How accurate is HbA1c?

[NeetaMD]

Hi, I am in the UK and my HbA1c has been in the pre-diabetes range since 2017. However, I only eat within a 10 hour period so my blood sugars rises are only after my 3 eating episodes as I don’t snack. For the remaining 14 hours when I am fasting my blood sugars are usually within the normal range. Does anyone know if this might mean that if I ate like many do, three meals a day plus a couple of snacks spread out over say a 14 or 15 hour period a day my HbA1c could potentially be higher?

 

[Melgar]

Hi, I am in the UK and my HbA1c has been in the pre-diabetes range since 2017. However, I only eat within a 10 hour period so my blood sugars rises are only after my 3 eating episodes as I don’t snack. For the remaining 14 hours when I am fasting my blood sugars are usually within the normal range. Does anyone know if this might mean that if I ate like many do, three meals a day plus a couple of snacks spread out over say a 14 or 15 hour period a day my HbA1c could potentially be higher?

Hi there @NeetaMD I’m not sure what you mean by “eating episodes” ? To answer your question in part, my thoughts are, it is probably what you eat and how efficient your body is at metabolizing that food efficiently , notably carbohydrates and sugars, that counts.
Snacking between meals can cause weight gain in some, this may aggravate an already distressed system and may lead to increased blood sugars in those people who are susceptible to type 2 diabetes.

I’m not sure I have answered your question, but I think body metabolism is complex with many factors at play so there is no straight forward answers to your question in my opinion.

 

[Lakeslover]

The simple answer is it could, but equally it might not. HBAic is effectively measuring your average blood sugar over 2 to 3 months. So if eating snacks raises your blood sugar significantly, or keeps it raised for a longer time then yes HbA1c will rise. On the other hand if the snack does not raise your blood sugar HbA1c will not rise.

To illustrate that a snack for me of a piece of cheese or handful of walnuts does not raise my blood sugar (it can even make it drop a little).

If I were to eat a bag of crisps or a piece of toast I would see a significant fast rise. If I then did that more than once a day my overall blood sugars would raise and my HbA1c would be higher.

 

[KennyA]

Hi, I am in the UK and my HbA1c has been in the pre-diabetes range since 2017. However, I only eat within a 10 hour period so my blood sugars rises are only after my 3 eating episodes as I don’t snack. For the remaining 14 hours when I am fasting my blood sugars are usually within the normal range. Does anyone know if this might mean that if I ate like many do, three meals a day plus a couple of snacks spread out over say a 14 or 15 hour period a day my HbA1c could potentially be higher?

The biggest influence on your BG and therefore the HbA1c result, is the carbohydrate - starches and sugars - that you put in your mouth. Your liver will then do its best to keep you at its idea of what your BG should be - but the liver takes its cue from how high your BGs have been recently.

So it's not only a question of how many times you eat, it's what you eat. If you aren't eating carb, you won't see a BG rise caused by carb. I eat once a day - I really don't want to eat more often (no hunger) because I eat mainly fats and protein.

 

[NeetaMD]

Thank you @Melgar. When I say eating episodes I mean that I don’t graze but have 2 meals and a light evening snack. I don’t eat low carb as I was specifically advised by GP not to restrict these but to focus on complex, low GI carbs instead. However I don’t process those carbs very well with my glucose levels staying higher for longer than expected after eating so I agree it all depends on an individual’s metabolism.

 

[NeetaMD]

Thank you @Lakeslover. I know that if I restricted my carb intake I might lower my HbA1c but I would have to ensure I keep my calories intake up to avoid losing more weight. You sound like you are clear on what you can eat to avoid those harmful blood glucose rises.

 

[NeetaMD]

Thank you @KennyA. How do you manage on one meal a day without losing significant weight? I eat good sized meals and have a great appetite yet can’t put the weight on and my GP believes I am in denial and might actually have an eating disorder!!

 

[Lakeslover]

Thank you @Lakeslover. I know that if I restricted my carb intake I might lower my HbA1c but I would have to ensure I keep my calories intake up to avoid losing more weight. You sound like you are clear on what you can eat to avoid those harmful blood glucose rises.

From my experience I can restrict my carbs but keep calories up by adding things like cheese, butter and cream.

 

[NeetaMD]

From my experience I can restrict my carbs but keep calories up by adding things like cheese, butter and cream.

Thanks, but I’ve already upped my intake of those foods and have each daily. Without the carbs I can’t avoid losing more weight which is why I’ve been advised to avoid restricting them but then can’t lower my HbA1c