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Interpreting my first hba1c test - Help

P

Paul_K

Member
Messages
12
Location
London
Type of diabetes
Type 2
Treatment type
Insulin
Hi all. I was diagnosed T2D (originally T1D diagnosis) around 6 months ago and just received my hba1c test results for the first time and would appreciate some help in interpreting the results.

45 mmol/mol = 7.4
Normal Range = 20 - 42 mmol/mol

Everything in the test results shows up green except this and my white blood cell count, which was high due to an infection at the time of testing. How should I be interpreting this? Is 3 mmol/mol above the normal range significant? This hba1c test includes the crazy high numbers I had whilst in ketoacidosis for over a week (diagnosis time) and the time it took me to obtain a degree of control of my BG. If it helps, I'm on 10 units (Lantus) Insulin (20 units at the start), 4 metformin and 1 sitagliptin. I've lost 24kg (53lbs) in that time too.

I wasn't too fussed about it at first as it's my first test and it doesn't "look" too far outside the "norm", but then i saw some of the results in peoples signatures, 5.4 and similar and now I feel like it's much higher than it should be. I won't have the opportunity to discuss it with my DSN until 6 Dec so here I am...

If you need any additional information please feel free to ask.

Paul.
 
Paul_K said:
Hi all. I was diagnosed T2D (originally T1D diagnosis) around 6 months ago and just received my hba1c test results for the first time and would appreciate some help in interpreting the results.

45 mmol/mol = 7.4
Normal Range = 20 - 42 mmol/mol

Everything in the test results shows up green except this and my white blood cell count, which was high due to an infection at the time of testing. How should I be interpreting this? Is 3 mmol/mol above the normal range significant? This hba1c test includes the crazy high numbers I had whilst in ketoacidosis for over a week (diagnosis time) and the time it took me to obtain a degree of control of my BG. If it helps, I'm on 10 units (Lantus) Insulin (20 units at the start), 4 metformin and 1 sitagliptin. I've lost 24kg (53lbs) in that time too.

I wasn't too fussed about it at first as it's my first test and it doesn't "look" too far outside the "norm", but then i saw some of the results in peoples signatures, 5.4 and similar and now I feel like it's much higher than it should be. I won't have the opportunity to discuss it with my DSN until 6 Dec so here I am...

If you need any additional information please feel free to ask.

Paul.
Click to expand...

Everything you need to know about a1c......
http://www.diabetes.co.uk/what-is-hba1c.html
 
Yes, non-diabetic range is up to 41.
42 to 47 is classed as pre-diabetic
48 and above is diabetic.

Your result of 45 is in the pre-diabetic band. (or 6.3% in old units) It is equivalent to an average of 7.4mmol/l as per the units we see on our glucose meters.

Before you compare your levels to anyone else's on here, make sure you are looking at levels in the same measurement units. Some people use the old units in their signatures, in your case this would be 6.3, not 7.4.
Have a look at this converter.

http://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

I understand how confusing it all is. I was in the same confused state as you when I was first diagnosed, and I expect everyone else was too. You will get used to it.
 
Hi and welcome @Paul_K
I will tag @daisy1 for her helpful info for newcomers.
45 is in the prediabetic range. So that would be counted as well controlled. HbA1c is an average of the last 2 to 3 months so what was happening 6 months ago would not be relevant. Do you know what your HbA1c was at diagnosis? I took 6 months to get my levels down to the normal range and if you were dangerously high it could take a lot longer.
 
Thank you for the links and information, it's much appreciated and settled my anxiety somewhat. I do have a follow up question though. Bluetit and Hiitsme, you guys said that my reading is within the pre diabetes range, does that hold true even though meds are involved? As in, i'm not achieving the 7.4 through diet and exercise alone yet so is it a faux pre D reading or will my DSN likely tell me i'm pre D at my next appointment? That would be nice.
 
Hiitsme said:
Hi and welcome @Paul_K
I will tag @daisy1 for her helpful info for newcomers.
45 is in the prediabetic range. So that would be counted as well controlled. HbA1c is an average of the last 2 to 3 months so what was happening 6 months ago would not be relevant. Do you know what your HbA1c was at diagnosis? I took 6 months to get my levels down to the normal range and if you were dangerously high it could take a lot longer.
Click to expand...

I wish I knew my original hba1c results but I was diagnosed at a really poor hospital and I get little to no information from them. The only reason I have my results from this test is because my local surgery based DSN asked for the results of my latest test done there but they didn't send her them, so she had me give blood at the surgery that same day and now I have something meaningful to look at. Here's an example of how bad the hospital I was diagnosed at is. A few months after I was diagnosed, a young woman in her mid 20's was admitted in ketoacidosis, exactly the same as me. The difference was that they sent her home diagnosed as having a hangover, she died in her bed that night.
 
@Paul_K

Hello Paul and welcome to the forum :) As mentioned above, here is the basic information we give to new members and I hope you will find it useful. There is a lot of advice on carbs and levels and a link to the Low Carb Program which you could join. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 220,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
Paul_K said:
I wish I knew my original hba1c results but I was diagnosed at a really poor hospital and I get little to no information from them. The only reason I have my results from this test is because my local surgery based DSN asked for the results of my latest test done there but they didn't send her them, so she had me give blood at the surgery that same day and now I have something meaningful to look at. Here's an example of how bad the hospital I was diagnosed at is. A few months after I was diagnosed, a young woman in her mid 20's was admitted in ketoacidosis, exactly the same as me. The difference was that they sent her home diagnosed as having a hangover, she died in her bed that night.
Click to expand...
It is probable that your original HbA1c was much higher, given the medication you are on. You come over in your posts as someone who want to know, understand, and take control of your situation. That's a great attitude. Make sure that you book a blood test every 3 months, don't wait for them to call you, they might not! Insist on a print out every time so that you have the record too. With your meter you can test the impact of differnt foods on your blood sugars and adjust your meals accordingly. Don't get too hung up on the absolute numbers but look for trends after a fair number of readings. You are looking for a downward trend. Discuss with your HCP how YOU want to proceed. It may well be that your meds can be reduced in due course if you continue the way you are. This is a journey that will last the rest of your life, enjoy it all the same!
 
Hi @Paul_K
It would be well controlled diabetic with the meds you are on. It might be that you could discuss reducing some of your meds with your DSN at your next appointment. Well done on the weight loss as that will have helped. Do you test at home? I presume you must do as you're on insulin. What sort of numbers do you get during the day?
 
Paul_K said:
Thank you for the links and information, it's much appreciated and settled my anxiety somewhat. I do have a follow up question though. Bluetit and Hiitsme, you guys said that my reading is within the pre diabetes range, does that hold true even though meds are involved? As in, i'm not achieving the 7.4 through diet and exercise alone yet so is it a faux pre D reading or will my DSN likely tell me i'm pre D at my next appointment? That would be nice.
Click to expand...

Your bloods are currently in the pre-diabetes range, but you are still a full blown diabetic because of your levels when initially diagnosed at the hospital. You are not pre-diabetic. You are diabetic with good control. Once diagnosed we stay diabetic unless and until we manage to reverse it for a sustained period without the aid of medication. (and not many can do that, although some have).

As said above, when you see your nurse have a discussion about reducing your meds and take her advice.

I hope that makes it clearer for you.
 
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