HbA1c result

peterb999 said:

Hi all,

I was diagnosed a diabetic type 2 in January 2023 with a reading of 110. This really scared the life out of me as apparently 110 is really high.

I had to phone them up, but I couldn't speak to a doctor, just the receptionist who couldn't tell me why except my results were a "bit high" - but she said as she had no medical training she didn't know anything else. As you can imagine I am pretty worried about this (though surely it can't be that urgent if I have to wait a week for another appointment). I wonder if any forum members have had a problem with their liver since diagnosis? I don't drink at all really, maybe 1 can every two weeks. I feel like my life is totally out of my control at the moment, no matter what I do, something else goes wrong, arrghh.

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Hi @peterb999 ,

Sheesh, you have been through the wringer. I'm sorry. As for the liver, well, my situation was a little different from yours. It was giving me trouble, and I was diagnosed with a fatty liver. I googled reasons why it would be fatty, diabetes was one of them, and I borrowed our diabetic cat's meter to rule it out. You can imagine the ground opened up under my feet when I saw double digits on there, because I knew straight away what it meant. Came out of nowhere for me, T2 did... But there it was, my numbers were worse than the cat's! In the meantime, I was seeing a specialist who tried to send my husband out of the room so I could talk about my closet alcoholism. Nope. Just diabetic. No drinking problem. When we have a lot of glucose floating around, and our bodies can't burn it off or wee enough of it out, it stores it in fat cells. It has to go somewhere, after all, and our organs are prime realestate for storage. Voila, non-alcoholic fatty liver disease. Part of metabolic syndrome, which a lot of T2's have. Any or all of the following are contained therein: Type 2 diabetes, high blood pressure, high cholesterol, obesity and non-alcoholic fatty liver disease.

Now, @Antje77 is right, I got that under control before serious cirrhosis occurred, while the specialist told me there was nothing he could do -I suppose because I kept insisting I did not drink anything other than tea and coke zero- and told me he'd see me again for painkillers when my lived would eventually kill me, in a year or so. Scare me into admitting to my lies, perhaps? That was 10 years ago. Going low carb helped deplete the glucose stored in fat cells, and my liver function is alright. Been a bit problematic again for a while there (perimenopause messes with my blood glucose levels, and my mom's passing two years ago made things go wonky diet-wise for a bit too. Still not a drinker, though!), but I seem to be on the right track again. So low carbing and blood glucose control are important. And if your liver is already taxed, you might want to abstain from that one can every two weeks as well. (Sorry!).

Thing is though... Your blood glucose is now, absolutely beautiful. I don't know how long it's been like that, and it takes a while for a liver to recuperate a little, in so far as it can (depends on whether the fat cells got inflamed and turned to scar tissue; where there's scarring, there's no functioning liver cells), but... If they're asking you now whether your stool and colouring are off, that's a bit concerning. They're asking after jaundice, and that occurs when the liver is failing. So if I were you, I'd ask after the specific numbers, what the range is supposed to be and whatnot (may be available through your practice's app or online enviroment?), and whether it really is something to jump to jaundice over or whether they're just crying wolf, which is entirely possible. Whatever's next, stick with the low carbing, and do not, if you are okay with that, drink alcohol. You don't want to tax an organ that's seemingly had a beating even more, I'd guess.

Get the numbers, and hopefully, with those, some peace of mind. You're right, all of a sudden they're not in a hurry to see you anymore, and that is a good thing... But I think you'd likely sleep better if you had those numbers and their meaning.

Be good to yourself, and don't dispair just yet. After all, you're talking to someone who should've kicked the bucket 9 years ago. At the same time, if you do notice the whites of your eyes or your skin turning yellow, your stool being different than it should be, do call in the cavalry and get thee to a hospital. (I don't think that'll happen, but I have to say it, just in case).

Hang in there eh,
Jo

peterb999 said:

Hi,

Thanks for such a long detailed response. It is appreciated.

I don't fully understand why this would suddenly happen though - I only had my last blood test in January and the liver and kidney etc. was fine then. I was h1abc 49 back then and am now 38 so I don't see how my liver can suddenly be bad.

I am definitely not yellow at all and my stool today was the normal dark colour. I have had no physical symptoms at all and I feel pretty well really (well apart from my eyes) It makes me wonder if the person who phoned me on Tuesday night was actually a nurse practioner who didn't really have any medical knowledge. She wasn't able to answer my questions, just ask me some. It could be that the doctors surgery maybe get the results of that days blood tests and if any are elevated or strange then they get this non-medical person to phone and ask a few questions to see if I needed to go to A&E that night. She said someone would phone me the next day (she said only part of the results had come through from the lab), but they didn't and just sent me a text booking me in for another blood test. I'm really hoping that maybe it was just slightly elevated and that they were just been overly cautious. You would think that if it was really bad they would have told me to either come in straight away or go to the hospital, not just leave it for another blood test in a week.

I have been so lucky for over 50 years of having no illnesses whatsover and I always have really appreciated that. It's a ****** getting old, haha.

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Yeah, getting older isn't for the faint of heart! But I do think you're likely right... If your liver doesn't feel hard or sore to the touch, and you don't notice anything weird, it shouldn't be as bad as all that. And yes, sometimes someone'll call because some measurement is off, without knowing whether it's a bad thing, per se. I mean, I had to calm down a freaking-out assistant because she thought I was about to drop into a coma or just, dead, (diabetic ketoacidosis), while it was just a ketogenic diet that got ketones into my urine, which is perfecty fine. Context matters!

I think it'd be safe to let it go for now, and breathe. If it was that bad, you'd indeed likely be seen sooner.
Off to bed I go... Hopefully you'll sleep well tonight.
G'nite,
Jo

peterb999 said:

Ok, thanks to @JoKalsbeek mentioning about going onto my GPs website I went into the NHS website and have found all my results.

Everything is fine and within normal limits - apart from my Serum alamine aminotransferase level which is 673 and should actually be between 0-45 so it is way way high.

I've looked on AI (totally annoymised though) and given it all the figures from the test. It said that that number is way too high and needs urgent investigation - but it says all the other figures for the liver are fine to very good. I have been taking Vitamin D3 supplements and I think I may have overdone with that. AI says that it is possible so I have completely stopped taking them and AI seems to think there is a possiblilty that the figure could go down in the 8 days between the last blood test and the next.

It reckons that my liver is stressed but not failing and the other figures mean that it could be reversible. I really really hope so.

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Well, with ALT's like that, I'd certainly want answers and further testing done... Vit D toxicity can directly and indirectly cause all sorts of problems, but it doesn't have to be that... So best to get checked out and make sure. Keeping fingers crossed just stopping the supplements will get things sorted for you!

Are you taking statins. I discovered you shouldn’t take vitamin D if on them as it doubles their level.

It's good to hear the numbers are coming down @peterb999 - try not to worry much, as you don't want to elevate your stress levels. From where you were, you've come a long way and have made improvements along the way. Always look at the bigger picture. Be proud. You sound like a fighter, and I am sure you will be fine.

I have the low-fat crisps from Lidl, but don't go crazy on them lol

I also get the sugar-free biscuits from B&M, from time to time, I have them with my cup of tea (no sugar)

With the Metformin, I take it in the morning with a glass of water, sometimes I take it after having my breakfast.

Hi @peterb999, welcome and congratulations to bringing down your HbA1c despite having a difficult life.

Here is my two cents worth.
Taking charge, i.e. realising that you need to do something, apart from pills, of your T2 diagnosis is the first step.
You the managed to lower your HbA1c into the normal range by changing your diet, so well done.
A lot of us here have done this, but now comes the hard bit, is this sustainable?
Diabetes is a marathon, not a sprint.

Looking at your diet, it appears that you might not eat enough. I am curious if you have lost weight?.
In my view all diets which are based on food restriction only are destined to fail. A reason for this is that our bodies are not like combustion engines, where it is only about how much fuel is required to drive from A to B.
We are hormonal "machines" and act differently to carbs, fat and protein.
When only lowering overall calories we will always feel hungry. Even more, our base metabolic rate will lower and the body will need fewer calories, so we might be hungry and gain weight again. This is is clearly not sustainable.
It is also the cause of so many people yo-yo dieting and feeling miserable.
Fatty foods, greek yoghurt, butter, cheese, olives, olive oil, eggs, meat, fish are much more satiating than carbs and your are not getting hungry again after two hours.

Thus when reducing carbs in our diets we have to replace these with fats or protein to keep it sustainable
Many of us here, myself included, have increased fats in our diet and it seems to work, i.e. we never feel hungry.
Some of us even lost weight by switching from too many carbs to more fat in our diets.
I am tagging @KennyA, who might want to comment.
Proteins are less of an issue here unless you want to gain muscle mass.
An aside, low fat food is a double offender, i.e. has it too much sugar and no fat, so it will make you hungry.
Hence all low fat foods or substitutes, such as margarine, have been banned from my fridge.

I am not commenting on your blood test in the initial post, with this one reading off scale, as I am not an expert.
But I hope that this gets resolved quickly.
Regarding medicine - my GP took me off metformin after lowering my HbA1c into the low 40s. As metformine is not lowering your blood sugar level any way, it is not clear to me if it is still required. You might want to discuss with your GP. I am not one for vitamin products, but if they make you feel good, take them.

peterb999 said:

Hi Jo,

Just wanted to say that I really appreciate your post on another persons thread that I've just read which was very helpful to me. My lovely diabetic nurse when I was initially diagnosed seems to be quite outdated with her advice (still have chocolate but not as much to treat yourself etc.)

She told me that I must have my metformin (2 in the morning and 2 in the evening) as I actually eat the food, but looking at your post saying you should eat the food first and then have it. How long should I wait? 10 minutes, 20 minutes etc? When you mentioned the "explosive" bit that explains a few things to me, haha.

Unfortunately I never got any diet advice at all from my nurse. She forgot to put me on the NHS course that she initially offered. I was diagnosed at 110 h1abc in Jan 2023 and when I got it down to 60 she said I must know what I was doing so the diet course probably wasn't worth it.

I have got down to 38 which I am grateful for but it's meant I literally hardly eat anything anymore.
A days meal consists of 2 slices of wholemeal bread toast for breakfast with no added sugar drink (1/2 a pint). Lunch time is a sandwich of lettuce, tomato, onion, peppers and two slices of meat (ham, beef, turkey etc.). I then have dinner at about 5pm which is usually chicken, steak, gammon with a side salad (lettuce, tomato, onion, peppers) while the people I eat with have chips, jacket potatoes, new potatoes.

Does this sound ok to you?

I noticed that you mention greek yoghurt so I'm going to start having that as I do really like yoghurt.
Any other food recommendations would be gratefully received. I have moved last year and have got my first meeting with the diabetic nurse in my new area next week - I have a feeling that because I am down to 38 she is probably going to just tell me to carry on with what I am doing. To be honest, because the old diabetic nurse seemed a bit outdated with her approach (she was asounded that I got it down from 110 so quickly and kept it off as she said most of her other patients hadn't been able to do that - but if the advice she gives isn't the greatest ......).

She told me that crisps were fine to eat diabetes wise (she did say there are no health benefits at all to them but they are a nice treat). Is the thinking of that still the same? I thought potatoes were bad so I stopped eating crisps entirely (I do really miss them).

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Hello Peter,

Glad to be of some use. No need to wait, just make sure the pill has something to land on, rather than just the "bare" stomach lining. If that doesn't help, well, honestly... I'm not sure with your HbA1c, why you're still on metformin to begin with, really... Your numbers are non-diabetic, so that might be something to discuss with the nurse? But that is also immediately something to address in your diet... Your blood glucose is excellent, yes, but... The way you're eating, you must be hungry all the time. The bread in there could still be spiking you, which can cause hunger soon after, as carbs demand carbs, so... If you could ditch the bread and eat more nutrient dense foods? Fats, protein, the stuff your body runs on when there are no carbs to be had, and contain minerals and vitamins? I'm a fan of all sorts of lettuce, but it's just water, really... It doesn't add a whole lot of nutrition to your diet, though the tomatoes, peppers etc sound good. Put in more things with fats and protein? I adore tuna salad, I chuck in some mayo, sundried tomatoes as well, olives too... More above ground (no pulses) veg with your meals would be good.. More meat with the fats still on, fish, poultry. You're having it, I just fear not enough to keep from going hungry. Might not be the case at all, but just covering the bases. Eggs? Lots and lots of eggs instead of the toast you mentioned, maybe? With bacon! https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might be of some assistance as well. Just, you know, I think you'd likely do well to eat more things with vitamins in them... Just less carbs.

Crisps.... Yeah. No... I'll steal two or three from my husband if he's having any, which only happens twice a year or so, but that's just about my limit. Might be different for you though. You seem to be tolerating bread relatively well. Use a meter, see what's true for you. (Test before a meal and 2 hours later. If your blood glucose doesn't rise more than 2.0 mmol/l, preferably less, your body could cope with what you put in it. higher, and the meal needs a re-think).

The occasional crisp won't kill you.... Just don't snarf down a packet.
Good luck,
Jo