Hba1c Creeping Up..........................

Robo42 said:

Just has a 6 monthly Diabetic review, my HbA1c has gone 42, 44 & now 49 over 18 months. Suggested putting back on Meds so disappointed, cannot remember exactly what ones until I pick up at the Pharmacy. I had previously been tried on Metformin, Metformin SR, Gliclazade MR, Dapagliflozin and Linagliptin all made me ill and gave them up when I managed a lower Hba1c without them. So when I find exactly what to be tried on I'll ask if anyone has any comments on the upcoming drug. But I still want to get back off meds.

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Have you tried reducing your carb intake + exercise?

Robo42 said:

been a bit held back with long term back prob & the associated leg pains

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Do you do resistance training at all? I used to have really bad lower back problems but I have built up my back muscles over the years, training very carefully in a gym. Of course you would have to be very mindful and cautious, but there may be some exercises you can do without causing pain. I wouldn't recommend fighting initially!!!

I wouldn't worry too much about lack of exercise. Diet is the key.
You say you eat well, but what are you eating?
Are you using a meter to see what your food choices do to your levels?

Robo42 said:

but eat quite wel

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Eating "quite well" and cutting down on harmful carbohydrates can be two very different things when Type 2 is introduced into the equation.
The fact that your HbA1c levels are rising shows that your food intake isn;t so good for you as you think.
If you want to give us some meal examples we could point you at some better (for you) alternatives perhaps?

Robo42 said:

Just has a 6 monthly Diabetic review, my HbA1c has gone 42, 44 & now 49 over 18 months.

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While carbs will be the most obvious things to cause raised BG, there have been two things that have affected my BG. The most frustrating and annoying for me is the dawn phenomena which doesn't always happen every morning so really frustrating. The other is the effect of proteins and fats which my body is more than happy to fuel a rise in BG. I'm fortunate enough to have a freestyle libre and was surprised the first time I noticed a BG rise after eating two eggs. I've highlighted me and my purely because it's what happens to me and might not be a problem for others. Certainly drives me bonkers at times. Strangely enough, this morning is the first "flat" BG reading I've had for several days.

DavidGrahamJones said:

I'm fortunate enough to have a freestyle libre and was surprised the first time I noticed a BG rise after eating two eggs.

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Is that all you ate? Did you have a drink?

Could it simply be you were on the rise anyway, nothing to do with the eggs, but more likely a liver dump?

As far as I am aware, protein does not break down very quickly, and any rise in levels will be quite a long time after eating.

DavidGrahamJones said:

the effect of proteins and fats which my body is more than happy to fuel a rise in BG. I'm fortunate enough to have a freestyle libre and was surprised the first time I noticed a BG rise after eating two eggs

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@DavidGrahamJones this is illuminating. You may have suggested the answer to a conundrm. I am not knowingly troubled by the dawn phenomenon. However there is a mismatch between my meter readings and my A1c. During the winter I was eating pretty low carb c.20g daily but I had lots of health problems and sometimes had to take meds that can raise bg, so an A1c of 37 (down from a previous 41) seemed reasonable. I was confident that given better health I would improve on that. Over the next months I began taking Metformin and gradually worked up to 2g daily of Glucophage XR (recommended by Dr Bernstein as more effective than the generic Metformin) by the beginning of May. I was also even stricter about carbs. During the whole month of May there were only 2 days when my fasting bg was over 5, and those readings were only 5.2 and 5.3.

At the start of June my next A1c had gone up to 38. Even allowing that A1c tests are not very accurate, that was at least no better than my previous A1c.( I would have expected at worst 34 = average 5.8). 38 = average 6.4. It is very rare for me to see a meter reading at any time as high as 6. I try to avoid going as high as 5.6. So why this discrepancy? I am hoping soon to start testing with a Libre for a while, and maybe this will show something quite unexpected, as it did with you. Is something happening in the middle of the night, or a rise in response to eating protein and even fat that I am not catching, even though I often test repeatedly after meals?

Any thoughts would be welcome.

Bluetit1802 said:

Is that all you ate? Did you have a drink?

Could it simply be you were on the rise anyway, nothing to do with the eggs, but more likely a liver dump?

As far as I am aware, protein does not break down very quickly, and any rise in levels will be quite a long time after eating.

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Agreed about the protein. Could it be that David GJ is ultra sensitive to the physical presence of ANYTHING in his digestive system. Dr Bernstein warns that over-stretching the gut by eating too much even of lettuce or sawdust raises bg. @DavidGrahamJones, how long did the rise after the eggs take to subside?

Alexandra100 said:

At the start of June my next A1c had gone up to 38. Even allowing that A1c tests are not very accurate, that was at least no better than my previous A1c.( I would have expected at worst 34 = average 5.8). 38 = average 6.4. It is very rare for me to see a meter reading at any time as high as 6. I try to avoid going as high as 5.6. So why this discrepancy? I am hoping soon to start testing with a Libre for a while, and maybe this will show something quite unexpected, as it did with you. Is something happening in the middle of the night, or a rise in response to eating protein and even fat that I am not catching, even though I often test repeatedly after meals?

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This is how unreliable HbA1c tests can be, particularly someone with Hb variants and other forms of Red blood cell peculiarities. (and very few of us know if we have these anomalies)

My results in mid June.

My own data with rigorous testing 6 to 8 times a day converted to HbA1c measurements = 33
MySugr estimate = 32.5
Libre HbA1c estimate = 32
A1cNow (Home HbA1c test) = 33
Actual HbA1c = 43.

An HbA1c of 43 is equivalent to an average of 7.1mmol/l

Hand on heart, I have only seen the odd level of 7, maybe 2 or 3 times at an hour after main meal, and then very briefly before it falls. I live most of the day and all of the night in the 4s and 5s. Post meal 5s and 6s.
Queried with GP who believes my data, is concerned, and has contacted the biochemist at the lab my practice uses. The biochemist is arranging for my blood to be sent to another lab at Salford Royal Hospital that uses a different measuring system that can eliminate some of the peculiarities in Hb.

Bluetit1802 said:

This is how unreliable HbA1c tests can be, particularly someone with Hb variants and other forms of Red blood cell peculiarities. (and very few of us know if we have these anomalies)

My results in mid June.

My own data with rigorous testing 6 to 8 times a day converted to HbA1c measurements = 33
MySugr estimate = 32.5
Libre HbA1c estimate = 32
A1cNow (Home HbA1c test) = 33
Actual HbA1c = 43.

An HbA1c of 43 is equivalent to an average of 7.1mmol/l

Hand on heart, I have only seen the odd level of 7, maybe 2 or 3 times at an hour after main meal, and then very briefly before it falls. I live most of the day and all of the night in the 4s and 5s. Post meal 5s and 6s.
Queried with GP who believes my data, is concerned, and has contacted the biochemist at the lab my practice uses. The biochemist is arranging for my blood to be sent to another lab at Salford Royal Hospital that uses a different measuring system that can eliminate some of the peculiarities in Hb.

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My goodness!!! I am trying to take comfort from your history, and it is certainly very helpful, but I do find all this unpredictability upsetting. Also, of course, getting such a high A1c undermines my argument that low bg is more important than low cholesterol. Great that you have got your GP with you.

Bluetit1802 said:

Is that all you ate? Did you have a drink?

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Yes. No.

Bluetit1802 said:

Could it simply be you were on the rise anyway, nothing to do with the eggs, but more likely a liver dump?

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In my opinion no because when I see dawn phenomena it's more dramatic, reaching higher numbers (12-15), and from as early as 04:00, 9 hours after eating. I can't find the one I was thinking about but this is an example of where I had coffee at 06:00 and poached eggs at 07:00. Change of plan, it's not uploading.

Bluetit1802 said:

As far as I am aware, protein does not break down very quickly, and any rise in levels will be quite a long time after eating.

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That might be so, but not supported by my experience. PDF loaded but won't expand. You can click to see bigger picture.

Alexandra100 said:

how long did the rise after the eggs take to subside?

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On the example I tried posting only 30 minutes, so pretty good really. The frustrating thing is a lack of the same thing happening each time. I ate some cooked red cabbage from a restaurant the other day, big mistake because it might have caremelised a bit. Readings went haywire for many hours.

DavidGrahamJones said:

Yes. No.



In my opinion no because when I see dawn phenomena it's more dramatic, reaching higher numbers (12-15), and from as early as 04:00, 9 hours after eating. I can't find the one I was thinking about but this is an example of where I had coffee at 06:00 and poached eggs at 07:00. Change of plan, it's not uploading.



That might be so, but not supported by my experience. PDF loaded but won't expand. You can click to see bigger picture.

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Do you always get a rise after eating, or just this once?

Alexandra100 said:

Do you always get a rise after eating, or just this once?

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Not always, I'm pretty careful in monitoring my food intake. I wish I could find the one I was thinking of. It showed 5 - 7 all night, then a blip when I ate the eggs, not serious, certainly nothing like DP when it happens, but enough.

DavidGrahamJones said:

Readings went haywire for many hours.

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I do sympathise. All this is so discouraging. I too find that once my bg is up it can take hours to go down again, so I tend to be a bit paranoid about letting it get up in the first place. I believe it is due to a deficient 2nd phase insulin release?

DavidGrahamJones said:

In my opinion no because when I see dawn phenomena it's more dramatic, reaching higher numbers (12-15), and from as early as 04:00, 9 hours after eating.

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So could eating the eggs have stopped the more extreme DP you refer to?
Maybe a different way of looking at it?