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HBA1C raised despite medication

L

LG82

Member
Messages
8
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hello,
I was quite young at 30 when I was diagnosed with type 2 diabetes. I was not overweight and had an OK diet. I was advised that it was possible it was induced by chemotherapy I had many years earlier but no one could 100% confirm this.
I diet controlled this for around 5 years before needing medication. Moving forward I have tried various medication and I am now on 3 different types of medication but my HBA1C remains in the 80s and I have been referred to the diabetes center.
Does anyone else have a similar experience and know what next steps might include?
 
Hi @LG82 & welcome to the forum

Can you share more on the medications you are on as this would be helpful for members to be able to give more tailored replies. It’s not unknown for someone your age to be misdiagnosed as T2 when they are actually T1 or LADA. Have you been tested for T1?
 
I am currently taking Metformin 2000mg, Sitagliptin 100mg and Gliclazide 320mg per day. I was prescribed Dapagloflozin 3 weeks ago but had to stop them due to side effects.
I dont believe I have been tested for type 1. I have access to my medical records and cannot see anything related to diabetes tests on hba1c.
Also I am 43 now so I have had this for a long time.
 
I’m T2 diet only so don’t want to give you duff info but there is something called LADA, I’ll tag a couple of our T1 LADA members for you @Antje77 @Nicola M @EllieM @Jaylee
 
Thank you.
I do have other health issues too so I am on other medication so they may also be contributing.
My hba1c has been high for around 3 years, the GP changes my meds and then they go down slightly and then after a few months they go back up.
 
Hi @LG82 .

Welcome to the forum..

My own experience I was diagnosed T1 as a kid.
Sky high sugars & DKA. https://www.nhs.uk/conditions/diabetic-ketoacidosis/

Instant type one or “Juvinile diabetes” at the time for me..

You could try or push for a “C-peptide test” to find out what your pancreas is actually doing??

Hopefully someone with a more initially confused diagnosis can help with your inquiry.

Best wishes..
 
It's quite good in a way having a read through some of the posts to see other people also have or have had similar issues. To be honest the GP doesn't have any dedicated diabetes specialists and I find advice varies from one GP to the other so maybe the diabetes center is better suited for me.
 
The Diabetes Center may well be better suited for you. Meanwhile, you don't say - are you testing your glucose, either with a finger prick meter or a Continuous Glucose Monitor? It would be helpful to see your reaction to foods, especially carbs, and also stress, poor sleep, etc. You can get a free Libre CGM, applying to Abbott, which lasts 15 days, and also a free Dexcom CGM, which lasts 10 days.
 
Hi and welcome @LG82 . It could be the chemo damaged your beta cells, but also you could be misdiagnosed as T2 when you are actually LADA T1. It is always a question when blood sugars cannot be controlled by diet, exercise or medications. Your young age is also a red flag.

They will likely test to see how much insulin your pancreas is producing. If they don't send you for a C-peptide test then ask for one. They test the level of insulin oroduction by testing the level of your C-Peptides. If your C-Peptides are low <250 pmols then they would likely test for autoantibodies. There are 4 relatively common autoantibodies associated with LADA . With you having high blood sugars Autoantibody positive would likely be enough to diagnose LADA.

In general 2 or more of any of the 4 types if autoantibodies means a T1 diagnosis.

I have attached some info on LADA stage development .

Type 1 diabetes staging classification opens door for intervention | Type 1 Diabetes TrialNet

www.trialnet.org

Edited as A sentence didn't make sense
 
Last edited:
Aww thank you all.
I test using a finger prick meter and on average my readings are around 11-12 before food and upto 15 after food. I also have an under active thyroid, have regular b12 injection, vitamin d, and currently on a 3 month course if iron tablets. On top of that I have some unknown rare inflammatory disease affecting my eyes so I have a lot of medication.
I suppose reading it back there is a lot going on.
 
@LG82 Is your under active thyroid autoimmune - Hashimoto's ?
 
I agree with the others to ask for a C-peptide test to see how much insulin you are pruducing yourself.
If you don't produce enough (either because of an auto immune thing (T1/LADA), or because your treatment damaged your pancreas (T3C), the treatment you need is clear.
LG82 said:
currently on a 3 month course if iron tablets.
Click to expand...
I'm assuming this is because of anaemia. Low iron makes hba1c untrustworthy, your hba1c may be falsely high.
Still, your fingerpricks show that your BG is in the diabetic range so don't get your hopes up please!

If you want a better picture of your average BG than an hba1c, you can ask for a fructosamine test, this is the alternative in cases where hba1c can't be trusted.

The Effect of Anemia and the Goal of Optimal HbA1c Control in Diabetes and Non-Diabetes - PMC

Hemoglobin A1c (HbA1c) is the gold standard for the diagnosis of diabetes; however, many clinical conditions affect the HbA1c level, including anemia. And, the most common causes of anemia worldwide include iron deficiency anemia (IDA). We performed ...
pmc.ncbi.nlm.nih.gov
 
I was diagnosed with an under active thyroid 12 months before the diabetes but no I have never been advised it was hashimoto's.
Yeah I was started on iron tablets about 6 weeks ago but I was borderline for anemia, haematology picked up low ferritin levels.
I have had a lot of diabetes medication over the last 4 years which have not worked or worked for a short time and then stopped working.
I think personally I should have pushed for a referral a long time ago.
I will let you know what they say.
 
Just an update on this. I got a free trial of the freestyle libre and I bought an extra one to monitor my blood glucose levels over a month. I am noticing what to me seems odd behaviour.
In the night they drop to between 4-6 sometimes they have dropped below 4 (checked with a finger prick) and the alarm wakes me up, however within half hour of waking they rise rapidly from around 6 to around 11-13, after this they dont seem to come down during the day. After eating they then rise more to around 14-15.
I usually have my tea around 6ish and I dont eat anything after that until the next day.
 
Food diary might be helpful.
This will give us an idea about how many carbohydrates you are eating in a day.
 
My personal thoughts, and they are just personal, if your night time figures are normal, then your natural production of basal insulin is enough to maintain normal blood sugars. It is your daytime blood sugars that are raised, which may suggest it could be food intake. That said I would still push for a C-Peptide test just see how much insulin your pancreas is producing.
 
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