Test results on diagnosis

[Atad heavy]

Good evening everyone,

I am trying to understand my blood test results and I would really appreciate some help.
My Hba1c was 48
My fasting glucose was 5.9mmol/L. It then says that a fasting glucose of less than 6.1 mmol/L makes the diagnosis of diabetes mellitus unlikely.
A value of 6.1 - 6.8 mmol/L is classified as "impaired fasting glucose"
Concentrations greater than 6.9 mmol/L indicate probable diabetes.
In the absence of symptoms a diagnosis of diabetes should only be made if a fasting plasma glucose is 7 mmol/L or greater on more than one occasion.
I don't understand why I was diagnosed as type 2 when my results have never been greater than 6.5 & I have no symptoms

 

[NoCrbs4Me]

An HbA1c of 48 and higher is diagnostic of diabetes, regardless of what your fasting blood glucose levels are.

https://www.diabetes.co.uk/what-is-hba1c.html

It's likely that your blood glucose levels after eating are quite high, even though your fasting levels are ok. It can take a long period of time (years) with elevated blood glucose levels before any symptoms manifest.

 

[Guzzler]

My HbA1c was 11.1 (98) at diagnosis with not a single symptom. And I'm still here to tell the tale because I (finally) accepted that I had T2 and did something about it. My last A1c was 6.1 (43) and I fully expect to be in non Diabetic numbers at my next review. Focus on the job to be done rather than questioning the results and you will start to feel a little easier about the diagnosis itself. Good luck.

 

[Atad heavy]

An HbA1c of 48 and higher is diagnostic of diabetes, regardless of what your fasting blood glucose levels are.

https://www.diabetes.co.uk/what-is-hba1c.html

It's likely that your blood glucose levels after eating are quite high, even though your fasting levels are ok. It can take a long period of time (years) with elevated blood glucose levels before any symptoms manifest.

Thankyou for replying, I have been self testing for a month & my highest reading 2 hours after eating was 7.4. My monitor is predicting 5.2 for hba1c

 

[Atad heavy]

My HbA1c was 11.1 (98) at diagnosis with not a single symptom. And I'm still here to tell the tale because I (finally) accepted that I had T2 and did something about it. My last A1c was 6.1 (43) and I fully expect to be in non Diabetic numbers at my next review. Focus on the job to be done rather than questioning the results and you will start to feel a little easier about the diagnosis itself. Good luck.

Thankyou for replying
When I was diagnosed as pre diabetic I followed the Drs advice & my diet was the recommended eat well plate. 5 years later & no change in the fasting blood glucose levels. When I was diagnosed as type 2 I bought a blood glucose monitor and began eating to that. Since July I have lost 8.6 kgs and yet I have had days where I have eaten bread & potatoes and my 2hr after eating has gone up by only 0.6
It just doesn’t make any sense to me

 

[EllieM]

An HbA1c of 48 and higher is diagnostic of diabetes, regardless of what your fasting blood glucose levels are.

https://www.diabetes.co.uk/what-is-hba1c.html

It's likely that your blood glucose levels after eating are quite high, even though your fasting levels are ok. It can take a long period of time (years) with elevated blood glucose levels before any symptoms manifest.

That is very true but there is a small group of people for whom hba1c's are inaccurate. The hba1c assumes your red blood cells live for 3 months, if for instance you have anaemia then the reading can be higher than it should be.
https://diatribe.org/whats-normal-a1c-when-it-misleading
At the bottom of the article there's a long list of conditions which affect hba1c.

When I was diagnosed as type 2 I bought a blood glucose monitor and began eating to that. Since July I have lost 8.6 kgs and yet I have had days where I have eaten bread & potatoes and my 2hr after eating has gone up by only 0.6
It just doesn’t make any sense to me

If you think you've been misdiagnosed you could show them your blood sugar results and try asking for a fructosamine test instead of an hba1c.

 

[Alison Campbell]

As has been said you were not diagnosed on your fasting levels but on your HBA1C result. This represents your sugar levels for the previous 12 weeks.

No test is perfect but in the UK HBA1C, preferably two HBA1C tests a few weeks apart, are the common way GP's diagnose type 2 now. If there have been other abnormal test results a doctor may chose to diagnose on one HBA1C result. Do/did you have any other signs of metabolic syndrome, eg heart problems, high blood pressure?

For some, weight loss can improve your insulin sensitivity especially if diagnosed early at the lower HBA1C levels.

Well done for reducing your meter readings, let us know how you get on with your next HBA1C.

 

[Guzzler]

Thankyou for replying
When I was diagnosed as pre diabetic I followed the Drs advice & my diet was the recommended eat well plate. 5 years later & no change in the fasting blood glucose levels. When I was diagnosed as type 2 I bought a blood glucose monitor and began eating to that. Since July I have lost 8.6 kgs and yet I have had days where I have eaten bread & potatoes and my 2hr after eating has gone up by only 0.6
It just doesn’t make any sense to me

May I ask if you needed to lose a bit of weight? Weight gain is a symptom of Pre Diabetes and Type 2 Diabetes so if you did need to lose even a small amount technically you did have a symptom.
This mirrors my case, normal/low BMI then diagnosis, LCHF, a little weightloss and improved A1c.

 

[Atad heavy]

As has been said you were not diagnosed on your fasting levels but on your HBA1C result. This represents your sugar levels for the previous 12 weeks.

No test is perfect but in the UK HBA1C, preferably two HBA1C tests a few weeks apart, are the common way GP's diagnose type 2 now. If there have been other abnormal test results a doctor may chose to diagnose on one HBA1C result. Do/did you have any other signs of metabolic syndrome, eg heart problems, high blood pressure?

For some, weight loss can improve your insulin sensitivity especially if diagnosed early at the lower HBA1C levels.

Well done for reducing your meter readings, let us know how you get on with your next HBA1C.

Thanks for your reply, I had a heart attack 8 years ago so I am on heart medication & blood pressure pills. My next HBA1C test is due in about 3 weeks & I'm really feeling positive about the result with the changes that I have made to my diet

 

[Atad heavy]

May I ask if you needed to lose a bit of weight? Weight gain is a symptom of Pre Diabetes and Type 2 Diabetes so if you did need to lose even a small amount technically you did have a symptom.
This mirrors my case, normal/low BMI then diagnosis, LCHF, a little weightloss and improved A1c.

I gained loads of weight when I was put on HRT & no amount of dieting would shift it. My Doctor said HRT was not to blame but I found out otherwise when I met a scientist who worked for the company that made my medication. My weight had not increased between 2009 - 2018

 

[Atad heavy]

An HbA1c of 48 and higher is diagnostic of diabetes, regardless of what your fasting blood glucose levels are.

https://www.diabetes.co.uk/what-is-hba1c.html

It's likely that your blood glucose levels after eating are quite high, even though your fasting levels are ok. It can take a long period of time (years) with elevated blood glucose levels before any symptoms manifest.

Thanks for your reply. I have been self testing FBG also before my main meal & 2 hours later. I have been testing for a month now & I have had some surprising results which is what started me wondering about my diagnosis. The most challenging day was having to eat out -: my FBG that morning was 5.7. I had full fat Greek yogurt with a mix of flaxseed, almonds & walnuts for breakfast.
Lunch - half a cereal bread baguette with salmon, cream cheese, tomato & cucumber (only ate half of the bread)
Dinner - Beef bourguignon with 2 tablespoons of mashed potatoes, peas & carrots
for desert I had half a serving of creme brûlée
Before eating 5.1
2 hrs later 5.7
I was expecting the result to be a lot higher

 

[Daibell]

Hi. It sounds like your diagnosis was marginal and the HBA1C is only just into the diabetic region. I wouldn't test too often as there may not be much point unless it starts going towards the teens. Note that FBG isn't really a reliable test due to the overnight liver dump effect so use the HBa1C as a good guide and the meter two hours after a meal.

 

[Resurgam]

Now that I have been eating low carb for two years I could eat 'normally' and not react with high blood glucose, but I would start to see weight gain, and all the places where carbs are stashed away would start to fill up again, and my metabolism would begin to creak under the strain.
My Hba1c is classes as at the very lowest of prediabetes, but my ability to cope with carbs has been low all my adult life - I know what I will be sticking to now, no matter what I am advised.

 

[Atad heavy]

Hi. It sounds like your diagnosis was marginal and the HBA1C is only just into the diabetic region. I wouldn't test too often as there may not be much point unless it starts going towards the teens. Note that FBG isn't really a reliable test due to the overnight liver dump effect so use the HBa1C as a good guide and the meter two hours after a meal.

Thankyou your reply was very interesting, especially the liver dump effect. I have spent a lot of time on this site learning how I can help myself - I just wish I had researched LCHF diet when I was diagnosed as pre diabetic

 

[Atad heavy]

Now that I have been eating low carb for two years I could eat 'normally' and not react with high blood glucose, but I would start to see weight gain, and all the places where carbs are stashed away would start to fill up again, and my metabolism would begin to creak under the strain.
My Hba1c is classes as at the very lowest of prediabetes, but my ability to cope with carbs has been low all my adult life - I know what I will be sticking to now, no matter what I am advised.

Thankyou for your reply, looking at my results before & after eating I seem to cope with some carbs but if I went back to my old ways the weight would pile back on

 

[NoCrbs4Me]

Thanks for your reply. I have been self testing FBG also before my main meal & 2 hours later. I have been testing for a month now & I have had some surprising results which is what started me wondering about my diagnosis. The most challenging day was having to eat out -: my FBG that morning was 5.7. I had full fat Greek yogurt with a mix of flaxseed, almonds & walnuts for breakfast.
Lunch - half a cereal bread baguette with salmon, cream cheese, tomato & cucumber (only ate half of the bread)
Dinner - Beef bourguignon with 2 tablespoons of mashed potatoes, peas & carrots
for desert I had half a serving of creme brûlée
Before eating 5.1
2 hrs later 5.7
I was expecting the result to be a lot higher

I'm not surprised since that's not a lot of carbs. You may also want to check at 1 hour. And, also, by your previous comment, this is not the way you previously ate, which got your HbA1c up to a diabetic level. If you continue to eat reduced carbs you may find your HbA1c drops to non-diabetic levels.

If you did eat a high carb meal, you may find your blood glucose levels much higher.

 

[Atad heavy]

I'm not surprised since that's not a lot of carbs. You may also want to check at 1 hour. And, also, by your previous comment, this is not the way you previously ate, which got your HbA1c up to a diabetic level. If you continue to eat reduced carbs you may find your HbA1c drops to non-diabetic levels.

If you did eat a high carb meal, you may find your blood glucose levels much higher.

I think you have shown me where I am going wrong, I thought that what I had eaten that day was high in carbs. I am totally clueless about working out carbs which is why I bought the monitor so I will now try to learn more about this