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Type 2 HbA1C - how to interpret?

peacetrain

Well-Known Member
Messages
1,405
Location
Lancashire
Type of diabetes
Treatment type
Diet only
Hi Everyone,

Firstly, a huge thank you to everyone because I've learned a lot about diet on this forum and it's helped me enormously.

I was newly diagnosed type 2 in November 2013. HbA1C was115 and two weeks later 112. Prescribed Metformin 3 x 500mg but sometimes I forget. Cholesterol was 5.3 (bad fat 3 and good fat 0.8) no statins yet. On second visit in December I asked for a meter and was given one, no problem. I'm a 56 year old female primary school teacher and at the beginning of September I weighed 20st 4lb. Dreadful, I know, and double what I was before becoming a teacher and a single parent in my 30s.

I am still learning but I'm basically eating according to my meter and watching the carbs. I feel I'm obsessed most of the time and also scared to let anything past my lips...

I didn't want to post until I had the results of my new HbA1C test. My nurse called me yesterday with the results. and she was very pleased! OK, I don't understand some of the terms related to cholesterol but: down from 5.3 to 4.5. Bad fats were 3 (triglycerides?) And now 1.5. Good fats from 0.8 to 1.0+. LDL now 2.8 (don't understand what that means and didn't want to ask).
I'm now 16st 9lb. Was 19st 4lb at beginning of November. Seems to be dropping fast but I think it will slow in time.

The best result is that my BG reading is now 52!!! The nurse said normal is 53 or below. I've asked about stopping medication but agreed to review after next test in may. I have yet to fully unleash my exercise weapon so I'm hoping that will help ha ha.

I'm feeling elated at this moment. I cried when I was given my diagnosis because I felt I had done it to myself and that I was going to be a drain on the NHS.

I have lots of questions but I'll pace myself!!! Just one for now. I had the figure of 48 in my head for some reason, yet the nurse said 53 was the benchmark. having looked on Wiki there seem to be various methods of measuring. Please will someone advise me about my results? is the threshold 48 or 53? Also, how does that reading translate to readings I get on my meter? My average meter reading before eating is 5.4 and after eating readings average is 6.0.

I know I'm doing well and I have this forum to thank for that. I can't say thank you enough.

Many thanks (again) in advance.
 
What brilliant results you should be very proud so keep it up!

You are right with 48. The modern advice is 48 or less if you don't have other health issues. You should do that easily if you keep things up.

Btw your cholesterol levels are doing great too. For diabetics they like them under 4 but for non diabetics under 5 is seen as ok so your 4.5 total is doing well.
Keep at it as it becomes easier as the months go by.

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Thank you so much xyzzy. I see you are on the same level of medication as myself ... now I am chasing after your super HbA1C and cholesterol results .

Thankfully, my family have a history of great blood pressure so no problems there. I'm not on statins yet and would rather avoid if I can, although the nurse is gently telling me it may be advisable at some point. I really want my cholesterol level much lower and this leads me to my next question. I am having less than 50g carbs(12g carb is the max for me at any one time to ensure my meter readings are well under 7) daily and it's working but I am confused about the LCHF method. Won't the high fat content adversely affect my cholesterol levels? I used to be a cheese addict but now I'm scared to eat it.

Thanks again.
 
all i can say is WOW! you have and are doing AMAZING!
 
The lchf and cholesterol numbers are pretty specific to each individual. In my case my cholesterol improved on lchf compared to the average "5 a day" regime I was on before. I do take a low dose statin but that's mainly because my family has a history of high cholesterol regardless of what each of us eats and how much we weigh. My eldest brother is a stick but is still on a statin.

You have to be careful that your nurse and gp know how to interpret your cholesterol numbers correctly. Going on the total value is not necessarily good. The better value is your ratio of total divided by your hdl which should be under 4 according to NICE guidelines. LCHF will tend to make your good cholesterol (hdl) rise so your total may go up but it can still be a good thing. Also bad cholesterol (ldl) is made up of two types small dangerous particles and large safe fluffy ones. LCHF may increase the large fluffy good ones but because they are in the ldl value they look bad in your total when they're not.

The important one is to minimise your trigs as they're the particularly dangerous things. They are effected by the amount of trans fats and alcohol you're consuming.

For many lchf just translates into eating more green veg eggs cheese meat and fish while limiting sugar and starchy foods. The high fat bit then turns into just a reasonably small increase in natural saturated fat a that many achieve just by swapping low fat foods for their normal fat versions and avoiding processed foods. A good rule is be suspect of any food that comes in a box and be increasingly wary of any food that has a total carb count of more than 10g per 100g

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xyzzy clearly knows an awful lot more than me about cholesterol (and everything else) but i know my cholesterol has dropped like a stone since doing LCHF and i eat ALOT of cheese
 
Thank you both for sharing your practices. I am trying to keep my carbs below 50g for now. I did have a cheese toastie to celebrate my results ha ha. Xyzzy - I now steer clear of anything in a box and I have started to make my own bread (I slice and freeze but limit to a small portion when I do have it). My diet has been a little boring (mainly stir fries) but reading threads here means I'm gradually adding a variety of different foods. When I mentioned the stir fries to the nurse she advised it might be boring, I told her it's not when I add red hot chillies (I call them lip zingers ). Lee and Perrins is also a tasty addition.

You have both given me food for thought and I will look into adding more cheese. I have added eggs because the nurse said although they have cholesterol in them it doesn't transfer to the blood.

I've never drunk alcohol so at least that's not something I have to address but I have been a bit of an emotional binge eater, which is why I've ended up so overweight. I was a fitness fanatic in a former life so now I am swapping the compulsive eating to compulsive walking!!

Thank you so much!
 
For weight loss I did an initial period of counting calories as well as carbs. I found something call activity adjusted BMR (there are a number of online calculators if you Google for it). That will give you the number of calories that if you ate each day would maintain your current weight. If you calculate that and then take off 500 calories it should end up giving you a steady weight loss of about 2lbs a week. Slow and steady is what I'd recommend as that way you shouldn't get too hungry. Many people use the myfitnesspal or fatsecret websites to do all the working out.

If you don't like formal exercise like me then try to walk for at least 45 mins a day. Walking is excellent exercise on lchf as your body can meet the exercise glucose required by burning fat rather than depleting glucose stores that can then make you feel hungry. My formal exercise is walking the dogs and doing the eat 500 calories less each day than my BMR I lost 4 stone in six months.

In my case on an initial 50g per day regime I found I was eating far too few calories once I cut out the starch. My way of compensating is by adding things like full fat yogurt and double cream but obviously not too much. Full fat products are great to mix with fruit as they will slow down the bg raising sugar in fruit. I found I could eat up to 120g of any fruit so long as I had it with some cream or yoghurt after a main meal. If you eat fruit do it as part of a meal rather than as a snack.

Keep asking questions and don't believe Andy he's done the lchf thing brilliantly so take his advice!

Sent from the Diabetes Forum App
 
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i find the emotional binging thing has been helped by baking low carb treats like the stuff here www.diabeticgoodbaking.com its Ewelinas blog and definitely helps with the cravings, have you tried making your own beef burgers with the lee and perrins sauce? oh so good! hehe anyway great job, keep up the good work
 
You are obviously doing all the right things, just keep doing them. The weight loss is helping and your data will most likely continue to improve with continued weight loss.

For some reason, health care professionals seems to think that it is OK for the upper limits for type 2 diabetics to be higher than otherwise healthy people. Don't listen to any of that, aim to be normal. Try to get your HBA1c below 40 and try to get cholesterol below 4.0. You have nothing to lose.

Trigs are often wrongly ignored in diabetes management. The simplistic thinking is cholesterol - worry about heart, trigs - worry about alcohol. Triglycerides form intermediate stages between stored fat and glucose and liver and pancreatic trigs are what cause type 2 diabetes. Sugar and starch raise triglycerides. Fortunately, when you lose weight, you start to lose fats in the liver and pancreas and lowering your trigs is part of this process. This in turn lowers your early morning levels and your after meal levels and over the weeks, your hba1c.

You say that you still have weight to lose and so you have every reason to feel optimistic. You have great rsults already and are only half way there so to speak. Just carry on and feel good about it.
 
As xyzzy has mentioned exercise, I found that short periods of daily exercise are excellent. I used to use a rower or, walk. It made a big difference. Then I started to cycle on an indoor bike. That dropped my after meal readings by yet another full point. The best though, if you can get to one daily, is swimming. That was yet another full point drop for me. Walking is a little difficult for me because of the strain on my arthritic ankle but the others are all low impact on the joints.
 
peacetrain said:
I used to be a cheese addict but now I'm scared to eat it.
Click to expand...

Dont be! So long as it isn't a horribly processed squirty cheese then it's a great thing to have with some celery. Just work out how much you can eat calorie wise. If you like cheese and biscuits then Ritz are the best 8 are around 15g of carbs. I LIKED Ritz but they've recently changed the recipe and now they're not half as nice.

If you want to make a cheese sauce consider using something like Seriously Strong spreadable that comes in a plastic pot. It's only around 3g of carbs per 125g pot. Yes I know its horribly processed and comes in a box but there are exceptions to be found

btw I also eat salted butter (in moderation) instead of low fat horribly processed spreads.
 
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