My Hba1C has gone up !

[Lighthouse0104]

Hi everyone ,

I've been on a health and fitness journey for over six months now , I've lost a little weight and some inches , in February my Hba1C was 45 so in the pre diabetic range , I've carried on working hard to reduce this figure and to my horror it's now gone up to 48 !!

I'm in a calorie deficit , walk over 10k steps a day and also complete a cardio exercise session , 2 litres of water , sleep well , have a physical job. They are going to test me again mid July but why oh why has it gone up !! ??

 

[Lighthouse0104]

Also to add I do Intermittent Fasting 16:8 most days

 

[Rachox]

Hi @Lighthouse0104 and welcome to the forum and congratulations on your weight loss.
Can you tell us about your diet please, aside from the calorie deficit, do you calculate how much carbohydrate you’re eating? Tell us what you eat on a typical day, there may be some tweaks there to improve things.

 

[Lighthouse0104]

An example would be overnight oats with Greek yogurt , berries , nuts/ seeds

Boiled eggs

Protein wrap with chicken ,.leaves , tomatoes ,.cucumber

Chicken breast with vegetables sometimes with some pasta or rice ,.spices etc

Only water to drink or tea/coffee no sugar or sweetener anymore

 

[Lighthouse0104]

I am worried before mid July that it's going to rise again.

I do have diabetes in my family (elderly father and grandparents now passed )

And I do also have some worrying symptoms
Some blurry vision
Always tired regardless of a decent sleep nearly every night
Recent gum problems but now getting better with a regime
Wee more but I drink more water
Aching legs a lot of the time but I put this down to exercise

Oh and perimenopause symptoms too which many seem to cross over

I'm 47 years old

 

[Rachox]

An example would be overnight oats with Greek yogurt , berries , nuts/ seeds

Boiled eggs

Protein wrap with chicken ,.leaves , tomatoes ,.cucumber

Chicken breast with vegetables sometimes with some pasta or rice ,.spices etc

Only water to drink or tea/coffee no sugar or sweetener anymore

There are some carbs in your diet. The oats, wraps, pasta and rice. All carbs turn to glucose once digested. Many of us restrict carbs to control our blood sugars. Also do you ever test your blood sugar levels at home? It might be worth testing to see what effect the carbs you are eating are having.
Your HbA1c simply explained is an average of your last three months blood sugar levels so having a test after only a month will not tell you the whole story.

 

[Lighthouse0104]

Well unfortunately I don't get a choice when the retest is they've made the appointment for me , I'm just disappointed after all my hard work that the figure has gone up.
I've not had any discussion with a doctor yet so I'll certainly wait for that.
I just wondered if there could be an anomaly as to why it's gone up with my hard work in a 12 week period.
I've never been so active.

I don't have any blood testing equipment

 

[Rachox]

They may have decided to redo the test in a month to confirm the 48 result. 48 is the level at which a diabetes diagnosis is made and there should be two tests at a diabetic level for the NHS to then offer all the checks associated that, foot checks, biannual blood tests, retinal screening etc…
We can advise on testing equipment if you’d like or maybe take advantage of the free trials available for a continuous blood monitors for a Libre or Dexcom, again we can advise on them.

 

[Lighthouse0104]

According to the guidelines the retest should be done within two weeks as to diagnose diabetes so I guess that's why best test is close by

 

[Rachox]

According to the guidelines the retest should be done within two weeks as to diagnose diabetes so I guess that's why best test is close by

Yes my second test was done ten days after the first. The month wait confused me!

 

[Lighthouse0104]

They may have decided to redo the test in a month to confirm the 48 result. 48 is the level at which a diabetes diagnosis is made and there should be two tests at a diabetic level for the NHS to then offer all the checks associated that, foot checks, biannual blood tests, retinal screening etc…
We can advise on testing equipment if you’d like or maybe take advantage of the free trials available for a continuous blood monitors for a Libre or Dexcom, again we can advise on them.

Thank you yes please advise , I did have gestational diabetes and was infecting insulin , I found the finger pricking 5 X times a day extremely uncomfortable and it even stopped me playing my piano which is a hobby.
Is finger pricking the only way to test ?

 

[Rachox]

Finger pricks should be done on the side of the finger so shouldn’t affect your piano playing. As suggested above you could get the free trials available for a CGM, info at the end of the following.

Here’s some info with links for UK meters, and to be clear I have no commercial connections with any of the companies mentioned.



HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/



Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/



Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/





SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular:

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793



The strips are to be found here:

https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.



Don’t forget to check the box if you have diabetes so you can buy VAT free. (for all meters and strips)



If you’d like to try a free 15 day trial of the Freestyle LIBRE 2 plus follow this link:

Sampling | Diabetes Care | Abbott



Dexcom also offer a free trial of their Dexcom one + here

The Dexcom ONE+ CGM (Continuous Glucose Montoring) system | Dexcom

 

[Lighthouse0104]

Thanks that's really helpful , I obviously was never shown the correct way 7 years ago and it still haunts me now.

Thanks for all the info really appreciate it and hope that my next result has gone down by I'm worried about it

 

[KennyA]

Hi - as has been said there's a fair amount of carb in what you're eating. There's enough error in HbA1c testing (up to around 2-3%) so there is maybe not that much difference between your two quoted test results. This article is pretty good at explaining how the HbA1c test works - but note different countries have different standards, although everyone (just about) uses the 48mmol/mol (or 6.5% in percentage terms) as definitively diagnostic of T2 diabetes.

HbA1c

Glycated haemoglobin (HbA1c) should not be interpreted in isolation; the measurement accuracy and other parameters, including treatment goals and comorbidities, need to be considered.

www1.racgp.org.au

Personally I don't see how you can manage blood glucose without testing around food, at least until you learn how you react. Fingerprick testing worked (and works) for me, although I have used a Constant Glucose Monitor, which has some distinct advantages - full day BG pattern, no fingerpricking etc. Downside is cost.

My short answer would be that you don't need to "hope" that your blood glucose goes down. You can do things to give you the best chance of controlling it and reducing it. Ultimately that will probably mean reducing the carbohydrate you're eating - and there are carbs in many things which officially are labelled "healthy" - they are anything but if you have problems with excess glucose.

[Edited as forgot to attach link]

 

[Lighthouse0104]

Hi - as has been said there's a fair amount of carb in what you're eating. There's enough error in HbA1c testing (up to around 2-3%) so there is maybe not that much difference between your two quoted test results. This article is pretty good at explaining how the HbA1c test works - but nore different countries have different standards, although everyone (just about) uses the 48mmol/mol (or 6.5% in percentage terms) as definitively diagnostic of T2 diabetes.

Personally I don't see how you can manage blood glucose without testing around food, at least until you learn how you react. Fingerprick testing worked (and works) for me, although I have used a Constant Glucose Monitor, which has some distinct advantages - full day BG pattern, no fingerpricking etc. Downside is cost.

My short answer would be that you don't need to "hope" that your blood glucose goes down. You can do things to give you the best chance of controlling it and reducing it. Ultimately that will probably mean reducing the carbohydrate you're eating - and there are carbs in many things which officially are labelled "healthy" - they are anything but if you have problems with excess glucose.

Thank you for this , when I say hoped that was with all the changes I've already made to my eating and exercise and intermittent fasting but clearly this hasn't been enough which makes me unhappy.

However I need to sort myself out , thanks for all the advice and I certainly be getting a blood machine and be monitoring exactly what's going on for me

Hi - as has been said there's a fair amount of carb in what you're eating. There's enough error in HbA1c testing (up to around 2-3%) so there is maybe not that much difference between your two quoted test results. This article is pretty good at explaining how the HbA1c test works - but nore different countries have different standards, although everyone (just about) uses the 48mmol/mol (or 6.5% in percentage terms) as definitively diagnostic of T2 diabetes.

Personally I don't see how you can manage blood glucose without testing around food, at least until you learn how you react. Fingerprick testing worked (and works) for me, although I have used a Constant Glucose Monitor, which has some distinct advantages - full day BG pattern, no fingerpricking etc. Downside is cost.

My short answer would be that you don't need to "hope" that your blood glucose goes down. You can do things to give you the best chance of controlling it and reducing it. Ultimately that will probably mean reducing the carbohydrate you're eating - and there are carbs in many things which officially are labelled "healthy" - they are anything but if you have problems with excess glucose.

 

[Rosie9876]

Thank you yes please advise , I did have gestational diabetes and was infecting insulin , I found the finger pricking 5 X times a day extremely uncomfortable and it even stopped me playing my piano which is a hobby.
Is finger pricking the only way to test ?

As others may have pointed out, 48 isn't significantly different from 45, except it is an artificial marker above, putting you in a 'diabetes' level. So your question really is, why hasn't your HbA1c improved, given the effort you are putting in. A Continuous Glucose Monitor might be just the thing to help you find out.

You say you sleep well, but monitoring your glucose levels while you sleep might show stress rises. Stress is also a factor raising your A1c, and you might not be aware of it.

It will also tell you which foods trigger an undue spike. Starting a meal with protein/fat/fibre and a few carbs following has helped me, but people react differently.

Have you had your eyes checked because of blurry vision?

Gestational diabetes is an increased risk for Type 2. I also have diabetes in my family, though I didn't have gestational diabetes (afaik), but post a hysterectomy, I became diabetic even though I was not overweight. I don't know if menopause makes one more prone.

It's great that diabetes is being checked out and dealt with early on. Many of us sleepwalked for years with it. Good luck.

 

[debs248]

I'm late to the party but want to offer my sympathies. It can be very frustrating when you try really hard and results stay the same or get worse.

I'm also perimenopausal which is probably why I didn't suspect my increased urination, fatigue and blurry eyesight were diabetic signs, as you say, loads of overlap.

Hormonal changes can themselves increase your blood glucose levels, as can stress and poor sleep. There's a list (which I can never find when I need to) of 42 factors which affect blood sugars, most of which we can’t directly control. My BG is far more affected by how generous my liver decides to be than by anything I eat except pies.

Highly recommend cutting down on carbs a bit and testing BG before and two hours after any meal you want to investigate. If you're pricking the side of the finger it shouldn't affect piano playing. I have difficult capillaries so often have to prick 5 or 6 times to get a proper blood drop, but it's annoying rather than painful for the most part.

 

[KennyA]

I'm late to the party but want to offer my sympathies. It can be very frustrating when you try really hard and results stay the same or get worse.

I'm also perimenopausal which is probably why I didn't suspect my increased urination, fatigue and blurry eyesight were diabetic signs, as you say, loads of overlap.

Hormonal changes can themselves increase your blood glucose levels, as can stress and poor sleep. There's a list (which I can never find when I need to) of 42 factors which affect blood sugars, most of which we can’t directly control. My BG is far more affected by how generous my liver decides to be than by anything I eat except pies.

Highly recommend cutting down on carbs a bit and testing BG before and two hours after any meal you want to investigate. If you're pricking the side of the finger it shouldn't affect piano playing. I have difficult capillaries so often have to prick 5 or 6 times to get a proper blood drop, but it's annoying rather than painful for the most part.

Here it is:

42 Factors That Affect Blood Glucose?! A Surprising Update

diaTribe is a non-profit organization providing free cutting-edge diabetes management tips from diet and exercise, to ways to avoid diabetes complications.

diatribe.org

there are probably way more than 42.

 

[JoKalsbeek]

Thank you for this , when I say hoped that was with all the changes I've already made to my eating and exercise and intermittent fasting but clearly this hasn't been enough which makes me unhappy.

However I need to sort myself out , thanks for all the advice and I certainly be getting a blood machine and be monitoring exactly what's going on for me

When you say you need to sort yourself out, it sounds kind of stern? You made a lot of adjustments, you just kind of missed the main one that could make the biggest difference, is all... Which isn't strange in the slightest, as even medical professionals still often stress the importance of calorie reduction, when it's the carbohydrates that make blood glucose go up! Back to the drawling board, no biggy... If you eat chicken often, try going for the fattier bits, thighs or with skin on, you know, because you do need something to run on. Fats and proteins are going to have to be it, if you're going to lower your carb intake. Let go of the calorie restriction some, or you might end up rather malnourished. Have nutrient-dense foods so your body has something to fuel it, and so you don't become deficient in all sorts of vits and mins.

Also, I hope you'll have a better experience with blood glucose monitoring this time, now that you know the pricking's done on the side. For me, it showed me immediately that lowering carbs worked, so I knew I was on the right path. That was a relief, and it was quite empowering. So rather than being a measurement of how much insulin to take, it could potentially now be a measurement of how your adjustments are working for you. Which is a bit more hopeful, maybe?

Hang in there.
Jo