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HBA1c Test

Jellyfish

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11
Type of diabetes
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I've been a very stable type 2 diabetic for 10 years and my HBA1c has always been around 6.2-6.4 but my last results was 2.8!! I've been waking up in the night having hypos and I'm getting them during the day which I rarely had. I'm on Metformin but that's not controlling it. I couldn't get a diabetic nurse or doctor appointment for a MONTH!!!

I was put on Pregabalin for chronic peripheral neuropathy about 6 months ago and I take a raft of meds and immunosuppressants for Lupus and my liver, bone and lymphocyte counts have been up and down. Has thus happened to anyone else?
 
I will try but they already know the results and wouldn't bring it forward. I'm really worried, I'm frantically checking my sugars day and night.
 
I'm going straight to the doctors in the morning. I bought glucose tablets to keep by my bed and I'm monitoring my sugars literally every three hours through the day and night. When I last asked my GP for extra needles for my monitor kit she declined and said "we don't encourage you to check your sugar levels because there's nothing we can do about it even if it changes" that scared the @&£# out me! Why can't they change anything? Confused.
 
I believe there are two separate issues your hba1c count and the actual lows you are experiencing.

An hba1c of 2,8% corresponds to an average glucose level 1,9 mmol/mol, which does not seem credible.

I suspect that something is making your Hba1c result unreliable, probably either something to do with the other health conditions or more likely something to do with the medication you take for them.

For instance the HbA1c test assumes that your blood cells are replaced every three months. If you actually replace these cells faster then in the shorter period that the cells would exist less sugar would attach to the hemoglobin molecules thus resulting in an underestimation of your average glucose levels.

Probably more worrying are the frequent lows you are experiencing. You are right that Metformin should not cause this.

You are right to seek an urgent explanation from your doctors.

Hope you get the answers you seek and a solution to your problems

All the best

Pavlos
 
I've heard Pregabalin can play havoc with sugar levels so could be that or the chemo drugs I inject for my Lupus. Either way I'm going to the doctors tomorrow.

Thanks for your responses
 
Hello ,
Please let us know how you are doing ,,but you need an emergency appointment or go to a and e like others have suggested ...
It is my understanding that you can have a hypo on metformin ....and other medications ..you have a lot going on ...take care ..kat
 
Thanks Kat. I will post tomorrow once I've camped out at my GPs surgery.
 
Do you test at home, and what are the readings?

Chemo drugs will lower your red blood cell count, and hence your HbA1c could be incorrectly low as well, which may be why the doctor hasn't brought your appointment forward.
 
What worries me is because I have Lupus they blame everything on that. I have to have blood tests every month and I have to collect and keep the results. Every time it get them my result change and they keep writing "Normal for Patient-expected" so they move the goal posts literally every month. I've had chronic anaemia for four years and my neurosurgeon has PLEADED with my GP to investigate but all they do is say it's "normal for patient". I feel like I've been written off and I'm only 44!
 
The HbA1c will show as low if you are anaemic.
As to the GP, you should complain to the practice manager, quoting the neurosurgeons request, and asking why the GP has ignored it.
 
Tried that! Didn't work, got Rheumy to do a letter, that didn't work either. I've/we have been trying for four years to get it looked at but no one wants to pay for it. The hospital wants the doctors to do it and vice versa. Now they just move the goal posts and list it as normal.
 
It is just not right , normal for patient ....although we are all different anything that is abnormal should be investisged ...why is it just such hard work at times...look after yourself ..
You could ask for your concerns of no investigations to be recorded so it's on record ...only a thought ...Kat
 

If the hospital still want it done, but the practice won't action it, write to your MP asking him to intervene.
 
HI jellyfish I can't offer you any advice as I am a novice to all this... I just wanted to wish you the best of luck with the doctors. I hope you get it sorted as it must be scared living this way
 
Thanks for all of your advice and support, it's more than I've had from my doctors ! It's been a very scary time and knowing your doctors don't care is horrible, I feel worthless and as if I'm irrelevant to them. I will be camping out there tomorrow so I will post an update and let you know how I get on. Thanks again everyone.x
 
Ok, I finally got to see my diabetic nurse......they've reduced my Metformin but they don't believe it's that causing the low glucose levels. She believes something bigger is going on, maybe Lupus related that needs a thorough investigation (as I said Lupus gets the blame for everything). She is speaking to doctors to arrange tests, for what neither of us know! Not much hope or help but I'm happy I got to see someone at least. Follow up appointment in two weeks unless I continue to get hypos.
 
I will up date when I get more news but at least the ball is rolling.
Thanks again all.
 
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