Perplexing HbA1c results

girl afraid

Member
Messages
16
Type of diabetes
Type 2
Treatment type
Diet only
I was diagnosed with type 2 diabetes in May this year, although I was arguably "borderline". My HbA1c results are posted below, and as you can see, I am currently below the range!

57Vf5TD.png


I didn't expect progress this quickly and I suspect that something is wrong.

Some background:
  • I've also had Hashimoto's/hypothyrodism for 12 years and I began self-medicating with natural desiccated thyroid in June (I was preciously on levothyroxine, which I feel is ineffective).
  • I currently have iron deficiency anaemia.
All my recent blood results:
May 2016
July 2016
 

Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
Treatment type
Diet only
I currently have iron deficiency anaemia.
This can affect the accuracy of A1c results. The best test for people with anaemia is the fructosamine test, though from other threads there seems to be issues about getting this test done.
 
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Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
I agree with @Indy51

Anaemia can and does give false HbA1c results. You need to ask for the fructosomine test. You may find your surgery is reluctant to order this, but you might get somewhere if you press hard enough. Most labs in the UK don't do these so the blood has to be sent off to one of the few labs that do do it.

Have a Google round. There are hundreds of websites about it, including this particular website, which says:.

Limitations of HbA1c tests
Whilst HbA1c tests are usually reliable, there are some limitations to the accuracy of the test. For example, people with forms of anaemia may not have sufficient haemoglobin for the test to be accurate and may need to have a fructosamine test instead.

http://www.diabetes.co.uk/hba1c-test.html

That is a huge drop and unless you have been following a very strict low carb diet it is unrealistic.
 

girl afraid

Member
Messages
16
Type of diabetes
Type 2
Treatment type
Diet only
I agree with @Indy51
That is a huge drop and unless you have been following a very strict low carb diet it is unrealistic.

Thanks for your reply. I was quite the soda addict I'm afraid. I immediately knocked it on the head and I now mostly drink water, diet sodas and the occasional glass of orange juice. I'm attempting to go gluten free, although I haven't managed to completely eliminate gluten from my diet so far, but I no longer eat bread. I'm also vegan - I tend to eat meals with rice and baked potatoes. I've been referred to a dietitian.

I will push my doctor for the fructosamine test. When I was hospitalised with anaemia recently the nurse asked me why I wasn't monitoring my glucose, but my doctor hasn't mentioned anything about that. Is it something I should be doing?
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Thanks for your reply. I was quite the soda addict I'm afraid. I immediately knocked it on the head and I now mostly drink water, diet sodas and the occasional glass of orange juice. I'm attempting to go gluten free, although I haven't managed to completely eliminate gluten from my diet so far, but I no longer eat bread. I'm also vegan - I tend to eat meals with rice and baked potatoes. I've been referred to a dietitian.

I will push my doctor for the fructosamine test. When I was hospitalised with anaemia recently the nurse asked me why I wasn't monitoring my glucose, but my doctor hasn't mentioned anything about that. Is it something I should be doing?

A glucose meter will help you enormously. For starters it will show if your last HbA1c was near enough or way out. It will also help you formulate a suitable diet by showing you which foods raise your levels. Many of us buy the Codefree because it has the cheapest test strips.

http://homehealth-uk.com/product-category/blood-glucose/
 
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4ratbags

Well-Known Member
Messages
3,334
Type of diabetes
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While there was a considerable drop in 5 weeks it could also just reflect the great changes you have made to your diet. Definately get yourself a meter and then you will be able to keep a record of your own BS.
 

Sirmione

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477
Type of diabetes
Type 2
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Tablets (oral)
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HbA1c is normally regarded as a test of glucose levels over 3 months but by its nature it is weighted towards the most recent month. I will underline the suggestion already given by others get a meter and keep an eye on your own blood glucose levels.
The SD CodeFree is recommended because the cost of replacement strips is much lower than other meters.

Your HbA1c wasn't much outside the normal range before you changed your diet so a rapid change might no be that unusual..


hba1c-chart.jpg
 

Serena51

Well-Known Member
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491
Type of diabetes
Type 2
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Tablets (oral)
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A glucose meter will help you enormously. For starters it will show if your last HbA1c was near enough or way out. It will also help you formulate a suitable diet by showing you which foods raise your levels. Many of us buy the Codefree because it has the cheapest test strips.

http://homehealth-uk.com/product-category/blood-glucose/
If you buy the Codefree, use these codes at checkout to save more money
5 tubs strips - 264086
10 tubs strips - 975833
 
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girl afraid

Member
Messages
16
Type of diabetes
Type 2
Treatment type
Diet only
Thanks to all of you for the advice. My SD Codefree monitor arrived yesterday; I'm a squeamish wuss, but I've just about got the hang of it after a couple of failed attempts and wasted test trips! Although, the instructions say that low haematocrit levels can cause false results (mine were 0.29 when I was tested a fortnight ago).

I haven't really worked out a schedule for testing yet. I've tested myself twice today, for practice more than anything. Both were fasting results; 6.7mmol/L at 7.50am, and 6.4mmol/L at 9.30am. This seems to confirm that my HbA1c result was way off.
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Thanks to all of you for the advice. My SD Codefree monitor arrived yesterday; I'm a squeamish wuss, but I've just about got the hang of it after a couple of failed attempts and wasted test trips! Although, the instructions say that low haematocrit levels can cause false results (mine were 0.29 when I was tested a fortnight ago).

I haven't really worked out a schedule for testing yet. I've tested myself twice today, for practice more than anything. Both were fasting results; 6.7mmol/L at 7.50am, and 6.4mmol/L at 9.30am. This seems to confirm that my HbA1c result was way off.

The best to test is before a meal and two hours after first bite.
This will show how you are coping with certain foods.
If your two hour reading is higher than 2mmols from your pre meal reading something in that meal is not good for you. Or you need to portion down the food which is giving you the higher reading.

You need to keep a food diary. Record, readings, portion size and what you ate.
This will help you in what groups of foods (for instance grains) are intolerant.
The diary will help you see trends and also you can show your GP/dsn how you are doing.

Hope that helps.
 
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girl afraid

Member
Messages
16
Type of diabetes
Type 2
Treatment type
Diet only
Hi! I've just had a blood panel done again and my latest A1c is 5.5%. The only abnormality is the Mean corpuscular haemoglobin, which is below range (26.5 pg). I don't appear to be anaemic anymore but my Haematocrit is borderline (0.36) and my Haemoglobin estimation is a little low (118 g/L). My Red blood cell count is within range at 4.45 10*12/L.

I just want to be absolutely sure... My A1c result is unaffected by the Mean corpuscular haemoglobin, isn't it?