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HBA1C up, why?

B

BaxterStockman

Member
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8
I have had results of my annual test (type 2). HBA1C has gone up from 44 last year to 49 this year. My weight is exactly the same (I am very slightly overwieght having lost 2 1/2 stone when first diagnosed 4 years ago, but have maintained this weight and a good HBA1C ever since), I low carb to same extent and exercise very regularly (run, spin, tennis). Any ideas as to what has caused increase or is it inevitable for me and I will eventually end up on medication? I am 46 year old female. GP not concerned and says all other tests fine (BP, cholesterol etc) and level is still below that required for medication.
 
5 points on your Hba1c is not a massive rise, every test has a margin of accuracy, no idea what the percentage is for the Hba1c but it could account for at least a few of those extra 5 points.
My second thought is that although you say your diet hasn't changed for 4 years, are you absolutely certain that a few extra carbs haven't found their way in. I know from personal experience that carb creep is very real.
The other thing is of course, T2 is considered by most drs to be progressive, they expect that eventually we will no longer be able control it by diet and will require their help with medication.
If you're sure your diet hasn't changed at all, maybe your diabetes has changed?
So another look at the amount of carbs you eat, cut a few out here or there if you can, could easily claw back those 5 points.
How many carbs a day do you have? If I stray above 50g a day for any appreciable time, I notice my levels starting to rise, others need to be lower still, and some lucky people can do well on three times the amount I have.
 
My personal opinion is that T2 is a sneaky, tricky beastie who loves nothing more than luring us into a state of complacency so it can then throw another challenge into the works.

So it might be time to up your game a a bit
Fewer carbs
Change of exercise
Skip a meal quite frequently
Occasionally longer fasts
Medication

Are all tools in the box that may help you.
I keep them in mine as I was determined to hold something back for when my T2 tries it on, as it no doubt will. I plan to use one at a time should I be in your position
 
Thank you both so much. Am just feeling a bit disheartened as feel I try really hard. Probably a few more carbs by way of booze has crept back in over the last year although mainly stay below 50g. Easy enough for me to cut booze down though. I can't really fit more exercise in with full time work and kids so I think being tighter on the carbs is the way forward. I do fast through the week and only ever really eat 2 meals a day but can be stricter on that too. Thanks again.
 
BaxterStockman said:
Thank you both so much. Am just feeling a bit disheartened as feel I try really hard. Probably a few more carbs by way of booze has crept back in over the last year although mainly stay below 50g. Easy enough for me to cut booze down though. I can't really fit more exercise in with full time work and kids so I think being tighter on the carbs is the way forward. I do fast through the week and only ever really eat 2 meals a day but can be stricter on that too. Thanks again.
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Do you track your meals, specifically the carb intake, using an app? If not, might be worth doing for a couple of weeks just to confirm your diet is where you want it to be.

Another suggestion I'd make is weighing foods, combined with the point above. Humans are generally terrible eyeballers for portions, plus we can get a little more generous over time when doing it, so might just be worth checking your portions are where you want them to be too.
 
And as for exercise, weight lifting type is supposed to be better for bg than cardio type, so maybe try swapping one of what you do?
A cgm would help you learn what is happening with your bg on a minute by minute basis
 
The joker in the pack may well be menopause or perimenopause. It can add enough challenge that other small carb-creeps join in and cause small increases.
 
catinahat said:
5 points on your Hba1c is not a massive rise, every test has a margin of accuracy, no idea what the percentage is for the Hba1c but it could account for at least a few of those extra 5 points.
My second thought is that although you say your diet hasn't changed for 4 years, are you absolutely certain that a few extra carbs haven't found their way in. I know from personal experience that carb creep is very real.
The other thing is of course, T2 is considered by most drs to be progressive, they expect that eventually we will no longer be able control it by diet and will require their help with medication.
If you're sure your diet hasn't changed at all, maybe your diabetes has changed?
So another look at the amount of carbs you eat, cut a few out here or there if you can, could easily claw back those 5 points.
How many carbs a day do you have? If I stray above 50g a day for any appreciable time, I notice my levels starting to rise, others need to be lower still, and some lucky people can do well on three times the amount I have.
Click to expand...
A1c allowable error is 5%, so it is just possible that both the 44 and 49 results were generated by a true value of around 47. That would require both tests to be skewed at the maximum in opposite directions, so it's perhaps not likely.
 
KennyA said:
A1c allowable error is 5%, so it is just possible that both the 44 and 49 results were generated by a true value of around 47. That would require both tests to be skewed at the maximum in opposite directions, so it's perhaps not likely.
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Thanks for the info @KennyA, I had no idea it was as much as 5%
I didn't suggest that all of the OP's rise was due to the allowable error, just that it was a possible reason for some of it.
 
catinahat said:
Thanks for the info @KennyA, I had no idea it was as much as 5%
I didn't suggest that all of the OP's rise was due to the allowable error, just that it was a possible reason for some of it.
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Understood. In another part of the wood there are proposals in the US to relax HbA1c testing accuracy to 15% error, so that home A1c testing kits can be sold. That seems to me a step too far, but since the CDC has just redefined "normal" HbA1cs as "pre-diabetic" - they are also concidentally selling a "lower your A1c" package - money seems to talk very loudly.
 
MrsA2 said:
And as for exercise, weight lifting type is supposed to be better for bg than cardio type, so maybe try swapping one of what you do?
A cgm would help you learn what is happening with your bg on a minute by minute basis
Click to expand...
Thanks. Yes I do some strength stuff at gym but only introduced recently and not been doing it too regularly so will up that.
 
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