How do I calculate hba1c using an ‘average’ blood sugar measurement by the Freestyle Libra 2 app?

[deebie_newbie]

Meds - Trulicity injection 1.5ml, once a week.
Abasaglar Glargine 35 units, once a day.
Novorapid 6 units with main meal. If sugars are over 25 at bedtime, a second dose of 6 novorapid has been authorised by the consultant.

Got Freestyle Libra 2 cgm, last Wednesday.
In clinic, hba1c was 109. Has been 119 before and was 115 on referral to local specialist diabetes service.
History of mental health problems. Anxiety, depression, suicidal tendencies.
I do my best and when I am depressed and want to end it all, everything goes out of the window.
When mentally poor, I can go a full week without metformin (.500mg slow release daily), also, miss the Abagaslar for up to a week at a time. I usually Remember to do the trulicity once a week, then spasmodically check sugars when I feel ill, then rectify with novorapid. No judgements please. Doing the best I can with what I have.
Funding was approved last March for type 2 for a continuous glucose monitor. Got one last Wednesday.
Readings have been as low as 5 and 6.5, which for me, is amazing. Scared as 6 units of novorapid is too much with these numbers, so day 2 and 3 I just had 2 novorapid and today I haven’t had any novorapid at all.
Rang 111 earlier to see if I should take any novorapid today, if it was ok to still take the full dose of metformin today and also if it would be ok to leave trulicity until tomorrow to discuss with specialist nurses at the diabetes centre. (Open M-F 9-4pm.)
Just after guidance and support really. I want to know if there is a way of calculating an hba1c from an average that the app gives me, without waiting a week. I just want to see if my hba1c numbers have dropped, even a point or two.
Thank you all for reading and for your positive suggestions. xxx

 

[Antje77]

No judgements please. Doing the best I can with what I have.

No judgement at all, except to say well done for doing the best you can despite life throwing all sorts of obstacles on your road!

Here's a converter (you need to scroll down to the second one):
https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

And here's a chart which holds both ways of measuring hba1c and both ways of measuring blood glucose.
So you'll only use the top and bottom numbers, not the middle ones.
Your previous hba1c of 109 shows your average BG to have been around 16, so seeing numbers in the 6's is absolutely amazing!

 

[Deleted member 527103]

If you have the LibreLink app, it has a Estimated A1c?
This is available from the “burger menu” (the three lines at the top left of the app screen). No calculation is needed. The value is given directly in the app.
However, bear in mind this is an estimate which is calculated differently to the blood test. My Libre estimate was 10 lower than my blood test. I take it as a good way to track improvements and a good indication of what to expect but don’t be disappointed if it is different.

 

[deebie_newbie]

No judgement at all, except to say well done for doing the best you can despite life throwing all sorts of obstacles on your road!

Here's a converter (you need to scroll down to the second one):
https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

And here's a chart which holds both ways of measuring hba1c and both ways of measuring blood glucose.
So you'll only use the top and bottom numbers, not the middle ones.
Your previous hba1c of 109 shows your average BG to have been around 16, so seeing numbers in the 6's is absolutely amazing!

Thank you SO, SO very much. Exactly what I needed. My sugars have been up a bit today, but that is because I have only had one unit of novorapid today, instead of the prescribed 6, as my sugars were 12. I also reduced it to 2 units yesterday and the day before, so it’s a mix of trying to get used to the cgm and it’s readings, taking into account that I know what is happening now and also the fact that I live alone and am terrified of going too low overnight, so at the minute, until I get a bit more confident, I would rather err on the side of caution. I have had type 2 since 2012 and been on insulin since 2014 as a result of an emergency admission to hospital due to DKA and an abscess, which made my sugars go to 21, along with (+4) ketones. The nurse at the walk in told me I wasn’t a happy little care bear and that I had to go to hospital straight away. Bless her. xxx

 

[deebie_newbie]

If you have the LibreLink app, it has a Estimated A1c?
This is available from the “burger menu” (the three lines at the top left of the app screen). No calculation is needed. The value is given directly in the app.
However, bear in mind this is an estimate which is calculated differently to the blood test. My Libre estimate was 10 lower than my blood test. I take it as a good way to track improvements and a good indication of what to expect but don’t be disappointed if it is different.

Thank you so much, lovely. I have the app and have looked a few times, but it won’t estimate the hba1c until it has 7 days of data readings. I started late last wednesday night, half eleven at night, so technically 4 days have passed. Two sensors came off my arm on the hottest day of the year, and I know they are £50 a pop, so I waited until it was cooler and not so humid, scrubbed my arm 3 times with a scourer, to get rid of any dirt / grease / sweat, then used injection swabs to clean, then dried the area, just to doubly make sure. Lol. Yes, I know. Scourer. The joys of ocd. Pleased to say that the third disc has stayed on since 11.30pm, last Wednesday night and I phoned the manufacturer helpline, (number listed on the box,) kept the lids (serial numbers) and they are going to send me 2 replacements. If you don’t have the lid with the serial number of the disc and the disc comes off, the serial number is registered within the app, so all is not lost. Thank you again, for your kind advice.

 

[Antje77]

My sugars have been up a bit today, but that is because I have only had one unit of novorapid today, instead of the prescribed 6, as my sugars were 12. I also reduced it to 2 units yesterday and the day before, so it’s a mix of trying to get used to the cgm and it’s readings, taking into account that I know what is happening now and also the fact that I live alone and am terrified of going too low overnight, so at the minute, until I get a bit more confident, I would rather err on the side of caution.

Sounds like you're on top of it, adjusting your doses to what is happening.
Being on a basal/bolus regime (long and short acting), you're having the same treatment as T1's. You might want to have a look into carb counting, so you can start to dose for what you eat instead of using a fixed amount. That's how it usually is done with T1.

I have had type 2 since 2012 and been on insulin since 2014 as a result of an emergency admission to hospital due to DKA

And speaking of type 1, have you actually been tested to make sure you have T2?
You have been on a typical T1 treatment for a long time, starting with an episode of DKA.
While this is possible in T2 as well, it's much more common in T1.

 

[deebie_newbie]

Managed to finally get the app to give me a reading. Was 109 last Wednesday, and 4/5 days later, 67. Didn’t think that was actually possible. Just putting it on here as a reminder for the bad times. To show me I have done it once, so can do it again. Thanks.

 

[Antje77]

Managed to finally get the app to give me a reading. Was 109 last Wednesday, and 4/5 days later, 67. Didn’t think that was actually possible. Just putting it on here as a reminder for the bad times. To show me I have done it once, so can do it again. Thanks.

The real hba1c is a result of your blood glucose over the past 3 months, the app only has data from the past week.

So while your hba1c won't be 67 if you had it tested now, it will be around that number if you manage to stay this stable for a while!