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hba1c vs fingertip levels

A

allen-uk

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Hello.

I read somewhere that there was a direct relationship between hba1c results and the previous 3 months' average blood results, and that a good hba1c of, say 5.8%, meant that fasting bloods would have been 5-6 fairly consistently.

So why aren't mine!

Hba1c has for several years been between 5.6 and 5.9%. Fingertip testing in the mornings is way too high - 9, 10, 11, sometimes even more.

I am sure I have diabetes II - I have most of the usual symptoms, and my metformin/gliclazide medication does seem to keep my fingertip levels in some sort of check.

My question is this, then. Can hba1c levels be affected by other things, or are they the real 'Golden Rule' for diabetic testing? If so, does the fact that doctors sort of *****-foot around my condition, sometimes calling me 'insulin resistant', sometimes 'type II diabetic', indicate that I should perhaps be looking for some other medical condition to hang my hat on?

I'm also on the usual 'old man' medications, i.e statins and blood-pressure pills, and have early CKD; my nephrologist says that the kidney failure is caused by type II diabetes.

Thanks.

Allen.
 
Hello Allen, most if not all T2s are also insulin resistant, it goes with the T2. So it matters not what your doc. calls it it comes to the same diagnosis.

As regards the HbA1c and finger tests, they are different tests using different methods and different units.

Some say that a reationship can be calculated by some formula or another, and this may give some very approximate results, but the fact is what you have found is much what I have found, i.e. they don't correspond.

Your finger tests tell you what is going on hour to hour day to day and are a snapshot of what BGs are at that time. The meter you use is accurate to + or - 10%, assuming the strips are calibrated spot on. The HbA1c is accurate to lab. standards, that is, quite accurate.

The HbA1c measures your Bgs by averaging out over two or three months, it depends how quickly your red blood cells die and are replaced, we all vary.

I would take the HbA1c as being accurate and start looking for reasons why you think the finger tests are high.

Remember, an average will smooth out the peaks and troughs, you could be 9 in the morning but might have been 5 all night, what is called the dawn phenomenon could be the cause of higher BGs in the morning, you liver dumps sugar to set you up for the day, but your body doesn't know how to use it properly. The result is higher BGs. There is not much we can do about it, if it happens it happens.
Sometimes eating a snack of something slighly carby last thing at night might help.

As my doc. said to me " Stuff your finger tests, all I need is the Hba1c results to see how things are going". Well, not quite like that but I got the message!

Hope it helps

H
 
Yes hallii, it certainly does help.

Makes you wonder about the usefulness of fasting blood tests, though - maybe they should creep up on you at 4 in the morning and take a quick test-tube full, as it could be more accurate.

Thanks for the help.


A.
 
My doc said I was to take my Metformin with my evening meal ... My fasting bg was too high every morning so he then said take two more at night!! I figured out that the two with the LC was pushing the sugar levels too low hence the liver dump ... I now take 1 Met at breakfast and one at lunch ... Perfect readings fasting and throughout the day ... I can tell my doc thinks I'm a subversive little *+#* haha
 
Catherine: haven't read that article yet, but I will in a minute.

Mary: quite agree with your approach. It's your body. Also, your GP sounds about as knowledgeable about diabetes and metformin as most GPs. There used to be a consultant-led hospital clinic in this area, but over the past few years The Cuts (may there be terror at their name) have caused this clinic to close, so we are left with our GPs, or, even worse, our GP's 'diabetic nurse'. In our case, that was the nurse nearest to the rack of leaflets, and that's about her level of expertise, too! What sort of HBa1C readings do you get?


Allen.
 
I read the article, Catherine, with its overview of HBA1C, thanks.

Not much further forward, though. The morning liver dump sounds interesting, so I'll try and investigate that. My average so-called fasting readings have been 10 to 11 for the past months, but my HBA1C remains at 5.8%.

Sometimes (after Christmas, for example), I eat 'properly' for 3 months, no chocolates, biscuits, sugars, all that stuff (and no booze, I gave that up in 2002), and end up with an HBA1C of about 5.7-5.9%.

Othertimes, I give up giving up for 3 months, eat what I fancy, get all sorts of mid-teen fasting readings, and.... end up with an HBA1C of about 5.7-5.9%.

No, I'm not going to eat like an idiot for the rest of my life, whatever the haemoglobin says. Eating too much sugary stuff makes me feel bad the next day - a bit like a hangover, funnily enough.

I wish life was a bit more black and white, though!


Allen.
 
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