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Struggling to reduce Hba1c

J

jfy30

Member
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15
Hi everyone,
I’m new to this forum and wondered if any of you could offer me some advice.
Three months ago I was told that my blood sugar level was in the pre-diabetic range (Hba1c of 44) This was a bit of a shock as I am a slim 55 year old, not overweight (BMI 21), exercise regularly and I eat a pretty healthy diet. I have no family history of diabetes. I was given this news by a consultant who I see as I have high cholesterol (familial). I started low dose 10mg statins a year ago and had this been increased to 20mg following this appointment 3 months ago. After reading up on causes, the only thing I could put the high level down to was possibly stress? I had been very busy at work and also had a trapped nerve in my neck which was causing me a lot of pain and disrupted sleep. Although my diet was fairly healthy, for the past three months I adopted a low carb/sugar diet. This has resulted in me losing almost a stone in weight and an inch from my waist, my bmi is now 19. I bought a blood sugar meter and over the 3 months I have had readings:
Before breakfast between 4.1 and 4.8
Two hours plus after meals between 3.9 and 5.4
I’ve just had my Hba1c redone and the result is exactly the same as before...44. I’m at a loss as to know what to to to reduce it. I’m also puzzled as to why it is still that high when the readings I have been taking using the meter average at a lower level, unless during the night my blood sugar is high? I don’t want to lose any more weight and I exercise regularly (gym, walking and Pilates class). I’m shocked that my change in diet has had an impact on my weight and size, yet it’s had absolutely no impact on my blood sugar.
My trapped nerve has resulted in me now having a partially frozen shoulder :-( so I don’t sleep particularly well, could this be having an impact on my blood sugar?
Apologies for such a long post. Any advice would be welcome as I don’t know what else to do to reduce my blood sugar. Many thanks.
 
Stress, lack of sleep and Statins raise your blood sugars. Here is an article on Statins:
https://www.mayoclinic.org/diseases...blood sugar,blood glucose levels and diabetes.
Your waking blood sugars and two hours plus are normal and would suggest you should get a normal Hba1c. Could you self-fund a Libre to get more data? You need a better blood sugar picture of what is going on. I hope you feel better soon.
 
Many thanks for your prompt reply. I was wondering about the Libre, it might be worth me investing in it as at least I would know what’s happening to my blood sugars during the night. Interesting about the effect statins can have on blood sugar, guess they certainly may not be helping it. I’ve been getting my liver function checked regularly as previously my liver enzymes have been slightly raised. Since starting the low carb diet 3 months ago the liver results have reduced and are now well within the normal range. That shows the impact of the change in diet!
 
All sounds a bit odd to me given the blood sugar meter results you’ve had, your readings look great, but the Hba1c is out of kilter. If you’ve only had 3 months between these tests it could just be that the 2nd one has been done a bit too soon & you may have to wait for another month or two to see the improvement work through to this test.

I’ve got a Libre and would recommend it, impressive bit of kit. I’m similar to you in I’m just in the prediabetic range & for the same reasons as you it was a complete shock, as I’d wrongly assumed T2 Diabetes only affected unhealthy & overweight people, I was very ignorant & wrong.
 

Hi there, I was similar to you when I was 55yrs old (I'm 59 now). Slim, fit and all the rest and diagnosed at a routine 'well women' clinic as pre diabetic. They went through all the 'lifestyle' blurb but accepted there was nothing that I could improve on in the 'don't smoke/exercise more/lose weight etc, etc'. In the end they said 'Well watch what you eat'. My diet at that time was pretty healthy (forgetting the carb issue for a moment as I did eat wholegrain/root veg etc). Roll on 3 years and following a chaotic Drs appointment I was rushed to hospital, placed on a drip and diagnosed with the onset of DKA. I came out of hospital on insulin and tests confirmed I was actually type 1, hence this 'pre diabetic' diagnosis was in fact the onset of type 1. The problem is they don't do any tests other than the hb1ac test (often discovered by routine tests and so on) and when that comes back in the pre diabetic category they leave it at that regardless of how you present. 3 years later, even then they kept going on about type 2 but then decided because I presented as thin (by that time), ran 5 times a week and had a sky high hb1ac, they did a C Peptide test and an antibody test, both confirmed type 1. I say this not to alarm you but to bear it in mind, you may not fit the albeit dodgy & misleading 'pre diabetic on your way to type 2' profile (even though you may be) so IF you are finding no matter what you do your numbers are not reducing or are rising then raise it with the Dr. I wish I had and hadn't skipped happily along getting worse and worse for the next 3 years with slowly rising glucose levels, (nobody checked them during those 3 years either incidentally and when I asked why in hospital they said the GP had missed the pre diabetic guidelines of yearly checks). Sorry to ramble but my main point is to keep an eye on it all. x
 
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There can be a number of reasons why Hba1c readings can be 'falsely' high arising from a decreased red cell turnover so cells are exposed to glucose for a longer period of time than normally. The most common causes of this include deficiencies in iron, vitamin B12 or folic acid. Maybe worth getting these checked out as well.
 
Thank you all for your replies, lots to think about. I think I need to have a chat with my gp to see where I go from here. I think more blood tests would be helpful to check some of the things which have been mentioned. KK123, I’m pleased you have told me about your experience, it goes to show the importance of keeping an eye on all of this. Hope you are ok now. I’m so glad I found this forum
 
Absolutely what Jay-Marc said above, something doesn't add up.
Your FBG & PP as perfect, you should be looking at a HbA1c in the low 30's.
The Libre will also answer your questions.
 

How long had you been low carbing when the recent A1c was done?

Your meter numbers would certainly suggest you could be lower in the A1c, but it also suggests you might be missing some higher numbers that could be happening between the finger prick tests.

Sounds like you are feeling and seeing some benefits of reducing your carbs, but I might be inclined to invest in a libre, or commit to a stringent period of testing. For example, you talk about "....Two hours plus after meals between 3.9 and 5.4....". That sounds a bit unscientific.

I know it can be disruptive, jumping up to test or getting your kit out at a specified time, but I'b be inclined to commit to if for a couple of weeks at least. When I was in my most intensive period of testing, I used to set a countdown alarm on my phone, which I would start when I started eating. That kept me on the straight and narrow.
 
I was wondering about trying to do a more intense period of testing (including trying during the night). It might be worth me trying this for a few days first before spending around £150 on the Libre. Then at least I could check more accurately as you suggest DCUKmod. I’d been on low carb for 11 weeks before the second Hba1c test was done. Could it take longer to impact this test or could it be that I’m having big spikes straight after eating or during the night? More frequent testing might help me to further understand what’s going on.
 


The Libre isn’t as much as that if you have a reasonably up to date smartphone, I’ve got an IPhone X & as a result was able to download the app & use that to scan the sensor. As such a month of Sensor equipment has only cost me £118. Half that if you just go for a 2 week trial & buy just the 1 sensor. You only need the full starter pack if you have an old or no smartphone.
 
Thanks so much DanW13, I hadn’t realised that I would be able to use it with my phone. I think one sensor for a 2 week trial would be a great idea.
 
I agree. Also bear in mind @jfy30 that the relationship between blood glucose levels and HbA1c was arrived at empirically, that is to say that a lot of people had their blood glucose and HbA1c measured and a average conversion was derived. There will always be outliers where it is inaccurate, due to length of life of red blood cells, anaemia and probably many other factors. If it was me with those figures I wouldn't worry, just get it checked again in a year's time.
 
jfy30 said:
Thanks so much DanW13, I hadn’t realised that I would be able to use it with my phone. I think one sensor for a 2 week trial would be a great idea.
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No probs, what I did was go on the Abbott Libre website & ask their online help if my phone was compatible, they were really helpful & confirmed it was so I was then able to just buy the sensors only.

Personally I’d recommend buying 2 sensors as the time flies by and it’s useful to have the extra one to confirm there was nothing dodgy with sensor 1 & also to get a clear idea on trends & test which foods hinder/help blood scores.

Im doing an update later today on my first 3 weeks with the Libre, just waiting for my latest Hba1c test & result later today first, hoping for an improvement but only likely a modest one as it’s only been 6 weeks since my 1st one, so bit too soon really.
 

To be honest, you need to weigh up the balance of how much more you would spend on test strips, versus, c£50 for a single Libre sensor, if you have a compatible smart phone. (most, but not all are these days, so please do check prior to spending out: http://nfcworld.com/nfc-phones-list/).

11 weeks would usually give a decent indication on your A1c test, however, I will say right up front that my A1cs never, ever, ever match or even come close to the prediction on my meter or Libre.

For the last 6 years, my A1cs have skirted 30, but both meter and Libre suggest lower still. I just accept it now.

What sort of things have you been eating in your LC adventure? Sometimes in the early days we can make a findamental error. I know I made a few of those, so worthwhile just double checking.

Could you give us an indicative menu for a day or two?
 
Thank you for all your replies. I think I’ll go ahead and get a couple of the Libre sensors. Wonder why your meter/Libre readings don’t match your Hba1c results DCUKMod?
A typical day’s meals would be rolled porridge oats with milk, cinnamon and grated apple (have checked glucose after this and doesn’t seem to cause a very big rise), salad for lunch (e.g. rocket, courgette, cheese, few berries) or a piece of Burgen bread toasted with marmite and butter. For eve meal would have something like salmon or chicken, salad and cauli rice or homemade bolognaise with courgetti. I avoid rice, pasta and potatoes. I sometimes have a small piece of dark 70% chocolate, almonds or a small plain biscuit as a snack. I don’t snack on anything else. Any further advice on diet would be appreciated.
 
I should also add that I usually have one coffee and two cups of tea a day with small amount of milk. Apart from that I drink water. I allow myself one medium glass of dry white wine once a week. Sometimes (no more than once a week) I’ll have a small cake or a couple of chocolates.
 
jfy30 said:
I usually have one coffee and two cups of tea a day with small amount of milk.
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This is a small tweak, but did you realise that double cream has half the carbs of milk? I note that you don't want to lose weight, so you could swap out the milk in your drinks for cream. That's what I do. I find that having cream in my coffee guilt-free is bliss. Cream in tea is a bit odd, but I've come to like it.
 
jfy30 said:
A typical day’s meals would be rolled porridge oats with milk, cinnamon and grated apple (have checked glucose after this and doesn’t seem to cause a very big rise
Click to expand...
It will be interesting to see if this is confirmed by your Libre sensors. Sometimes rises can come later than expected and so escape detection by finger prick tests. Most of us here can't cope with porridge. As for the grated apple, unless apples are your favourite fruit, how about buying frozen berries instead? Much lower in carbs than apples and very convenient as the bag of frozen berries can just sit in the freezer and be raided for small quantities as desired. IMO much more delicious than apples, and great with a small amount of low carb high fat Greek yoghurt and perhaps even some whipped cream.

https://www.dietdoctor.com/low-carb/fruits
 
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