Hba1c borderline but blood glucose ok?

[cyclonic]

Just been informed my blood glucose blood test was OK but Hba1c or whatever it's called was 44 and borderline. What's the usual next step one doc wanted me to go for a glucose intolerance test and this guy wants to repeat the Hba1c? I fasted for both tests but he doesn't seem aware of this even though he told me to the first time. Been having some symptoms for about six months now. tired, thirsty, feeling feint when hungry, so I dropped about 20 lbs and cut out all cakes and biscuits. It's a problem for me to exercise as I'd like as I need a new knee. Is there still hope?
I would post in Pre-diabetes but you guys are the experts.

 

[LittleGreyCat]

The two tests are different.
HbA1c is a measure of your blood glucose levels over the last 2-3 months and so is pretty accurate for diagnosing diabetes and showing how good your control is. Overnight fasting does not affect this test because it is a long view.

Fasting blood glucose is a one off test to see how your body managed your blood glucose over night - that is assuming it is taken in the morning.
Loads of things can affect this and it is just an indicator - if it is high then you would normally have additional tests to confirm/deny diabetes.

Where you are in the "grey area" and it looks as though you may be pre-diabetic then you can have a Fasting Glucose Tolerance Test to confirm or deny.
As I understand it (never had one) you fast just like for a blood test and then they feed you a measured amount of glucose then check your BG at intervals to see how quickly your body can cope with all the extra glucose.

This should confirm if you are pre-diabetic.
The alternative is to wait for another month or so and have another HbA1c test to see if you score higher or lower.

Well done on dropping 20lbs.
Have you looked at the dietary advice on this site?
Cakes and biscuits aren't good, so well done for cutting them out, but you should be looking at all sugars and carbohydrates in your diet with a view to cutting those back if you are having a lot.

There is hope - you are not hitting diabetic numbers - so now is the time to really have a good look at your diet and lifestyle and see where you can improve things to get your BG firmly into non-diabetic territory.

Cheers

LGC

 

[cyclonic]

Thanks very much for your advice. Just had an argument with the GP receptionist this morning about it not being necessary to fast for an Hb1ac as the GP is insisting it is, but as I have already fasted for the blood glucose for the previous Hb1ac at the same time, a repeat test seems redundant. I'm starting to feel really ropey now, constant thirst and a booming headache, absolutely drained and I was sick after eating last night. If I'm too tired to exercise I feel a lot worse the day after and really have to push myself. I don't know why the NHS keep pushing us to get checked when GPs are like a brick wall, my mother was diabetic, due to an undiagnosed underactive thyroid, I have the same condition, she died of a stroke in her late fifties mainly due to the GP's incompetence. They are making me feel like a hypochodriac.
Thanks for your compliment on dropping weight, it's only taken two, no sorry three weeks, so that's probably another symptom? No point in asking the GP haha.

 

[Bluetit1802]

It is not necessary to fast for an HbA1c test, although it won't make any difference if you do. It is, however, necessary to fast for a blood glucose test. Maybe your doctor has ordered both, in which case you will need to fast.

As the HbA1c is a sort of average of the previous 2 to 3 months, it is pointless having another one soon after the first. Best to wait 2 or 3 months between or your results will overlap.

I have never had a full glucose tolerance test. I just had a fasting blood glucose test followed by an HbA1c. There was no need for further tests as the first ones showed I am diabetic.

Did you try to lose weight, or did it just happen? Great loss though, but in 3 weeks it sounds a lot.

 

[cyclonic]

No he hasn't ordered another blood glucose test, just the Hb1ac, yes I agree, it seems pointless.
I remember last year going through a spell when weight just dropped off me for no reason, but I am fat due to my thyroid packing up, so I thought "oh great". I can't eat more than 1500 calories a day without gaining weight in any case but cut out my two biscuits and a piece of cake per day and replaced it with an apple and banana. I seemed to develop sort of mild diabetic symptoms when the thyroid gave up the ghost, increased thirst and mainly urinating through the night, but that stopped when I normalised the thyroid levels. The weight gain was horrific though, I can easily lose or gain half a stone in a week. It's probably fluid, you think?
Thanks for your advice.

 

[Bluetit1802]

I have no experience of thyroid problems, so I can't comment. However, if your doc has ordered another HbA1c there is no harm in having it. It may serve to confirm the first, or may come back better or worse. I would have it if I were you.

Bye the way, I would also cut out the banana - full of glucose and instant release glucose at that. Try a few berries or nuts instead.

 

[LittleGreyCat]

Sounds like you are having a tough time.

Can you give us an idea of your daily diet so we can give a bit of advice?
Already - apple is good banananananana not so good

 

[cyclonic]

Sounds like you are having a tough time.

Can you give us an idea of your daily diet so we can give a bit of advice?
Already - apple is good banananananana not so good

Hi thanks for your sympathy, there's a lot worse off though,

For brekkers I have a bowl of porridge made with water and 2 sweetners and a dash of semi skimmed milk.
Many, many, cups of tea, milk no sugar.
Lunch- a peanut butter sandwich on wholemeal bread ( or a banana sarnie ) followed by an apple ( I used to have 2 Rich Tea biscuits too but no more )
Many, many more cups of tea.
Evening meals could either be any thing from 2 crumpets,or 2 tuna baps to quiche and salad but always followed by a low fat yoghurt and now an apple has replaced my jammy scones. I miss my scones.
A moderate amount of tea, more during football matches to stop me drinking beer.
Evening snack is now 5 cream crackers with some healthy marg stuff instead of my jammy scone.

Merely by cutting out my daily 2 biscuits and scones I have dropped about 24lb in almost a month. This is very dramatic for someone with no working thyroid. When I was in hospital once I actually gained weight on their strict diet after Nurse Rachet scolded me for being borderline obese. You think the fact that my pulse was only 54 bpm they'd had realised I had hypothyroidism.

I'll take your advice and drop the banana, thanks.

 

[cyclonic]

I have no experience of thyroid problems, so I can't comment. However, if your doc has ordered another HbA1c there is no harm in having it. It may serve to confirm the first, or may come back better or worse. I would have it if I were you.

Bye the way, I would also cut out the banana - full of glucose and instant release glucose at that. Try a few berries or nuts instead.

It was a different doctor, who wasn't aware I'd already had the test twice ( neither was I tbh ) and he was adamant, no IGF test, no HbA1C retest and no referral to an endocrinologist. Full complaint lodged with the NHS. It would be worthwhile keeping an eye on your thyroid btw as the conditions go hand in hand. Yes! We have no bananas.

 

[cold ethyl]

Sadly there's an awful lot of carbs in that menu.. Cream crackers aren't best snack for diabetics. Better with some cheese or cold cooked meat, nuts,olives, celery with cream cheese or pate. Your probably packing a lot carbs via all the milk in tea - try green tea or black tea maybe or lactofree milk.
Low fat dairy isn't best option as often the fat has been replaced with sugars.. Try natural Greek yogurt and a few berries.
Similarly, crumpets, baps and sandwiches are not doing your levels any favours. Really you'd be better off replacing them with a proper meal.

 

[LittleGreyCat]

Agree with Cold Ethyl.
Have a look at some of the low carb information and see how you feel.
Do you have a testing kit?
If so, have you tested two hours after each meal to see what your BG levels are?

The weight loss is very good but you might lose at least as much and have better BG if you eat more fats/protein/veggies.

I would also check up on the spread you are having - recently the view on that has changed and now butter is thought to be better for you.

Suggestions (picking up on some things you already eat):

egg, bacon, mushroom and tomato for breakfast (porridge can spike your BG because it is mainly carbs)

cheese and apple for lunch

tuna and salad for the evening meal.

This cuts out the bread, crumpets, biscuits and pastry - all of which can be addictive and can also play havoc with your blood glucose.

Everyone is different but carbs are very close to sugars (sugar is a carbohydrate which is very easily processed).

Cheers

LGC