Hello!

[londonpob]

Hi all

I have been reading lots of forum posts and thought it was about time I said hello!

I am not quite sure where I am on the journey at the moment, so in the process of educating myself and making lifestyle changes to put myself in the best possible position. I'll try and explain the salient points as it helps me to write it all down - apologies for the longer than normal intro post!

I have been pre-diabetic for a few years, and doing more exercise and gradually losing weight. I had a regular check-up with my GP in August after a gap due to the crazy Covid years, and had my regular blood test which I was expecting to have improved given the weight loss (around 15kg from 115kg). To my and my GP's surprise my HBAC1 had shot to over 100! This was a bit of a shock as I had no symptoms, and felt very well! After a long list of questions from the GP, and a discussion about options we agreed we would try lifestyle changes before medication, and review every three months. I must say the GP, and the diabetic nurse have been fantastic.

At my first appointment with the diabetic nurse she did a blood test with a meter which came back as 11, which was high (just after breakfast) and I was given a meter so I could check my levels myself. I then started testing multiple times a day, and significantly reduced my carb intake immediately - this led to slightly blurry vision at times which I understand can result if you reduce your sugar intake very quickly - this cleared up within a couple of weeks thankfully, but I guess demonstrates there was a reduction in blood sugar and did give me a bit of a scare

Then things got a bit confusing!

I regularly tested waking blood sugar, and then before/after meals, and I have only had three readings over 10 (a 12.1, 11.5 and a 13) all after breakfast, and all the others readings are 6/7/8s. Reading as much as I could it was my fasting blood sugar that was within the diabetic range (started at 8, but now high 5s and low 6s after my dietary changes). I got myself a Freesytle Libra for a couple of weeks to try and understand how to reduce my fasting blood sugar, and then I discovered the delights of the morning phenomen where my blood sugar levels are mid 5's until around 6am, whereupon they increase to get me going in the morning! The average glucose calculated by the Libra was 6.5, and the estimated HBAC1 was 42 (this is within six weeks of the previous high reading), and time in range between 4 and 9 was 95% so now I am even more confused - I had a session with the GP who agreed the high HBAC1 result doesn't really make sense, but some of the blood levels are still within the diabetic range, so let's continue with the lifestyle changes and see where we get to in a couple of months.

This last week I did a private HBAC1 test just to put my mind at rest - I wasn't really sure what to expect, hoping it would be much closer to a healthy level, and worried it would be a high again and I was getting low readings from the Libre. It was 44!

I have diabetes in the family, so I am taking the high blood test result very seriously and will continue with the lifestyle changes and get back to a more sensible (for me at least) weight, something I should have done a long time ago. I have lost 10kg since the original doctors appointment in August, and hoping to lose another 5kg before my next HBAC1 check through a combination of healthy low carb eating, and more exercise.

What I don't understand is that the blood sugar readings I have seen don't match the HBAC1 result I got - which indicated an average of 16 mmol, and I have never seen a reading close to that, and wearing the Libra the highest reading I had was a 11.

Hopefully the next HBAC1 in a few months will help provide some clarity!

It's all a bit confusing, but a lot of the posts here have been reassuring and helpful, so whilst I appreciate the above is a bit of a ramble, I hope it's useful for someone now or in the future!

 

[Antje77]

You only started testing after significantly reducing your carbs,is that correct?

 

[catinahat]

Welcome to the forum @londonpob
Firstly I want to congratulate on your impressive reduction of your HbA1c and your weight loss.

The hba1c test measures how much glucose has stuck to your red blood cells. The life span of red blood cells is around 12 weeks. So it's looked upon as a sort of average of what your glucose levels have been over that 12 weeks. When you had the hba1c result of 100, that would have reflected the amount of carbs in your diet in the preceding 12 weeks, before you altered your diet and started your testing regime.
Obviously the more glucose stuck to the cells, the higher your blood sugar levels have been over the lifetime of the cells. But it's not really an average, its not actually measuring your sugar level, just how much got stuck sometime in the last 12 weeks.
How long do your blood cells live? The average 12 weeks, maybe yours hang around for 13/14 or perhaps they turn their toes up after 10 weeks. It's a useful tool for Dr's to diagnose and to see if we are improving or getting worse, but it's definitely not a reliable average.

On the other hand the finger prick test is actually measuring your sugar levels in real time, so an average worked out using the results from your meter are a real average. The more finger prick tests you do, the more accurate that average will be.

 

[londonpob]

You only started testing after significantly reducing your carbs,is that correct?

I had reduced carbs for about a week before I got the meter, so yes correct.

I have experimented since with carbs to understand their effect as it's not always easy to avoid them - wearing the Libra for a couple of weeks was very insightful. In the mornings carbs with nothing else (a piece of toast) raised my levels to 8/9, toast with an egg was barely a blip. I did do a pizza experiment on holiday in Italy (in the name of science) and had a 6.7 before lunch and a 6.7 two afters, so it looks like I am a lot more sensitive to carbs in the morning than the afternoon.

 

[londonpob]

Welcome to the forum @londonpob
Firstly I want to congratulate on your impressive reduction of your HbA1c and your weight loss.

The hba1c test measures how much glucose has stuck to your red blood cells. The life span of red blood cells is around 12 weeks. So it's looked upon as a sort of average of what your glucose levels have been over that 12 weeks. When you had the hba1c result of 100, that would have reflected the amount of carbs in your diet in the preceding 12 weeks, before you altered your diet and started your testing regime.
Obviously the more glucose stuck to the cells, the higher your blood sugar levels have been over the lifetime of the cells. But it's not really an average, its not actually measuring your sugar level, just how much got stuck sometime in the last 12 weeks.
How long do your blood cells live? The average 12 weeks, maybe yours hang around for 13/14 or perhaps they turn their toes up after 10 weeks. It's a useful tool for Dr's to diagnose and to see if we are improving or getting worse, but it's definitely not a reliable average.

On the other hand the finger prick test is actually measuring your sugar levels in real time, so an average worked out using the results from your meter are a real average. The more finger prick tests you do, the more accurate that average will be.

Thanks for the explanation.