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Misleading Hba1c Results

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BMW Lover

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My first post, please be gentle with me.

I'm a type 2 diabetic, diagnosed in 2001, been on insulin since 2008. I will admit that I was perhaps not a model diabetic in the early years but have made some significant changes to lifestyle since and would now like to fine tune my diabetic control.

My Hba1c results have been pretty good for some time in the range 42-50 which I am told is alright but could be a bit better. However my home testing results would suggest that the Hba1c results are misleadingly low. Home testing results are most commonly over 10, I have three different meters and the results are the same on all 3 meters.

I have had a diabetic review at the local surgery today and discussed this with the diabetic nurse who looked at my home testing readings and agrees the situation is very unusual but not unheard of. I should mention that they have done a full set of blood tests and everything has come back fine. They have asked me to keep a food/insulin/readings log for 4 days and go back to them for further investigation.

I'm really confused
 
Last edited:
BMW Lover said:
My first post, please be gentle with me.

I'm a type 2 diabetic, diagnosed in 2001, been on insulin since 2008. I will admit that I was perhaps not a model diabetic in the early years but have made some significant changes to lifestyle since and would now like to fine tune my diabetic control.

My Hba1c results have been pretty good for some time in the range 42-50 which I am told is alright but could be a bit better. However my home testing results would suggest that the Hba1c results are misleadingly low. Home testing results are most commonly over 10, I have three different meters and the results are the same on all 3 meters.

I have had a diabetic review at the local surgery today and discussed this with the diabetic nurse who looked at my home testing readings and agrees the situation is very unusual but not unheard of. I should mention that they have done a full set of blood tests and everything has come back fine. They have asked me to keep a food/insulin/readings log for 4 days and go back to them for further investigation.

I'm really confused
Click to expand...

Hi there, all I would say is that your at home readings are simply snapshots presumably taken following meals? It may be that the other 20 hours or so would show much lower readings, hence the hb1ac result which is an average of your levels over 3 months. I know you probably won't get one on the NHS but is it possible you could buy a libre and check your levels 24/7? They are a mine of information outside of actual mealtimes. x
 
Yes the Libre can be helpful, but it does have its little quirks. My greatest bugbear with it is rubbish recording below 4. According to mine, I am hypo most of the night and first thing in the morning. Only had to take jelly babies twice, all the other test pricks were over 4. As a result, it is giving me an estimated hba1c of 29. I had an hba1c done on Tuesday and am awaiting the results, probably in the 40s.

When I start full time finger pricking again, I will log the results in the MySugr app. After a few days, it gives you an estimated hba1c based on the data you enter. It's free, and although a couple of numbers out I, found it close enough to the lab test. Great for spotting trends.
 
Sorry, didn't realise it was your first post, welcome to the forum.

Tagging @JoKalsbeek for her nutritional info. What are you eating in a typical day?
 
Iron deficiency anemia can alter HBA1c results but normally giving false high results.
HbA1c results can be altered according to the time your red blood cells survive if they live a shorter time than the average as with some forms of anemia the result can be falsley low.
Some drugs will also give false low HbA1c results
Even vitamin C in high dosages can alter the results

There are alternatives to the HbA1c test such as the fructosamine test that can be more reliable in certain circumstances it may be advisable to talk to your GP about this.
 
BMW Lover said:
My first post, please be gentle with me.

I'm a type 2 diabetic, diagnosed in 2001, been on insulin since 2008. I will admit that I was perhaps not a model diabetic in the early years but have made some significant changes to lifestyle since and would now like to fine tune my diabetic control.

My Hba1c results have been pretty good for some time in the range 42-50 which I am told is alright but could be a bit better. However my home testing results would suggest that the Hba1c results are misleadingly low. Home testing results are most commonly over 10, I have three different meters and the results are the same on all 3 meters.

I have had a diabetic review at the local surgery today and discussed this with the diabetic nurse who looked at my home testing readings and agrees the situation is very unusual but not unheard of. I should mention that they have done a full set of blood tests and everything has come back fine. They have asked me to keep a food/insulin/readings log for 4 days and go back to them for further investigation.

I'm really confused
Click to expand...
If your HbA1c is relatively low when you're seeing double figures, that could mean you're hypo-ing on a regular basis, which keeps the average low. Naturally, it would be better to not fluctuate too much.
When you mention significant changes to your lifestyle, could you be more specific? The usual dietary advice is rather useless to T2's, so we really do need to know what measures you've been taking. What you eat on a given day for instance. Also, I have a quick-start-guide to a lifestyle change for T2, which should get your numbers under control, but with insulin and that regime, you'd hypo. So I hope you can carb count rather than rely on a fixed dose, or get help, because you might end up havign to cut back or ditch the insulin entitely. Not something to undertake on your own.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <--that's it. Hope it'll help, and please be careful eh.
Hugs,
Jo
 
Antje77 said:
Hi @BMW Lover , and welcome to the forum!
I think there are some conditions that can make hba1c results unreliable.
We have a member knowing quite a lot about that but I'm not sure about who it was. @Bluetit1802 , was that you or did I remember wrong?
Click to expand...

Thanks for the tag @Antje77 . Sorry to be late replying. I haven't been around recently. Yes, I was one that did a lot of research on reasons why the HbA1c can be unreliable. There are a lot of informative webpages if you have a Google. Some forms of anaemia are the most common reasons, also thyroid issues, some medications, and most often the length of time your red blood cells live. If they are short lived, your HbA1c will be lower than expected. There is no way of knowing how long your red blood cells live without intensive testing in hospital.
 
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