Hba1c on a keto diet

[Andrew Makin]

I've been low carb / keto for a long time, and even work with patients on reversing T2D. I fast regularly. I've never had a T2D diagnosis and my Hba1c has usually been high 30s. Latest routine check puts it at 43 mmol/l (7.1%). Spot checks with a keto mojo have always shown low BG, between 3.5 and 4.5. I don't understand how my a1c can have gone up.
Anyone got any insights?

 

[KennyA]

Hi Andrew and welcome. There's an acceptable error for A1cs of no ore than 5%, for 95% of the time. A true value of 50 could be shown (acceptably) as anything from 47.5 to 52.5. And one in 20 tests could be completely rogue. HbA1c skews heavily towards the last month, so is it possible that something was going on recently that might have bumped you even slightly higher?

Of course you could always ask for a retest....

 

[Antje77]

I've been low carb / keto for a long time, and even work with patients on reversing T2D. I fast regularly. I've never had a T2D diagnosis and my Hba1c has usually been high 30s. Latest routine check puts it at 43 mmol/l (7.1%). Spot checks with a keto mojo have always shown low BG, between 3.5 and 4.5. I don't understand how my a1c can have gone up.
Anyone got any insights?

Hi @Andrew Makin , welcome to the forum.

While an hba1c of 43 mmol/mol is only on the very low end of prediabetes, it doesn't really add up with your spot checks. So either you are missing some higher readings, or for some reason your hba1c doesn't match your BG as measured with a fingerprick.

Are your teststrips in date? Have you tested your meter against a different meter?

It can also be that the hba1c is off and your fingerpricks are correct.
There are different things which can cause this, have a read of this and see if anything rings a bell, scroll down to the section "FALSELY ELEVATED A1C" : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912281/