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Normal BG but high HBA1C after necrosis

M

markb23

Member
Messages
9
Type of diabetes
Type 2
Hi, I am new to the group and looking for some advice if possible, I had severe pancreatitis last year with 50% necrosis. I had my Hba1c tested in Feb and it was 43 but fasting glucose came back normal. I have just had them retested and again fasting glucose normal but now Hba1c 48. Also I was in hospital for a week in March and they tested bloods after every meal and it was always normal. Why is my Hba1c level going up but all blood sugar tests show normal?

Any ideas much appreciated
Mark
 
I'm just guessing about what might be happening to you to get that result, but a single test might not be revealing the whole picture of what is going on after meals - particularly if your pancreas is not able to provide a normal output of insulin.
Your information shows 'type 2' - by the way - which is why I read your post - but you are anything but - you need advice from someone dealing with a similar situation.
However increasing Hba1c would infer that at some points in the day you have higher than normal blood glucose levels - have you been advised to eat smaller meals more frequently, or fewer carbs, or any other protocols which could help an unhappy pancreas deal with what you are eating?
 
 
Hi, although half my pancreas has died i can still eat food fine without adding enzymes, but since I had my Hba1c done in march and it was 43 I have gone on to low carb diet, lost weight and walked my **** off to get healthy, but that seems to have made things worse lol.
 

Or possibly slowed down any rapid advancement in the condition with your change in diet excersise?
Just helping to push up your thread. Someone in similar circumstances will be along soon..!
 
Did you pick up on what any of your normal post prandial BGs were after eating in hospital? A hba1c of 48 is equivalent to average blood sugars of 7.8.

A hba1c of 48 is diagnostic of type 2 diabetes.

A hba1c of 43 is equivalent to average blood sugars of 7.1 and indicates pre-diabetes.

There is type 3c diabetes, which is the term applied to diabetes caused by chronic pancreatitis, physical damage to the pancreas or pancreatectomy (partial or complete). If the 50% necrosis of your pancreas has caused a reduction or cessation in beta cell function then you can do all the walking, weight loss and low carbing you want, but you won't avoid the increase in blood sugar levels if you don't have pancreatic function. Have you been informed of the risk of developing diabetes following severe pancreatitis? Are you receiving follow up to check on you pancreatic function with cpeptide tests? You might want to have a look at the 3c section of the forum for info on 3c diabetes, you might want to ask your healthcare team for a cpeptide test to see if you are making insulin.
 
Hi @markb23

Have you got your own blood glucose meter? It sounds like you haven't, in which case I believe you need to buy one. That way yu aren't waiting between tests to see what is happening. You can test at home, at any time. You can test your morning fasting, your levels before and after you eat, bedtimes, and any other random time. Keeping a food diary will help, and keep records of your levels alongside the food. You will then have a better idea of what is happening, and also will be able to show these to yor doctor if necessary.

The HbA1c is reliable for most people, but not for everyone (including me). The results are based on our red blood cells living the average time of around 120 days. Some people have RBC that die and are replaced with new ones in a shorter period than 120 days, and some people have longer living ones. In these 2 cases, the HbA1c may be higher or lower than expected.

Please don't worry. Your own meter will help enormously.
 

Thanks for reply, they did say I was at high risk of diabetes and I have a hospital follow up in Sep although they seem more concerned about the enzyme function for the food and leaving the diabetes for the GP. I have not had a cpeptide test, I will ask for one when I see GP next week.
 

Thanks, I will buy a glucose meter tomorrow and will keep a food diary.
 
markb23 said:
Thanks, I will buy a glucose meter tomorrow and will keep a food diary.
Click to expand...

Good man. You won't regret it.
Do be careful when buying one that you chose one that has cheaper test strips. They do vary in price from around £7-50 for 50 up to nearly £30. You only need one meter but you do need thousands of test strips.
 
markb23 said:
Thanks, I will buy a glucose meter tomorrow and will keep a food diary.
Click to expand...
Meter?
It's worth the investment!
Food diary; great idea.. Keep a close eye on hidden, sneaky carb content in certain foods.. Look at the panel on the back as opposed to the "green light" system on the front of any packaging...

Sounds like you're getting a "handle" on it..

Keep us posted how you get on...?
 

Hi @markb23 and welcome to the forum. Sorry to hear about the troubles you've been having - I hope you find this forum helpful and supportive; there are loads of people with all kinds of different experiences all willing to offer help, answers and friendly support.

It's my understanding that the HbA1c is an average measurement of what your BG has been doing for the last 3 months (roughly), while your day to day meter test is a snapshot of what's happening right now. You said that you were in hospital in March, which is a scant 4 months ago, but if nothing was done to try to control your sugar levels (and you've not been regularly testing so have no idea what your BG patterns are like through the day) then that high overall level would have persisted.

The good news is, once you have a meter, it's very easy to understand the impact that the food you eat has upon your BG, and a food diary is probably the best decision you can make when it comes to learning what you eat, when you eat and how you eat. I've found mine absolutely invaluable and now keep one for my son, too.

There's lots of good advice available both on the forums and on the main site:

http://www.diabetes.co.uk/what-is-hba1c.html

You're in the right place and asking the right questions. Good luck on your journey and take heart - you're not alone, and your journey, though it seems daunting at the moment, could well turn into something incredibly empowering.

Sock
 
Thank you for your reply, I will start my metering and food diary tomorrow and hopefully learn a bit more then.
 
Good luck! And don't put yourself under too much pressure, Mark. Right now you're learning and you're anxious and this is all new and worrying. Don't declare war on your body, just take some time to learn about what it's doing. Keep things as simple as you can, and remember to leave it two hours after eating before testing and to do your fasting reading literally as soon as you open your eyes if possible.

You're going to be fine! Do keep in touch though, eh?
 

I have Type 3c also and pancreatic insufficiency following acute severe gallstone pancreatitis which also caused necrosis of pancreas nearly 5 years ago. I was diagnosed diabetic last December with Hba1c of 52. Immediately went on a no added sugar low carb diet, already a vegetarian in prep for fasting blood glucose test a month later. My fasting blood sugar had gone up. My take on this if firstly there is variation particularly where a damaged pancreas is concerned. Also sugar has been stored in the liver and following a good diet can help the body clear out this stored sugar which may cause an increase in glucose in the bloodstream. This type of diabetes is more complex as the pancreas is also struggling to heal itself which can cause fluctuations in how it manages glucose. I got my HBa1c down to 48 but experience a lot of variation in my daily fasting blood sugar and worry about the next average count going up. It's hard not to get disheartened by the constant struggle particularly when it's not giving the results you expect. We're in it for the long haul....just keep up everything you're doing and expect some set backs.
 
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