HBa1C What options?

Spiker · Apr 4, 2015

Galathea said:
7.3 and 6.8 were the fasting readings taken by the doctor using blood from my veins..... His rationelle for leaving it three months was because he said no harm would happen in three months and he wanted to see if .... Err.... Dunno.( maybe He just wanted to see if I stopped bothering him? )

I think that might be the case. Annoying patient, diagnosing herself.
He has a wafer thin case to think you are not diabetic since one of your two venous FPGs was under 7, even though the average of the two is over 7.0. I don't know what he's playing at. If you come back in 3 months time with FPGs around 6.9 is he going to pronounce you non-diabetic or 'controlled by diet' or what.

Galathea said:
I think I will change practices. I have nothing to lose......

I tend to agree with you

Galathea said:
In the meantime..... If I am diabetic then what can I do apart from exercise. ( I am a gardener so I move around a lot every day). and stick with the low carb?

Just keep doing what you are doing I think - low carb, test regularly, exercise, and keep talking and asking questions here on the forum.
@donnellysdogs is a gardener too, as well as a lovely lady, I'll tag DD and see if she can come along for some moral support.

Galathea said:
I suspected I wasnT right about 7 years ago and my doctor gave me a fasting glucose tolerance test...... She said the results were ok.... I never thought to find out what they were.... But on the way home I felt absolutely dreadful. I was grey by the time I got home and had to sleep it off for two days. I wonT be volunteering for a GTT anytime soon....... II cannot cope with feeling that bad again.

That sounds awful and does sound like you were prediabetic even 7 years ago. You must get it sorted. You are being really proactive, don't let one sceptical GP stand in the way of you looking after your health. I mean I hope he's right and you're wrong, and you're not diabetic or prediabetic, but it seems unlikely.

Robbity · Apr 4, 2015

I've always had the option of an appointment with our practice vampire for blood tests or going to our local hospital, where they had a turn up, take a ticket, and take your turn procedure. But when I was due to go for my test last month, the doctor said that the hospital has now gone over to an appointments system. They were always extremely busy, so I don't know if this has got unmanageable and/or they were not able to reach some target or other...

@Galathea - definitely keep up with your diet regardless, as it's still going to help with your higher glucose levels. To a certain extent going low carbs does also mean that you may need to also watch calories as it doesn't have any magical powers if you're eating more than your body needs for fuel. And just keep on testing regularly, it's the only real way we know what's going on.

Robbity

kyler · Apr 8, 2015

Hi doctors most be good in my area as at my 1st visit doctor had my blood taken at this visit by nurse then phoned me next day with result of my hbac1 which as it is your BG over last 3 months I do not see it makes any difference what time of day tested Kyler

Dillinger · Apr 8, 2015

I think you are doing exactly the right thing; well done for being tenacious.

What scares me is the number of people who will get this atrocious type of "ho-hum" "wait and see" "I can't really be bothered" type of health care and just go away and don't come back whilst their health is deteriorating because the primary carers can't be bothered to do their bloody jobs.

Also your GP's fatuous 'your weight loss has nothing to do with low-carbing, it's all to do with calories in calories out'. Who gives a ****? We have thousands of pages of arguments about that here, but the point is you are managing to lose weight; you should be congratulated and supported in that. It's great; keep doing what you are doing.

The sad fact is that as diabetics we are on our own; we have to manage it and think for ourselves as certainly no one else is going to.

Best

Dillinger

smidge · Apr 8, 2015

When I was first diagnosed, it was as a result of a GTT - my 1 hour peak was well into double figures and I was still way over 11mmol at the two hour test. I was given the GTT because I had gone to the doctor with a completely different issue and she decided to take a random blood test - which happened to be about an hour after my breakfast of a bowl of Special-K and a glass of orange juice - that test showed a glucose level of 14mmol.

My fasting blood test was in the 4s. My HbA1c was also OK - I can't remember exactly what it was, but it was in the non-diabetic range. I would not have been diagnosed as a result of these tests, but I turned out to be in the early stages of LADA and my residual insulin production was still strong enough to make fasting and HbA1cs unreliable as diagnostic methods for me.

Personally, I'd ask for the GTT and put up with a few hours of feeling not very well.

Smidge

Galathea · Apr 8, 2015

I have pretty well worked out that I may be on my own with this....... I am going to carry on for the next few months and I managed to shame the doc into giving me a prescription for testing strips....... Only he wrote the wrong ones down.... So today I have collected my revised scrip from the doctors, only to find he has prescribed a measley one cassette of 50 tests. I get all my prescriptions free because I have auto immune thyroid problems so its worth me collecting the test cassette. But I have others on the way, which I just bought on eBay.

The advice and information on here is proving invaluable. I have had problems with underactive thyroid for years and this eventually resolved when I used all the information from the forums to get the correct medication...... I now contribute regularly to the thyroid forums... I rather suspect that diabetes is going to amount to the same sort of learning curve.

Xx G

Baruney · Apr 9, 2015

Spiker said:
On WHO criteria (endorsed by DUK) you are frank diabetic. What is your GP playing at?

http://www.diabetes.org.uk/About_us...vention/New_diagnostic_criteria_for_diabetes/

Methods and criteria for diagnosing diabetes

Diabetes symptoms (e.g. polyuria, polydipsia and unexplained weight loss for Type 1) plus:

a random venous plasma glucose concentration ≥ 11.1 mmol/l or

a fasting plasma glucose concentration ≥ 7.0 mmol/l (whole blood ≥ 6.1 mmol/l) or

two hour plasma glucose concentration ≥ 11.1 mmol/l two hours after 75g anhydrous glucose in an oral glucose tolerance test (OGTT).

With no symptoms diagnosis should not be based on a single glucose determination but requires confirmatory plasma venous determination. At least one additional glucose test result on another day with a value in the diabetic range is essential, either fasting, from a random sample or from the two hour post glucose load. If the fasting random values are not diagnostic the two hour value should be used.

Haemoglobin A1c (HbA1c) testing to diagnose diabetes
An HbA1c of 48mmol/mol (6.5%) is recommended as the cut off point for diagnosing diabetes. A value of less than 48mmol/mol (6.5%) does not exclude diabetes diagnosed using glucose tests.

A health care professional nomination for diabetes.co.uk hall of shame?

Galathea · Jun 3, 2015

Baruney said:
A health care professional nomination for diabetes.co.uk hall of shame?

I saw a the doc today, he says I am not diabetic despite my average bg being 8+. I am on a low carb high fat diet and have been now for three months.. The last three fasting bg tests he has done have been from a vein and have been 6.3, 7.8 and 10. My HBa1c. Has also been done 3 times.... 41, 42 and 44.
I lost a stone but the weight loss has stopped. The 10 happened because I are two oat cakes at tea time the day before the test.

I asked for the results of my fasting glucose test, which was done 10 years ago.... I felt terrible when I left the surgery, i drove home and arrived looking grey and shaky. Apparantly the blood glucose, after two hours was 3. I haven't had another test, I can't face it.

I think I need a trial of metformin, I am worried that currently my bs can raise to around 15 with just the very smallest amount of carbs like a spoon of mashed potato or an oat cake.

I have been and collected the forms today for a different doctors practice. I think its time to move.

Am I right or am I deluded? I said to the doc I was worried about an auto immune version of diabetes. (LADA -I already have two auto immune diseases) and he said worrying would give me diabetes.

My blood is currently over the range about 45% of the time, despite the low carb diet.

Would really appreciate everyone's thought on this.

Thank you ...

G

Lesleywo · Jun 3, 2015

Galathea said:
I saw a the doc today, he says I am not diabetic despite my average bg being 8+. I am on a low carb high fat diet and have been now for three months.. The last three fasting bg tests he has done have been from a vein and have been 6.3, 7.8 and 10. My HBa1c. Has also been done 3 times.... 41, 42 and 44.
I lost a stone but the weight loss has stopped. The 10 happened because I are two oat cakes at tea time the day before the test.

I asked for the results of my fasting glucose test, which was done 10 years ago.... I felt terrible when I left the surgery, i drove home and arrived looking grey and shaky. Apparantly the blood glucose, after two hours was 3. I haven't had another test, I can't face it.

I think I need a trial of metformin, I am worried that currently my bs can raise to around 15 with just the very smallest amount of carbs like a spoon of mashed potato or an oat cake.

I have been and collected the forms today for a different doctors practice. I think its time to move.

Am I right or am I deluded? I said to the doc I was worried about an auto immune version of diabetes. (L, ( I already have two auto immune diseases) and he said worrying would give me diabetes.

My blood is currently over the range about 45% of the time, despite the low carb diet.

Would really appreciate everyone's thought on this.

Thank you ...

G

Lesleywo · Jun 3, 2015

Are you under an endocrinologist for your autoimmune diseases? If so you might see if you can be tested for GAD antibodies. You could have an autoimmune attack going on but still producing some insulin ... just a thought.

And no, you're not deluded .. your doctor is though.

Rillum · Jun 3, 2015

You're doing the right thing. You're clearly diabetic with fasting blood sugars above 7 a lot of the time. Good luck, hope the next doctor is more competent.

Galathea · Jun 3, 2015

Lesleywo said:
Are you under an endocrinologist for your autoimmune diseases?

I saw an endocrinologist about the Hashimotos when the doc decided to take me off Liothyronine due to cost.. The endo took me off the t3, saw my obvious decline, gave me back the t3 and said I needed it although it was a placebo. (Whatever) Says he doesn't believe in it. So have never been back. The lichen sclerosus was diagnosed by a different hospital dept.

Will get myself tested for GAD antibodies if I can, At least I will know where I stand re Lada. One of the labs must be offering the right test...... Genova? Blue horizon?

Thanks for the replies.... I am not a panicky person, though I just need back up in the form of this forum sometimes... Its easy to think I may be deluded.

Xx g

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