Regular Blood/Sugar Monitoring vs. HbA1c

I would accept both for what they are. HbA1cs are an average of your blood sugar levels over the past 8 - 12 weeks. Finger prick tests are a snap shot of your blood sugar at that moment in time. I like to test regularly at home to monitor trends while waiting the three or six months for my HbA1c

To me there is no conflict, I test twice a week, or if I eat something radically different it keeps me on the straight and narrow, I consider my six monthly HbA1c a confirmation of my regime.

@Priam , I notice that you asked a very similar question last September. Can I ask what’s worrying you about the two different tests?

Both provide useful data. Neither is a definitive marker of metabolic health. This is because they only tell you what is, or has been in, the blood - not in the entire body - an important distinction to understand if using oral hypoglycaemics or exogenous insulin as treatment.

HbA1c is, in my view, inadequate on its own because it doesn’t tell you how your body reacts to individual meals and/or pharmaceutical drugs. It won’t provide any data on hyperglycaemia or hypoglycaemia events, only an average.

Jim Lahey said:

Both provide useful data. Neither is a definitive marker of metabolic health. This is because they only tell you what is, or has been in, the blood - not in the entire body - an important distinction to understand if using oral hypoglycaemics or exogenous insulin as treatment.

HbA1c is, in my view, inadequate on its own because it doesn’t tell you how your body reacts to individual meals and/or pharmaceutical drugs. It won’t provide any data on hyperglycaemia or hypoglycaemia events, only an average.

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It is also often altered if you donate blood.

In-range fingerstick tests and a higher HbA1c could indicate that your BG is higher at times you’re not testing yourself.

Priam said:

which would you accept.

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When you were diagnosed with T2D, what "proof" did you accept ?

If it was from an elevated HbA1c then I would suggest you continue to use that measure.

If you want to rely on finger prick tests using a very inaccurate device to tell you, you will need to test 50+ times a day, not get much sleep and have very tough fingers.

I know which I prefer.

I know which I prefer after over 4 years of HbA1c tests that bear no resemblance to any of my other data despite constant and frequent finger prick tests at all times of the day, 12 or 13 Libre sensors with levels mentally adjusted for the Libre inaccuracies, and more recently two AIcNow home tests. It wouldn't worry me if I never had another HbA1c test. My red blood cells just do not play ball. So much so that my GP agrees with me.

I know I am nowhere near alone with this on the forum.

Priam said:

I'd forgotten I'd asked before. What concerns me is that you could have several meals in a day - all giving an acceptable reading, but from a glycemic loading point of view (i.e. the more you eat) this could drastically affect HbA1c.

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I keep to the same number of meals and snacks each day always totally under 50g of carbs a day. That keeps my blood sugars stable and therefore my HbA1c stays stable too.

EllieM said:

Don't forget that Hba1c can be inaccurate (either high or low) if you have one of a number of metabolic peculiarities

https://www.goodrx.com/blog/could-your-hba1c-diabetes-test-be-wrong/

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Thank you for the link. Unfortunately it seems that the info is only available to U.S. citizens.

I use my meter mainly to monitor my pre and post meal levels and trends, and to see how stress, illness, pan, and meds might affect my glucose, and this information is much more vital for (attempting!) to manage my diabetes than any 3 or 6 six monthly averages which essentially tell me s*d all. I need to know what's going on on a day to day basis to enable me to attempt to remedy any apparent problems. It may not be 100% accurate but has proved to be perfectly consistent in the patterns and trends it's been showing me over the years I've been working with it.(And these patterns have been similarly consistent but slightly lower when using a Libre sensor,)

My meter can give me useful and quite quite detailed (fasting, pre & post meal, etc) averages over different periods ranging from 7 to 90 days. I know from experience that my HbA1c is always slightly higher than my predicted result using our Diabetes.co.uk HbA1c calculator. Basically my meter is my diabetes information source, and my HbA1c is/has to be my doctor's and DN's.

Robbity