Normal Hba1c but high glucose readings

[EdAW]

Hi,

Just seeking some advice. I have recently had many of the symptoms of diabetes such as excessive thirst, fatigue etc and have been off work feeling so unwell so went to the GP.

My Hba1c test came back as 41 this week so just within 'normal' but I have been tracking my blood sugar levels with a home monitor.

My waking readings have been
7.4, 7.9, 6.6 and 6.6

2 hours after lunch my readings have been
14.8, 16.1, 11.4 and 12.1

Just wondered if anyone had any advice on what to do next. I shared some of these readings with the GP who wasn't particularly concerned and said to see how I am in another week or so.

Thanks for your help!

 

[Antje77]

My Hba1c test came back as 41 this week so just within 'normal' but I have been tracking my blood sugar levels with a home monitor.

My waking readings have been
7.4, 7.9, 6.6 and 6.6

2 hours after lunch my readings have been
14.8, 16.1, 11.4 and 12.1

Those readings don't really add up with the hba1c so something must be going on.

I shared some of these readings with the GP who wasn't particularly concerned and said to see how I am in another week or so.

Well, it's weekend now, so in only a couple of days it will be 'another week'.
I'd keep testing and making notes of food and test times, and keep nagging my GP if it were me.

Should you start seeing numbers in the high teens which don't come down in a couple of hours, please seek advice through 111.
Should you develop nausea/stomach ache alongside high numbers (high teens or higher), don't wait until working hours but seek medical help to test for ketones. Very unlikely, but not impossible.

Good luck!

 

[EdAW]

Thanks for the advice - it's really helpful to hear from someone with some insight into what is typical or not. This is all very new territory that I'm not familiar with.

 

[searley]

Hba1c is a 3 month test so I can imagine that if the high readings are very recent that it’s not affected the hba1c yet

Another possible issue could be that while you are waking with a higher than normal reading you could have normal levels all night and you are getting a bg rise as your body prepares for waking up.. so you can have low numbers off setting higher numbers

So instead of testing immediately on waking up wait an hour but still before eating to see if the levels drop

 

[Antje77]

Just to make sure, are your test strips in date?

 

[EdAW]

Hba1c is a 3 month test so I can imagine that if the high readings are very recent that it’s not affected the hba1c yet

Another possible issue could be that while you are waking with a higher than normal reading you could have normal levels all night and you are getting a bg rise as your body prepares for waking up.. so you can have low numbers off setting higher numbers

So instead of testing immediately on waking up wait an hour but still before eating to see if the levels drop

Thanks that's really helpful.

I've actually been taking a couple of morning readings - upon waking and before breakfast around an hour later. The results I gave in my first post were the second and higher readings from each morning...

6.1 ---> 7.4
7.2 ---> 7.9
6.6 ---> 6.5
6.6 ---> 6.6

Thanks again - it's much appreciated.

 

[EdAW]

Just to make sure, are your test strips in date?

Yes - Nov '24.
Another family member tested one out when I had a high reading after lunch and got a very normal reading.

Thanks!

 

[HSSS]

As well as the possibility of more recent rises that aren’t showing on the hba1c yet (3 months but weighted more to the more recent weeks than the oldest) do you have any red blood cell conditions that might make an hba1c unreliable?

 

[EdAW]

As well as the possibility of more recent rises that aren’t showing on the hba1c yet (3 months but weighted more to the more recent weeks than the oldest) do you have any red blood cell conditions that might make an hba1c unreliable?

Not as far as I am aware. The anaemia test they also did this week showed size of red blood cells was in the normal range. Thank you for your help!

 

[EdAW]

I fell asleep so took my result a little later at over 2 hours after lunch which came out as 8.4 today. Then 7.2 around 3 hours after. I had switched to brown bread today which I imagine might mean the level wouldn't peak quite so high? Sorry - I'm no expert at all.

My suspicion is that a glucose tolerance test might suggest differently to the Hba1c...?

 

[Hopeful34]

It would be helpful if you tested before you ate, as well as 2 hours after and logged what you ate as well.

 

[EdAW]

It would be helpful if you tested before you ate, as well as 2 hours after and logged what you ate as well.

Hi. My readings before lunches have been 6.4, 6.3, 5.9, 5.8, 5.8. Sorry, I didn't want to dump all of the results if they weren't useful.

The last couple of days where it has been a bit lower were after switching to a no added sugar porridge for breakfast.

My lunches each day have been a sandwich, a couple of crisps and some apple, strawberries and grapes. I switched to brown bread today which coincided with a lower reading after lunch.

I've been keeping a diary in case it was helpful.

Thanks again!

 

[MattInUSA]

Just wondered if anyone had any advice on what to do next. I shared some of these readings with the GP who wasn't particularly concerned and said to see how I am in another week or so.

Hi me! I'm in the states and had the same issue of A1C not aligning with my home numbers. I actually paid out of pocket for some blood tests and then measured the glucose readings against my own meter (which I tested in the car a few minutes before the blood draws), and they were wildly different. Definitely keep hounding your GP because your A1C is hard to imagine with the fasting and post-prandial numbers you're getting. You're not by any chance sick? My father had some crazy finger stick readings that turned out to be a result of infection. Are you on any supplements? If so, I would stop all of them for a few days before you're retested as they can falsely lower the A1C.

 

[EdAW]

Hi me! I'm in the states and had the same issue of A1C not aligning with my home numbers. I actually paid out of pocket for some blood tests and then measured the glucose readings against my own meter (which I tested in the car a few minutes before the blood draws), and they were wildly different. Definitely keep hounding your GP because your A1C is hard to imagine with the fasting and post-prandial numbers you're getting. You're not by any chance sick? My father had some crazy finger stick readings that turned out to be a result of infection. Are you on any supplements? If so, I would stop all of them for a few days before you're retested as they can falsely lower the A1C.

Thanks that's really interesting. Not on any supplements.

I've got a bit of a cough but nothing more. Had a broad range of blood tests that all came back clear and with no sign of any infection.

Last year I was very unwell and was just given antibiotics. In hindsight, the symptoms were in line with being very hyperglycaemic and not knowing. Again I had a bit of a cough/cold at the same time.

Could it be that my body is just about managing my blood sugar levels until I am unwell and then things go out of control? I don't know whether that is plausible?

Thank you for your help - everyone has been so kind and helpful.

 

[EdAW]

Hi all.

I have another GP appointment this afternoon and just wondered if there was anything I should make sure I share or ask for? I think a glucose tolerance test might be a good idea?

Thanks again.

 

[MattInUSA]

An OGTT (with insulin) would be great if your GP will agree to it. Mine wouldn't. I'd be very clear that you're not feeling well and are getting some strange numbers along with symptoms that indicate diabetes. He could probably run a fructosamine test, which covers the last 2-3 weeks and may be (or may not be) more accurate than the A1C.

 

[EdAW]

An OGTT (with insulin) would be great if your GP will agree to it. Mine wouldn't. I'd be very clear that you're not feeling well and are getting some strange numbers along with symptoms that indicate diabetes. He could probably run a fructosamine test, which covers the last 2-3 weeks and may be (or may not be) more accurate than the A1C.

Thanks for your reply. I went back to the GP yesterday who was really helpful and referred me to hospital for same day emergency care where they repeated all of the previous tests and did a few more. They have referred me to endocrinology now so just got to wait to hear from them.

 

[Lamont D]

Thanks for your reply. I went back to the GP yesterday who was really helpful and referred me to hospital for same day emergency care where they repeated all of the previous tests and did a few more. They have referred me to endocrinology now so just got to wait to hear from them.

As a precursor to seeing your endo, you might want to keep a record of your food and readings from your meals. If the endo suggests an oral glucose test, ask if would be prudent for a five hour extended test, rather than the usual two hours test. This would not only give the first phase response, the spike but would also see if there is a second phase and the impact thereafter. Other diagnostic tests, would help eliminate other conditions. A list of symptoms, could also help!

 

[EdAW]

As a precursor to seeing your endo, you might want to keep a record of your food and readings from your meals. If the endo suggests an oral glucose test, ask if would be prudent for a five hour extended test, rather than the usual two hours test. This would not only give the first phase response, the spike but would also see if there is a second phase and the impact thereafter. Other diagnostic tests, would help eliminate other conditions. A list of symptoms, could also help!

Thanks for the suggestions - I really appreciate it. An extended oral glucose test might be an idea as my levels have sometimes continued to increase after 2 hours too.

 

[mansingh01]

Hi,

Just seeking some advice. I have recently had many of the symptoms of diabetes such as excessive thirst, fatigue etc and have been off work feeling so unwell so went to the GP.

My Hba1c test came back as 41 this week so just within 'normal' but I have been tracking my blood sugar levels with a home monitor.

My waking readings have been
7.4, 7.9, 6.6 and 6.6

2 hours after lunch my readings have been
14.8, 16.1, 11.4 and 12.1

Just wondered if anyone had any advice on what to do next. I shared some of these readings with the GP who wasn't particularly concerned and said to see how I am in another week or so.

Thanks for your help!

What medication are you on?