Received HbA1c

[PreferredPronoun]

I have had problems with tolerating carbs for a while, which results in BG spikes that I do not like. I was tested by an endo for diabetes and discharged as not having it. I was eating low carb diet for a few months and asked my GP to see if anything changed with my average glucose because I noticed some higher spikes than 2 months ago.

The result was: 4.6% HbA1c.

So, I explained to her how I tried to get back to carbs for 2 full weeks, and it normalizes the pancreas response according to literature I read, for normal people after low carbing. I continued to have issues with spikes and feeling garbage-like and defaulted back to what does not cause the spikes.

Anyone has ideas on what this means? My brother also seem to have spikes, so maybe it is some delayed insulin release syndrome?...

 

[LooperCat]

Healthy people have spikes after eating carbs.

Healthy people have HbA1c scores like you have.

 

[PreferredPronoun]

Healthy people have spikes after eating carbs.

Healthy people have HbA1c scores like you have.

Yes, but from what I researched, it seems like CGMs has shown people never exceeding https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/

In addition, I failed glucose tolerance test, but it was taken while on low carb diet, so it might be an invalid measurement. I am just wondering what is going on here because I should have gone back to normal glucose metabolism after 2 weeks of carbs, but it did not happen (shrug)

 

[ziggy_w]

Yes, but from what I researched, it seems like CGMs has shown people never exceeding https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/

In addition, I failed glucose tolerance test, but it was taken while on low carb diet, so it might be an invalid measurement. I am just wondering what is going on here because I should have gone back to normal glucose metabolism after 2 weeks of carbs, but it did not happen (shrug)

Hi @PreferredPronoun,

Probably blood sugar spikes after eating are much more common than we think -- however they wouldn't be picked up most of the tests (except an OGTT). For example, if I remember correctly, an HbA1c test wouldn't show blood sugar spikes that last less than two hours because the sugar molecules will detach themselves again from your red blood cells.

There is a NHK (Japanese broadcasting company) documentary discusses the topic, which you might be interested in:

 

[PreferredPronoun]

Hi @PreferredPronoun,

Probably blood sugar spikes after eating are much more common than we think -- however they wouldn't be picked up most of the tests (except an OGTT). For example, if I remember correctly, an HbA1c test wouldn't show blood sugar spikes that last less than two hours because the sugar molecules will detach themselves again from your red blood cells.

There is a NHK (Japanese broadcasting company) documentary discusses the topic, which you might be interested in:

Wow this was so informative. My other doctor, a family friend, argued that you should eat so that your glucose is never above 7.8, no matter what. If food causes you to go there, you get rid of that food. So glad I listened. My HbA1c reduced from 4.9 to 4.6 from last December as well, so I think it is the way to go for me. For all I am concerned, failing OGTT is not normal, and my brother having spikes mean there is some genetic component in play that we need to prevent by eating foods that do not cause the spikes. Thank you a lot for the info.

 

[ziggy_w]

Hi @PreferredPronoun,

Glad it was helpful.

Agree -- I also believe there is a gentic component to this. Before becoming diabetic, I believe I also experienced blood sugars spikes and corresponding fast drops (didn't measure blood sugars then, but this is how it felt) -- just didn't know that this wasn't normal.

Wished I had been like you and picked up on this earlier.

Also agree with your other doctor and family friend -- I try to never let my blood sugars rise above 7.8 mmol, even half an hour or one hour after a meal. Jenny Ruhl (bloodsugar 101) cites convincing research that this is when beta cell damage begins.

 

[PreferredPronoun]

Hi @PreferredPronoun,

Glad it was helpful.

Agree -- I also believe there is a gentic component to this. Before becoming diabetic, I believe I also experienced blood sugars spikes and corresponding fast drops (didn't measure blood sugars then, but this is how it felt) -- just didn't know that this wasn't normal.

Wished I had been like you and picked up on this earlier.

Also agree with your other doctor and family friend -- I try to never let my blood sugars rise above 7.8 mmol, even half an hour or one hour after a meal. Jenny Ruhl (bloodsugar 101) cites convincing research that this is when beta cell damage begins.

True. I find that my body feels weird when I go above 6. A headache, tiredness, some sweating and pain in inner right ear (haha). To be fair, it also seems to me that HbA1c has many deviations such as blood cell life span to make it uniformly reliable. For instance, it told me my avg blood glucose is 4.8 mmol/l but I regularly see 5.2 or so on my meter even after 3-4 hours of the meal. So, it could be higher, but glucose just does not glycate as much as to other people cells.

I remember having some sweating after carby meals going back two years ago. Now, that I see it is my BG above 6 mmol/l, it makes me wonder whether I was spiking a ton, but just did not pay attention. Fortunately, I enjoy this way of eating. And there is a lot of science on Reddit /r/ketoscience being posted daily that it seems to be okay. What was your experience?

 

[ziggy_w]

Hi @PreferredPronoun,

I agree with you, this way of eating is very enjoyable. There are definitely worse ways of eating. In terms of health, I believe its main benefit is the lowering of insulin levels. There seems to be some emerging evidence that very high insulin levels are as bad as high blood sugar levels and are associated with some of the problems generally associated with diabetes such as high blood pressure and dislipidemia. I have been low carb now for about 3 yrs, and I have definitely seen a positive impact on my blood pressure and blood lipids.

Maybe if they start measuring insulin in addition to blood sugars, metabolic problems will be diagnosed earlier and many might not have to progress to T2. Did you have an insulin test?

Also agree that depending on the life span of your red blood cells (plus some other issues), HbA1c results may not accurately reflect your actual blood sugar levels. Yours don't sound too far off though, especially given the fact that we don't measure blood sugar levels over night, when they tend to be lowest (unless you are using continuous blood sugar monitoring of course).

I am surprised that you can feel symptoms when your levels are above 6 mmol -- to be honest I don't feel anything at this level -- just goes to show that we are all different.

How long have you been low carbing?

 

[PreferredPronoun]

Hi @PreferredPronoun,

I agree with you, this way of eating is very enjoyable. There are definitely worse ways of eating. In terms of health, I believe its main benefit is the lowering of insulin levels. There seems to be some emerging evidence that very high insulin levels are as bad as high blood sugar levels and are associated with some of the problems generally associated with diabetes such as high blood pressure and dislipidemia. I have been low carb now for about 3 yrs, and I have definitely seen a positive impact on my blood pressure and blood lipids.

Maybe if they start measuring insulin in addition to blood sugars, metabolic problems will be diagnosed earlier and many might not have to progress to T2. Did you have an insulin test?

Also agree that depending on the life span of your red blood cells (plus some other issues), HbA1c results may not accurately reflect your actual blood sugar levels. Yours don't sound too far off though, especially given the fact that we don't measure blood sugar levels over night, when they tend to be lowest (unless you are using continuous blood sugar monitoring of course).

I am surprised that you can feel symptoms when your levels are above 6 mmol -- to be honest I don't feel anything at this level -- just goes to show that we are all different.

How long have you been low carbing?

Yes, my c-peptide was below normal range. So, I do not have insulin excess issue. In fact, it could mean that my body is very insulin sensitive, hence normal blood glucose (4.5) with c-peptide a bit below normal range.

I do not know what is the cause but almost always, I can feel the glucose rise by having a slight headache and feeling a bit tired. Then sweating starts at around 6.0. I am low carb since last December, so 6 months.