Some confusion about HBA1C

[jdolan1234]

Hello, I'm Type 2 diabetic

I recently had a blood test and my a1c was 36mmol/mol. This was a bit suprising for me because from January to October I had been neglecting my health, eating a lot of sugar and not taking care of myself. I never had any previous blood tests for about 3 years but I'm pretty sure that my a1c would have been sky high.

Only from the end of October to December did I get a wake up call and started intense cardio and intermittant fasting.

2 questions:

1) Considering that I was basically eating junk all year and only started looking after myself since the end of October, could I have really lowered my a1c in just 2 months?

2) What does the a1c really tell me? Is it just my average sugar levels or do you think I would have a normal insulin response now? I.e I eat food and my blood sugar levels would return to <6 after say a couple of hours? I dont have a glucose meter to confirm.

 

[Pipp]

Hello @jdolan1234 . I am going ask some questions of you, so that there is better understanding of your situation.

If you did not have a previous HbA1c how were you diagnosed with T2?

How long have you had T2?

For how long were you neglecting your health and diet? Was it just for the three years you mention?

As for your questions:
The HbA1c test shows average blood glucose for the last three months, with the greater emphasis on the most recent few weeks. So you should be aware that your ‘looking after yourself’ since end of October will have the greatest , perhaps skewed , emphasis on these last few weeks.

As for your insulin response to foods, use of a meter would give some insights, but you would need to record what you have eaten, and the corresponding blood glucose levels, immediately before, and 2 hours after. Possibly including a test after the first hour, too. Alternatively, a Continuous Glucose Monitor system such as Libre, would give a clearer picture.

 

[KennyA]

Hello, I'm Type 2 diabetic

I recently had a blood test and my a1c was 36mmol/mol. This was a bit suprising for me because from January to October I had been neglecting my health, eating a lot of sugar and not taking care of myself. I never had any previous blood tests for about 3 years but I'm pretty sure that my a1c would have been sky high.

Only from the end of October to December did I get a wake up call and started intense cardio and intermittant fasting.

2 questions:

1) Considering that I was basically eating junk all year and only started looking after myself since the end of October, could I have really lowered my a1c in just 2 months?

2) What does the a1c really tell me? Is it just my average sugar levels or do you think I would have a normal insulin response now? I.e I eat food and my blood sugar levels would return to <6 after say a couple of hours? I dont have a glucose meter to confirm.

I'd echo the questions above. It's certainly possible to reduce an HbA1c fairly quickly - you just need to read some of the success stories elsewhere on this forum. Personally, I went from an A1c of 49 in January 2020 to 36 in April the same year.

The A1c is a count of how many red blood cells have had a glucose molecule attached to them. That's an indication of how much glucose there has been in your blood during the lifetime of the red blood cells (max about 3 months). It tells you absolutely nothing at all about your insulin response.

To do that you would need to measure your blood glucose before and two hours after eating, and build up enough data over an extended period to enable some sort of conclusion. You'd need more than a handful of random readings. The issue with fingerprick readings is that you have only data from the tests: you have no idea what happens when you don't test. I would also suggest that you would need to use both fingerprick tests and a constant glucose monitor to get a full picture. The other option might be an oral glucose tolerance test, but I would guess that it's unlikely that your local health service would agree to one.

The other issue would be that even if you have possibly regained some measure of insulin sensitivity, that firstly isn't "a cure" and secondly might be very fragile - challenge your system with too many carbs, and you might quickly find yourself with a recurrence of high BG..