I’m prediabetic, 63 years old, bmi 22.8, doing moderate exercise. I control my blood sugar well by eating a low carb diet, so my most recent HbA1c had fallen from 46 to just within the normal range at 41. I do fasting, pre and 2hr post meal BS checks and keep an accurate food diary. If I eat anything with a ‘normal’ amount of carbs - bread, pasta, rice, pizza - my reading spikes at 2 hrs after a meal to 10-13, up 4-5 from pre-meal readings. It takes another couple of hours to come down. (Pizza was the worst - pre 4.6, post 14.5). If I stay around 30g carbs with some fat, eg, cheese, oily fish, olive oil, the rise is 2 or less. Fasting readings are around 7-9.
When I explain this to the GP or practice nurse, they can’t see past the normal A1c. It seems as if the only way I might persuade them that there is an issue would be to eat normally for 3 months, and get a raised A1c. They repeatedly explain in words of one syllable the difference between A1c and pinprick tests - I know and understand the difference, and it is precisely because I do that I know I have a problem with carbs which is not being picked up by the A1c. It’s so frustrating to just be told ‘A1c good, you don’t have a problem’.
A T1 with accurate insulin use, a T2 eating minimal carbs or a non-diabetic could have the same A1c, for different reasons. A T1 is effectively balancing carb intake and blood sugar using injected insulin. A T2 is taking in few enough carbs that what insulin they can produce and use is able to control blood sugar. A non diabetic is producing and using insulin efficiently enough to break down a higher carb intake.
I have a significant family history of LADA, onset around 60 (mum, aunt and uncle). I was married to a T1, so lived with glucose meters and measuring carbs in family meals for years.
I am fortunate enough to have access to private health care through work, and the nurse practitioner through that has referred me to endocrinology for investigation. I hope to discover whether this might be the start of LADA or just well controlled T2. It matters to me! I don’t want kidney, eye or foot problems any time soon, but I want to be able to eat granola, garlic bread, risotto or baked potatoes sometimes. And, as a trivial aside, if I’m diabetic, I would quite like to get test strips on prescription when I retire, rather than paying for them!
When I explain this to the GP or practice nurse, they can’t see past the normal A1c. It seems as if the only way I might persuade them that there is an issue would be to eat normally for 3 months, and get a raised A1c. They repeatedly explain in words of one syllable the difference between A1c and pinprick tests - I know and understand the difference, and it is precisely because I do that I know I have a problem with carbs which is not being picked up by the A1c. It’s so frustrating to just be told ‘A1c good, you don’t have a problem’.
A T1 with accurate insulin use, a T2 eating minimal carbs or a non-diabetic could have the same A1c, for different reasons. A T1 is effectively balancing carb intake and blood sugar using injected insulin. A T2 is taking in few enough carbs that what insulin they can produce and use is able to control blood sugar. A non diabetic is producing and using insulin efficiently enough to break down a higher carb intake.
I have a significant family history of LADA, onset around 60 (mum, aunt and uncle). I was married to a T1, so lived with glucose meters and measuring carbs in family meals for years.
I am fortunate enough to have access to private health care through work, and the nurse practitioner through that has referred me to endocrinology for investigation. I hope to discover whether this might be the start of LADA or just well controlled T2. It matters to me! I don’t want kidney, eye or foot problems any time soon, but I want to be able to eat granola, garlic bread, risotto or baked potatoes sometimes. And, as a trivial aside, if I’m diabetic, I would quite like to get test strips on prescription when I retire, rather than paying for them!
