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HbA1C and GTT not showing same result

vekeh

vekeh

Newbie
Messages
1
Type of diabetes
Prediabetes
Treatment type
Diet only
This might be a little bit of a mess as I’m not sure what information would be most helpful but basically I had a HbA1C test about a month ago, and I was told the result was 48 (mmol?). Earlier this week I had a GTT, which came back as in the range of pre-diabetes (I don’t remember the exact number the nurse said for the full result, but the finger prick test was 6.5). The nurse seemed rather confused that the two results didn’t correlate as either pre- or full diabetes and has ordered me to have another HbA1C test in about a month, but didn’t give any advice about what to do in the meantime.

I don’t really want to just sit on my hands and do nothing, but I’m not really sure what I can do – a simple google search says the typical lose weight, cut back on fatty meats yadda yadda … I’m borderline underweight and vegan. I’m also anaemic, have mild IBS and have chronic joint problems. I’m 22 (and female, which explains the anaemia). I’m not overly active, I have physio exercises I do daily and I walk back and forth to university most days but that’s about it (and about all I can manage honestly). The nurse suggested that the anaemia/bowel issues could be interfering with the glucose results?

Browsing a little I’ve seen people saying to lower carb intake, which is the staple of every meal I eat (I have uh.. “food issues” and eat the same thing every day, the most carby being bagels, cereal, bread, rice) and now I feel a bit wary of eating at all :(. My IBS Specialist has referred me to a dietician (before I knew of this glucose issue), but I feel like I should be doing something before that appointment.

Mostly I’m just sad and confused – should I actively be trying to lower the blood sugar result (seems like a good idea but I don’t really know how to do that?) or as the nurse seemed to suggest, do nothing don't worry about it and just wait for the next blood test?
 
She is right that anaemia can influence an HbA1c test and so if you are anaemic it shouldn't be used for diagnosis. Some forms increase it, some decrease it.
Haemolytic anaemia of any cause can lead to reduced HbA1c values because of reduced red cell survival.
Iron deficiency anaemia can lead to an inappropriate rise in HbA1c of 7 - 11 mmol/mol, which falls after iron treatment
Click to expand...
.http://www.pathology.leedsth.nhs.uk/pathology/Portals/0/PDFs/BP-2013-01 Diabetes.pdf
I think that you really need to talk face to face with someone about the sort of foods that you can eat before trying to adopt a low carb diet which is very difficult as a vegan. Hopefully you might be able to widen your diet .
it might be worth looking at Neil Barnards site. He is a doctor who advocates a vegan diet for diabetes and there are people who say that they do well on this diet. He has got some meal suggestions that might give you some ideas for eating more balanced vegan meals with or without diabetes.
http://www.nealbarnard.org/books/diabetes/
 
Hi and welcome. The HBa1C test is the most reliable and the results imply you are diabetic. You are quite young to be a T2 especially as you are not overweight. Keep and eye on your blood sugar by getting hold of a meter. There is always a background possibility of Late onset T1. For diet you obviously are aware of some of the options. In general keeping the carbs down and making up with fats and veg will help. As you are vegan try to keep the carbs low-GI as you won't be able to reduce them as much as non-vegans?
 
vekeh said:
This might be a little bit of a mess as I’m not sure what information would be most helpful but basically I had a HbA1C test about a month ago, and I was told the result was 48 (mmol?). Earlier this week I had a GTT, which came back as in the range of pre-diabetes (I don’t remember the exact number the nurse said for the full result, but the finger prick test was 6.5). The nurse seemed rather confused that the two results didn’t correlate as either pre- or full diabetes and has ordered me to have another HbA1C test in about a month, but didn’t give any advice about what to do in the meantime.

I don’t really want to just sit on my hands and do nothing, but I’m not really sure what I can do – a simple google search says the typical lose weight, cut back on fatty meats yadda yadda … I’m borderline underweight and vegan. I’m also anaemic, have mild IBS and have chronic joint problems. I’m 22 (and female, which explains the anaemia). I’m not overly active, I have physio exercises I do daily and I walk back and forth to university most days but that’s about it (and about all I can manage honestly). The nurse suggested that the anaemia/bowel issues could be interfering with the glucose results?

Browsing a little I’ve seen people saying to lower carb intake, which is the staple of every meal I eat (I have uh.. “food issues” and eat the same thing every day, the most carby being bagels, cereal, bread, rice) and now I feel a bit wary of eating at all :(. My IBS Specialist has referred me to a dietician (before I knew of this glucose issue), but I feel like I should be doing something before that appointment.

Mostly I’m just sad and confused – should I actively be trying to lower the blood sugar result (seems like a good idea but I don’t really know how to do that?) or as the nurse seemed to suggest, do nothing don't worry about it and just wait for the next blood test?
Click to expand...


The figure 48 (mmol/mol), in relation to your HbA1C test is quite a good result - anything between 48 and 58 is good control if you are diabetic and iirc, below 48 is pre-diabetic (or possibly 48 and under, which might partly explain the confusion?). Non diabetics will be anywhere between about 20 and 40, without needing to resort to any special measures like diet, exercise or medication.

Tricky to know what to advise re diet (and anyway, I'm not a dietician) but being vegan I'd guess, as already said, that slow release carbs are the way to go - so stuff like lentils, chickpeas and other pulses (lentils would be good for iron, I think?). Peanuts and nuts will give you some calories and protein, without too much carb, and thus help you with your weight. In relation to exercise: at least you're getting some :) Government guidelines say 2 hours of exercise per week that raises your pulse and breaks a sweat but any exercise is better than none.

Having said all of that, I'm going to suggest that you wait until you have a definite diagnosis, particularly since it shouldn't take very long. It could be that outside factors are influencing the numbers, as you've been told, in which case it may not help things to start restricting your carb intake, particularly if you have a limited range of foods to chose from. A month's delay in diagnosis is not going to massively impact on things, though of course it's always good psychologically to feel that you're doing something.

I hope things go OK and that you get some clarity from your next visit to the nurse. Do come back here: I've found it a very useful resource (I was only diagnosed back in the summer) and there will always be someone here to lend a sympathetic ear; we've all been there.
 
I was anaemic on diagnosis and I feel that my HbA1c was lower than it should have been.

Which way is your IBS @vekeh because IBS-D can deplete you of many important vitamins and minerals. Vitamin D deficiency can affect your blood sugar levels.

I gave up wheat and my IBS-D symptoms greatly reduced - I'm not coeliac. It is also good for having a lower carb diet if you don't replace it with substitutes.
 
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