards the rmost recent month.

So a lot depends on the built-in assumptions and inaccuracies of the tests amd measuring systems, and the amount of data available. Best advice from me would be to continue to test and then see, the next time you have your A1c done properly, how good the Mysugr app prediction was for you.
 
Thanks @KennyA & @Chris24Main

That helps a lot.

I was only properly diagnosed a couple weeks about but the few times I've had the HbA1C done they've been very varied.

46 > 48 > 42 > 81!

My goal is to get back within normal range of 31 - 42 by my next test in December.

It may sound stupid coming from an grown man but i'm a very fussy eater so textures, smells and even just the look of some foods put me off so I'm finding it difficult at the minute and thinking there is no way in hell I'm going to be able to keep this up for the rest of my life.

I dont drink often but it just so happens that each time I've been tested I've been out for drinks in the weeks before (about 6-10 pints) and of course the junk food which comes with it and the two day hangover. So I'm hoping this is why results are higher (or maybe im just in denial)

Thanks again. I'll keep this up for the next 2 months and hopefully you HbA1c will improve.
 
Hmmm. You need to manage testing (assuming you're doing fingerprick testing) with alcohol. I have found that alcohol tends to depress blood glucose readings because it interferes with the liver - the liver is processing the alcohol, and stops adjusting blood glucose levels by adding glucose, so levels fall. I've seen suggestions that the junk food/carb craving that sometimes goes with drinking is partly caused by this.

So all of this can lead people into thinking that a meal didn't/doesn't have the carb content/impact it had, because it didn't show up at +2hrs testing. I stopped testing meals where I'd had alcohol because of this. It was pointless. Sometimes I had lower BG levels after the meal than before.

The issue is that the carb has still gone in, been digested and processed, and has probably ended up as usual in muscle stores and as fat. But in essence you get a false picture, because you've taken the liver out of it.

The other thing that can happen is that if you are on a very low carb intake, this alcohol effect on the liver can lead to very low blood glucose levels - disorientation, etc. It's happened to me once, and once is way more than enough.

Years ago the dietitian on my "introduction to diabetes" course recommended that, if you are going to drink alcohol in quantity, you should ensure you have some carbs to eat to prevent just this. It was good advice.
 

I've only started to finger prick when i was diagnosed a few weeks ago and haven't / wont be touching alcohol for the foreseeable so that won't be a factor right now thankfully.
I'm just trying to do my best to figure out what foods work for me and at the minute with testing before and after it seem to gaining a little control over the BG so I'm hoping this will be enough to get me back into a normal range.
This is really useful to know if i do decided to have a drink in the future but likely i'll just give it up completely.
 
My usual fingerprick results every morning are around the high 5s and low 6s. I had my hba1c done a couple of months ago and it was 54. So just thought I’d give you my results based on my daily mmols. It might be a bit optimistic for it to be 35 but of course everyone is different and as you read many posts on this forum we can see there are many many variants and everyone deals with diabetes differently.
 
@KennyA - you know, that's a very obvious set of dots I've totally failed to join...

"don't drink on an empty stomach" -

For me, I find that I can now start feeling ill on a single drink, but I'd put that down to simply, the less I drink the less I feel like drinking, but it's much more likely that I don't have "enough" background glucose to cope with the effect of hijacking my liver to deal with any alcohol...
 
The other thing that's important is that there's only about 4g of glucose in the blood at any point at "normal" BG levels: the system is dynamic so glucose is being added and subtracted from the blood stream constantly; the glucose stores in muscles and liver hold about a day's worth of energy, but the brain needs 80% of that; if you've not eaten then the stores may already be somewhat depleted; and if in ketosis most if not all of that needed glucose is coming from the liver via glycogenolysis or gluconeogenesis.

In other words "don't drink on an empty stomach".

PS - let's not derail this further. Any more posts specifically about alcohol, please start a new thread.
 
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Cheers @MissMuffett

My morning results are coming in around the high 4's low 5's but today it was 6.5 even though it was 5.4 before bed. I have now learned about the "dawn phenomenon" lol

I dont know why my attached photo was showing an expected HbA1c of 35, my app is currently showing 39.1 which is the lowest its ever shown.

On a previous test i was 48 and when they tested me again 2 weeks later it was back down to 42. Either something is going on with the text itself or my body is just trying to P me off lol

Thanks again for all of your advice and guidance everyone.
 
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