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How reliable is the HbA1c .Not very it seems

Ok so your 8.4% at diagnosis 4 months ago covered the time from 4 to 7 months ago. This shows that your BG was less bad between 7 to 4 months ago than it was from now to 3 months ago, but still in the diabetic range.

The simplest explanation is that your BG has been rising steadily for the last 7 months, at least. Maybe has plateaud out in the 20s as you destroy your kidneys by forcing them to try desperately to dump the excess glucose.

Your pancreas has FAILED. Get on insulin NOW. Please.
 
Spiker said:
Ok so your 8.4% at diagnosis 4 months ago covered the time from 4 to 7 months ago. This shows that your BG was less bad between 7 to 4 months ago than it was from now to 3 months ago, but still in the diabetic range.

The simplest explanation is that your BG has been rising steadily for the last 7 months, at least. Maybe has plateaud out in the 20s as you destroy your kidneys by forcing them to try desperately to dump the excess glucose.

Your pancreas has FAILED. Get on insulin NOW. Please.
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I will contact the endo tomorrow Spiker and see what he says when i tell him my last weeks readings .:)
I should note my very first test was 11% . I did see him three weeks ago though for my first visit and it was then I was told over the phone that there may be an adrenal tumour as the results came back abnormal so I'm not leaving it months or anything and he didn't complain too much when he gave me the new meds .I don't know if he has seen my last test though as the secretary phoned me with the results.
 
Susiespearish said:
I've no idea what RH is Nosher .Yes he suspects I'm not producing insulin as I should .Will see what he says at the end of the month .My urine glucose is at the highest so yes possibly hyperglycaemic .Just hope the new meds kick in .
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RH is reactive hypoglycaemia. I flush insulin so after meals I spike then hypo. I am carb and sugar intolerant so I have to low cArb and test all the time to control my BSLs.
Please do what Jack suggests! Talk to your endo! Mine would be unhappy with me if I don't talk to him about problems!
 
jack412 said:
I don't know if it's been said yet, but you can have an average 8 with highs of 9 and lows of 7 or highs of 20 with lows of 4,...not your numbers but you get the idea..insulin at the end of the month may be the right path for now
a1c can mess up, but they should be aware of this and check you out for those things that mess it
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It is now 14% Jack so reflects the number my meter has been giving me all along .I must have thrown some low readings out in my sleep or something .
 
Susiespearish said:
Well that's reassuring (not that your test where in the 100's obviously!) but it might give me a reason to hold off on the insulin if i can use those HbA1c's as an argument why i don't need to .:)
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Exactly, my hba1c is now 58 but it's the swings in my sugars I need to take care of! Nothing's ever straight forward lol
 
I agree with Spiker. Anything over 7.5% HBa1C per NICE Diabetes Pathways needs insulin or more tablets if not already on three (Google it). This assumes you are low-carbing; if not then diet is the first port of call. The HBa1C test is very reliable and so are virtually all meters.
 
I think you need to get yourself looked at and Echo spiker in that. There is nothing normal about those readings. They are bad and you are heading into hyper bad territory. To give you some idea of where you are, many T1s are diagnosed with bs in the mid-twenties (diagnosed on a meter). You are practically there.


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tim2000s said:
I think you need to get yourself looked at and Echo spiker in that. There is nothing normal about those readings. They are bad and you are heading into hyper bad territory. To give you some idea of where you are, many T1s are diagnosed with bs in the mid-twenties (diagnosed on a meter). You are practically there.


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I know :-( Tonights reading is 21.5 .I am being looked at though ,they just aren't acting that phased .
It's not like I'm ignoring it .I was at the GP monday and he is well aware of the many 20+ readings as is the endocrinologist.I always take my meter and show them and there are readings on there at 27 ect .I'll phone again tomorrow .
 
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To me its accurate, because mine a1c is close to what my average reading is on my various meters - a few points out but nothing major ... though one meter of mine its out if left field (which is why that meter got tossed in the bin because of it being inaccurate)
 
I contacted the hospital at 9.30 this morning ,spoke to the endocrinology unit ...and .....they were distinctly unconcerned .I explained about my bloods and the high glucose in my urine and about my latest Hba1c being 14% ....they passed me through to the consultants secretary who told me she would have a word with him and phone me back .She just has and I was told to just keep taking the meds and keep my appointment on the 26th but to come in sooner if my ketones became high .I should have known really when Nicola said she was in the 100's often for four years.Neither my GP or the consultant seemed phased by my high numbers so I don't see what else I can do other than to strictly watch my diet and keep on the tablets .
 
Sorry nothing more positive came out of it. At least it is not too long till the appointment. Would it be possible to see your GP as he/she might know more about the adrenal scan and be able to talk you through what the endo might say/do at the appointment? At least then you might feel a bit more in control and be prepared with any questions/ thoughts?
 
cold ethyl said:
Sorry nothing more positive came out of it. At least it is not too long till the appointment. Would it be possible to see your GP as he/she might know more about the adrenal scan and be able to talk you through what the endo might say/do at the appointment? At least then you might feel a bit more in control and be prepared with any questions/ thoughts?
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I saw him Monday Cold Ethyl .Since I'm now "under" the hospital and have seen the endo once I imagine all the notes will be with him and they always take forever to send through results to the GP .I'll just look on the positive side and get those carbs down to the lowest I can stand .I could lose another half stone before the appointment ! :-) Thank you All for your concern .It is lovely to know that people care and @Spiker has given me the impetus to accept and start learning about insulin:)
 
There is another possibility for why your HbA1c score would not be an accurate reflection of your average blood sugar levels and that is if for some reason you replace red blood cells faster than the normal 3 months.
Your much younger than average blood cells will then have less glucose attached to them, even with high serum glucose levels, simply because they would not have had long enough to accumulate glucose. This would then result in an Hba1c which is falsely low. Given your last count I hope this is not true for you!
 
pavlosn said:
There is another possibility for why your HbA1c score would not be an accurate reflection of your average blood sugar levels and that is if for some reason you replace red blood cells faster than the normal 3 months.
Your much younger than average blood cells will then have less glucose attached to them, even with high serum glucose levels, simply because they would not have had long enough to accumulate glucose. This would then result in an Hba1c which is falsely low. Given your last count I hope this is not true for you!
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Thank you pavlosn :-) Interesting theory ,I shall do some further reading and as you say ,let's hope it's wrong !
 
Susiespearish said:
I contacted the hospital at 9.30 this morning ,spoke to the endocrinology unit ...and .....they were distinctly unconcerned .I explained about my bloods and the high glucose in my urine and about my latest Hba1c being 14% ....they passed me through to the consultants secretary who told me she would have a word with him and phone me back .She just has and I was told to just keep taking the meds and keep my appointment on the 26th but to come in sooner if my ketones became high .I should have known really when Nicola said she was in the 100's often for four years.Neither my GP or the consultant seemed phased by my high numbers so I don't see what else I can do other than to strictly watch my diet and keep on the tablets .
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GP's never do seem concerned about diabetes, as they don't really know much about it, my DSN and consultant are okay...have you got a DSN?? And ketones....do you have any? x
 
ohitsnicola said:
GP's never do seem concerned about diabetes, as they don't really know much about it, my DSN and consultant are okay...have you got a DSN?? And ketones....do you have any? x
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If a DSN is a diabetic nurse then only the ones at the hospital Nicola.I used to mostly see my GP and now the hospital clinic .Thankfully no ketones yet although I wouldn't mind the lower scale because that would mean I was ketogenic and I'm thinking of trying that after watching a very interesting talk posted by Lucy on here yesterday .I test every time my BG's go above 20 and this last week I've been testing far more than usual with my meter to see if the new meds i started on monday are having any effect :-)
 
Susiespearish said:
If a DSN is a diabetic nurse then only the ones at the hospital Nicola.I used to mostly see my GP and now the hospital clinic .Thankfully no ketones yet although I wouldn't mind the lower scale because that would mean I was ketogenic and I'm thinking of trying that after watching a very interesting talk posted by Lucy on here yesterday .I test every time my BG's go above 20 and this last week I've been testing far more than usual with my meter to see if the new meds i started on monday are having any effect :)
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Ah right I see that's weird...I never see a DSN at the hospital unless I am in for DKA ha! :/ I see mine at a seperate clinic! Atleast you have none though, and yes true but be careful in case they creep up even more?

Just a thought..do you have enough strips to test 2 hourly? Will give you a bit more of an idea of how things are going? :)
 
Susiespearish said:
If a DSN is a diabetic nurse then only the ones at the hospital Nicola.I used to mostly see my GP and now the hospital clinic .Thankfully no ketones yet although I wouldn't mind the lower scale because that would mean I was ketogenic and I'm thinking of trying that after watching a very interesting talk posted by Lucy on here yesterday .I test every time my BG's go above 20 and this last week I've been testing far more than usual with my meter to see if the new meds i started on monday are having any effect :)
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I must say I agree with Dr Spiker above; if you are getting those readings on a low carb diet as well then your pancreas is really not performing. How many carbs do you eat a day?

No ketones and high bloods mean that you have some insulin on board but the blood sugars imply not very much.

I think you need to shout and kick a bit to get this resolved quickly.

Best

Dillinger
 
Dillinger said:
I must say I agree with Dr Spiker above; if you are getting those readings on a low carb diet as well then your pancreas is really not performing. How many carbs do you eat a day?

No ketones and high bloods mean that you have some insulin on board but the blood sugars imply not very much.

I think you need to shout and kick a bit to get this resolved quickly.

Best

Dillinger
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Hi Dillinger .I've been trying to stick to around 70 grams of carbs but knocked it down to 35 when I stopped dropping weight as quickly a couple of weeks ago . My husband felt that i might get seen quicker by popping in to A&E when I have another reading around 25 .May try this .
 
ohitsnicola said:
Ah right I see that's weird...I never see a DSN at the hospital unless I am in for DKA ha! :/ I see mine at a seperate clinic! Atleast you have none though, and yes true but be careful in case they creep up even more?

Just a thought..do you have enough strips to test 2 hourly? Will give you a bit more of an idea of how things are going? :)
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I have enough to do that for a couple of days Nicola as I've just got my new strips .I'm going to invest in a code free as a back up I think. I'm not sure what a DSN is but i meant that the nurses did all the usual checks BP ect when I attended the hospital .I saw a nurse on my first visit to the diabetic clinic at the GP but I was probably so bolshy over demanding a meter that I've never been asked to return lol I just see the GP who is the diabetic specialist and runs the clinic at our practice anyway :-)
 
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