HbA1c result ? is it accurate

[eggie]

hi all

as i have just been dx as a t2 abt 3 weeks ago my diabetic nurse dine my Hba1c blood test and result came back as 5.2. i know that for all diabetic is great news and for me too. But as i explianed to the nurse that the reading will be false, she said no its accurate, i said the test is done over the last 3 months.

so months 1 and 2 the Hba1c count fine as BS fine no rise and then into month 3 my BS starts to rise, so i explained that reading will only give an account of the last month when my BS started to rise and not in months 1 and 2 as it was fine then so take the average from months 1 to 3 we have 5.2 but not taking in account the rise in month 3.

am i making sense that my Hba1c result will be false or is my nurse correct in saying its accurate.

any info apprecated.

Thanks

eggie

 

[Jo123]

Sure someone more expert will come along but I thought I had read on here that the last 4 weeks had more weighting in averaging out the result by a small degree.

 

[cugila]

Your HbA1c.
In the blood stream are the red blood cells, which are made of a molecule, haemoglobin. Glucose sticks to the haemoglobin to make a 'glycosylated haemoglobin' molecule, called haemoglobin A1C or HbA1C. The more glucose in the blood, the more haemoglobin A1C or HbA1C will be present in the blood.

Red cells live for 8 -12 weeks before they are replaced. By measuring the HbA1C it can tell you how high your blood glucose has been on average over the last 8-12 weeks. A normal non-diabetic HbA1C is 3.5-5.5%. In diabetes about 6.5% is considered good.

If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. The amount of hemoglobin A1c will reflect the last several weeks of blood sugar levels. It is only an average over that time and you will be able to affect the reading if your levels are down in the last few weeks, but it does cover the whole period. So, bingeing for two months and then being good for the last month isn't advisable.

The best readings are your daily readings which give you an instant picture of what is happening. The HbA1c test is just a trend indicator as to whether your Bg is well controlled or not. A good marker, but not the best. Averages of anything never are.

 

[eggie]

hi cugila

by reading your post and explaining a normal non person glucose level is below 5.5 as for me mine came back as 5.2 but was dx as being diabetic , i do have some days where i do not take my tabs and reading are at 8.3 after abt 6 hrs food and sometimes at 5.7 but also i have days when my readings are at 4.4 , 5.7 and sometimes 7.1 that could be down to the amount of carbs i'm eating which are cheese pasties cheese sandwiches mincepies . I'm now thinking on the lines i might be wrongly diagnosed as not having high blood sugar maybe have something known as hyperinsulemia, where the body producing too much insulin as as i had 2 episodes of hypo's already after being told that i am diabetic did have these episodes before but didnt what they where know i know.

Just to put my mind at rest i performed in home glucose test 75g of glucose bought from boots powdered form disssolved in 250ml of water. Fasted for 8 hours reading 5.1 drank solution and took reading at 45 mins 7.9 then at hour and half 6.1 and then at 2 hours 6.4. I know the test is not done acurately but it does give an indiction that my body does somehow over produce insulin because with that amount of glucose in my body my blood sugar should have rose considerably high in my opinion.

so the test done so it give an indiction of hyperinsulemia or is hyperinsulemia totally different or am i just Insulin Resistant.

any opinion welcome

Thank
Eggie

 

[cugila]

Hi eggie.

I have to be honest you have me totally confused. :?

Are you saying that you don't think you are a Diabetic ? If that is the case then you need to get a referral to an Endocrinologist and have proper tests done to confirm the fact one way or the other.
Either that or get your GP to arrange them

Only then can I hope to give you some better advice.

 

[eggie]

hi cugila

i know cugila its confusing but my Hba1c result reflects thats , a result of 5.2 would mean that i am not diabetic ? then the GP says i am so i am jut as confused then the test i performed at home my glucose never rose over 7.9 in two hours. a drink containing 75g of glucose my BS should have rose well over 7.9 , but it didnt most it rose in the 45 min peak was 6.1or so may be say 6.7 or 6.8 in the hour and then back to 6.1. So evrything is a bit confusing evidence suggests i am not diabetic GP says i am si confused.

As you suggest will ask GP to refer me for more tests and when i find out will post results here but mind you wont be for a while terrible around here for appointments can wait for months on end. so keep you posted when i hear more.

Thanks for all your advice given so far
Eggie

 

[cugila]

Hi Eggie.

I've had a cuppa and I'm back.


First of all a result of 5.2% does not mean you are not a Diabetic. What your reading could mean quite simply is that you are a Diabetic with a HbA1c of 5.2 % ? Now that is pretty good for any Diabetic. Can I ask are you sure it was a HbA1c test that was done ? Was the sample sent away for analysis ? Was it at a Hospital Clinic ?

Are you aware of what actual test/s weres carried out to determine that you were a Diabetic and the results ? Your GP/Nurse should have all this information to hand. It appears you have only been very recently diagnosed and if that is your HbA1c level then you have done exceedingly well in such a short time, dependent on what your diagnosis level was ?

I know you are desperate to get answers but it is really difficult to get to the bottom of this and we cannot diagnose you, only your GP or a Consultant is qualified to do that. Until things are clarified I suggest you carry on with your diet, except you need to cut out all the breads, pastry, pasties and mince pies, that is not a good diet for anyone, let alone a Diabetic.


Let uis know how you get on.

 

[eggie]

hi cugila

At present there is alot of confusion flying around especially with my GP,i seen him today for re occurance of migraines he agreed to refer me to Neurologist.

Now we discussed my diabetes story, he goes by what the blood result tells him the HbA1c of 5.2, and says that result tells him i'm not diabetic, then he turns round and tells me that my fasting result which was 6.6 was abnormal, i told him that result of 6.6 would suggest Pre diabetes, he said no that is abnormal that suggests diabetes. Then i said if 6.6 is diabetes then why you telling me I'm not diabetic he said because of your hba1c result which is 5.2. So obvously my GP doesn't know what he saying. Then he turn round and said to me your getting anxious because of your fasting result but i'm saying your Hba1c is telling your fine.

Confused ? yes just as me first he says my fasting result is abnormal and suggests i'm diabetic and then on the other hand he says i'm not. Anyway my blood tests that were done were the Hba1c test last week dx abt 3 weeks ago. Dont know where the results were sent didnt really ask. but one thing that the GP said to me and made me think was that the Hba1c is a test done to check level of glucose over 2 to 3 months, what he said was that the test revealed that there was a slight peak towards the end of the result.

So got me thinking , could be wrong, but this is what i thought the slight peak towards the end, could be the start of my diabetes as i really only felt ill abt 3 to 4 weeks ago, that peak could be the rise of my blood sugar but taken over the whole 3 month sand the average worked out and the result is 5.2. This was my hunch maybe i'm wrong but just got me thinking what the GP said that's all.

as for the savoury things i've started to cut down on them anyway and really see what difference it makes to the blood sugar, been pencilled in for a dietician so see what advice he or she gives.

Keep you posted on this saga.

Thanks
Eggie

 

[FordPrefect]

Well I'm not surprised you are confused if this is what your doctor is telling you. Ultimately he needs to make a decision are you or are you not diabetic and if he isn't sure then ask for a referral its not fair to expect you to live with this ambiguity. You need to know so you can plan and take the relevant action. Otherwise in a few months if you are like most of us you will forget about it and go back to how you were before potentially disastrous if you are in fact diabetic.

 

[hanadr]

Hi eggie
I'm confused, but I may be able to clear up a bit of your confusion.
There are 2 entirely different tests involved in what you write. HbA1c, which measures what's been happening to your blood glucose levels over the previous 120 days; it involves a syringe full of blood, which is sent off t the hospital. If yours is 5.2% it's at the higher level of NON-diabetic or lower level of diabetic. AVERAGE for non-diabetics is 5.1%. Average for diabetics is about 8% I believe. Desirable for non-diabetics is about 4.5%.
the other test is blood glucose. this is the one you do yourself with your meter. It tells you how much glucose is circulating NOW. Non-diabetics tend to have results close to 5mmol/l they don't vary by much.
the ONLY true diagnostic test for diabetes is the Oral Glucose tolerance test or OGTT.
there's an overlap between diabetes and non . I wonder if your doctor realises this. He/She doesn't seem clued up.
Hana

 

[eggie]

hi hanadr

well according to my GP my hba1c is quite normal at 5.2. My GP reckons at 5.2 i'm doing quite well even my diabetic nurse says so.as for testing, I do home testing and it varies quite alot, i get results ranging from 7.1 upwards to abt 16.1 but that depends on what i eat. when i eat cornflakes and some milk and have a cup of tea along with it my BS goes up to anything at 16 which is high but according to my GP its fine. Normally my GP is good at his job but when it comes to diabetes i think he ain't got a clue. Since i tried to explain to him the symptoms i get when my sugar is high all i get from him is dont test at home, at present i'm getting leg cramps also and sometimes pins and needles in my fingers along with dead legs but again he says evrything is fine i worry alot. he reckons i do alot of internet reading and make myself anxious abt thinking of the word diabetes. I told him evrthing i read is for my own use and knowledge but he just dont really wanna know. Also which i didnt know until joining this forum was abt foot problems, i think my diabetes must have gone undetected for some time now as i do have both toes with ingrown nails they do give my pain when knocked, i dint know that before, so another trip to the GP and what he as to say abt it.

Knowing him he most probably say i'm getting anxoius and stressed for nothing as usual but as Fordperfect states in the above post from yours i need to know where i stand. From all the symptoms i'm 100% certain i have diabetes, but my GP is looking at my Hba1c count at present and not convinced at all. So going to be hard to convince him.

thanks
Eggie

 

[stewcose]

Hi eggie

I'm new to this diabetic game as well (so NO expert). If you are getting blood sugar readings of 16 after eating, you need to do something about it. You can help yourself by looking at what you eat and how much you eat.
You need help from the doc as well. You must ask your doc for a fresh test. You may be asked to wait a few weeks. Meanwhile you will have to learn how to keep your blood sugar down. If the doc does find you are diabetic, he or she .may or may not give you something to help keep your blood sugar levels down. But what you do, what you eat and how much. will play a bigger role in keeping your blood sugar levels down.
It's a good job you are measuring your own 'at the time' blood sugar levels. Can I ask which make of meter you are using.

Take care of yourself

Stewart

 

[etmsreec]

Hi eggie,

You don't mention whether you're on any other medications or not. Are you?
Your GP might try a fructosamine test instead of/as well as the HbA1c.

Stuff that destroys red blood cells at an accelerated rate can "fool" the HbA1c whereas, for whatever reason, fructosamine tests don't get fooled so easily. The latter is less widely available than the HbA1c but it's still a good double check.

Steve

 

[cugila]

Fructosamine testing has been available since the 1980s. Both fructosamine and HbA1C tests are used primarily as monitoring tools to help diabetics control their blood sugar, but the HbA1C test is much more popular and more widely accepted. Fructosamine may be useful in situations where HbA1C cannot be reliably measured.

These include:
Rapid changes in diabetes treatment – fructosamine allows the effectiveness of diet or medication adjustments to be evaluated after a couple of weeks rather than months
Diabetic pregnancy – good control is essential during pregnancy, and the needs of the mother frequently change during gestation; fructosamine measurements may occasionally be requested along with glucose levels to help monitor and accommodate shifting glucose and insulin requirements
RBC loss or abnormalities – an HbA1C test will not be accurate when a patient has a condition that affects the average age of red blood cells (RBCs) present, such as haemolytic anaemia or blood loss. The presence of some haemoglobin variants may affect certain methods for measuring HbA1c. In these cases, fructosamine can be used to monitor glucose control.

Since the fructosamine concentrations of well-controlled diabetics may overlap with those of non-diabetics, the fructosamine test is not useful as a screen for diabetes.

 

[Patch]

Eggie - if you've had readings of 16+ I would say that there is no doubt that you are a Diabetic. That's a high reading even for a diabetic.

 

[hanadr]

Eggie
I have read his whole thread through again and I'm still confused. I wonder if your GP is too :? .
Have you ever had an Oral Glucose Tolerance Test?
That's the only official diagnostic test. Hba1c 5.2% could be high blood sugar non-diabetic OR very well controlled diabetic.
Since the confusion seems to be over the diagnosis, I'd go back and ask for the OGTT.
getting a 16 on a finger prick test is pretty close to diagnostic. It would be VERY unlikely for a non-diabetic to see that level.
Good luck
Hana

 

[wallycorker]

Hi eggie,

I myself am confused by your posts.

I was diagnosed with Type 2 diabetes nearly nine years ago with fasting blood glucose levels of just over 7mmol/l - my HbA1c at that time was only 5.7%. Those readings were sufficient to diagnose me as diabetic.

These days I have normalised my blood glucose levels. My fasting blood glucose would definitely never be above 7 mmol/l and is rarely ever above 6 mmol/l - my last HbA1c was 5.3%. With these results my situation would not be found by the usual detection methods - however, I am still diabetic and will be diabetic forever.

In addition, I understand that random non-fasting blood glucose levels over around 11 mmol/l are very indicative of diabetes. Certainly, your reading of 16mmol/l is very high and would fall well into that category.

I don't know whether that helps - hope that it does.

John

 

[eggie]

Hi stew

I got one from my diabetic nurse which a Accu chek Compact the one that uses the drum reel. I do watch what i eat very carefully, trying to cut down on heavy carbs. The reading which i got at 16 was from eating cornflkes with milk along with a cup of tea. Was quite shocked at that reding so cut out all cereals for time being.

Thanks
Eggie

 

[eggie]

Hi eggie,

You don't mention whether you're on any other medications or not. Are you?
Your GP might try a fructosamine test instead of/as well as the HbA1c.

Stuff that destroys red blood cells at an accelerated rate can "fool" the HbA1c whereas, for whatever reason, fructosamine tests don't get fooled so easily. The latter is less widely available than the HbA1c but it's still a good double check.

Steve

hi Steve

Was taking Metformin slow release once or twice a day depending on how much food i ate, took them for about 2 weeks and then had my Hba1c done and result was 5.2. when i was one Metformin i realised my BS was stable floating at around abt 6 -7. But since the result of my Hba1c i was told to stop taking them and ever since i stopped my BS readings have crept up, but GP not really convinced i need to start them again. He aid come back in December 2009 for another Hba1c test, but sine you mentioned the Fructosamine test i try an get the done and see what happens.

Thanks
Eggie

 

[eggie]

Eggie
I have read his whole thread through again and I'm still confused. I wonder if your GP is too :? .
Have you ever had an Oral Glucose Tolerance Test?
That's the only official diagnostic test. Hba1c 5.2% could be high blood sugar non-diabetic OR very well controlled diabetic.
Since the confusion seems to be over the diagnosis, I'd go back and ask for the OGTT.
getting a 16 on a finger prick test is pretty close to diagnostic. It would be VERY unlikely for a non-diabetic to see that level.
Good luck
Hana

Hi Hana
My GP is just truly focussing on my Hba1c test which was 5.2 , but most of state 5.2 is high for non diabetic or low for a controlled diabetic, as i was on Metformin 1 or 2 tabs XR version and had been on them for abt 2 weeks prior to my Hba1c test, i know 2 weeks won't dramatically lower my Hba1c count but it must make some sort of compensation the to the result.

I did ask for the OGTT but refused for now he said wait till December 2009 for the next Hba1c test and see what needs to be done from there. So wait and see what happens in december and what my result comes back as. Got a good feeling it's gonna be well over 5.2 this time.

thanks
Eggie