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Unexpectedly high HbA1c

L

LaserMum

Well-Known Member
Messages
72
Type of diabetes
Type 2
Hi,

I was diagnosed with Type 2 a few years ago (maybe about 10). My HbA1c has been fairly constant in that time between 48 and 53.

I was very keen to control this initially and I bought a BG monitor and kept a spreadsheet with the results (and pretty graphs). However, the DN ignored anything I gave her saying that there was no need to test as a T2. All they've kept saying for years is that I need to lose weight. I try but not very successfully.

In Feb-17 HbA1c was 53 then a couple of weeks ago it jumped up to 84. I have recently been diagnosed with severe liver fibrosis although it's not at the level for cirrhosis yet. I don't know if this will have affected the result.

My DN has given me a blood glucose monitor and test strips and asked me to monitor my fasting BG for a week.

Should I be very concerned about this?
 
Sorry, I have no words of advice for you, I just wanted to 'bump' your post so that it does not get lost further down the list. Best wishes for a good outcome.
 
Firstly you should be very concerned, as your BG will just keep getting worse unless you get BG under very good control. But all is not lost if you take control.

First, let’s start with drugs as they do help (but not as much as diet). You should be taking Metformin with the highest dose you can unless there is a good reason not to. SGLT2 Inhibitors are giving people very good results, and as they don’t have a risk of Hypo, they don’t stop you dieting and exercising, therefore ask your DN about them. SGLT2 Inhibitors are starting to show good results with fatty liver as well as BG.

Is your “liver fibrosis” related to “fatty liver”? If so “very low carb” has been proven to give good results. “very low carb” is also good for BG control and most people lose weight with it. The classic very low carb diet is “A New Alison for a New You”

I wrote a post a few days about “fatty liver” that may be helpful http://www.diabetes.co.uk/forum/threads/extremely-high-ggt-levels.131050/#post-1649576

I think it is time to put your Autism to work, search out all items of food your drink that result in you having more than 30g of carbs per day, and be obsessive about not eating them.
 
ringi said:
Firstly you should be very concerned, as your BG will just keep getting worse unless you get BG under very good control. But all is not lost if you take control.

First, let’s start with drugs as they do help (but not as much as diet). You should be taking Metformin with the highest dose you can unless there is a good reason not to. SGLT2 Inhibitors are giving people very good results, and as they don’t have a risk of Hypo, they don’t stop you dieting and exercising, therefore ask your DN about them. SGLT2 Inhibitors are starting to show good results with fatty liver as well as BG.

Is your “liver fibrosis” related to “fatty liver”? If so “very low carb” has been proven to give good results. “very low carb” is also good for BG control and most people lose weight with it. The classic very low carb diet is “A New Alison for a New You”

I wrote a post a few days about “fatty liver” that may be helpful http://www.diabetes.co.uk/forum/threads/extremely-high-ggt-levels.131050/#post-1649576

I think it is time to put your Autism to work, search out all items of food your drink that result in you having more than 30g of carbs per day, and be obsessive about not eating them.
Click to expand...
Many many thanks @ringi
Yes, my liver fibrosis is due to "fatty liver" (or NAFLD progressed to NASH) I shall investigate SGLT2 and “A New Alison for a New You”
Thanks again!
 
LaserMum said:
Hi,

I was diagnosed with Type 2 a few years ago (maybe about 10). My HbA1c has been fairly constant in that time between 48 and 53.

I was very keen to control this initially and I bought a BG monitor and kept a spreadsheet with the results (and pretty graphs). However, the DN ignored anything I gave her saying that there was no need to test as a T2. All they've kept saying for years is that I need to lose weight. I try but not very successfully.

In Feb-17 HbA1c was 53 then a couple of weeks ago it jumped up to 84. I have recently been diagnosed with severe liver fibrosis although it's not at the level for cirrhosis yet. I don't know if this will have affected the result.

My DN has given me a blood glucose monitor and test strips and asked me to monitor my fasting BG for a week.

Should I be very concerned about this?
Click to expand...

Sorry to hear about the diagnosis. Fortunately the same treatment that is shown to improve fibrosis also improves diabetes. So making a start onyour diet as soon as possible is likely to be helpful for both conditions.
You will not be surprised to find that that is a low carb diet.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122212/

here is my xmas song on how to do this ! I followed this andI'm 25kg down which again would hep both your conditions.


12 days of Xmas for those with T2 diabetes

· On the first day of Xmas - I got the diagnosis - 90 A1C and T2 diabetes for you.

· On the second day of Xmas I did my own research - and refused the drugs, 90 a1c and its T2 diabetes for me.

· On the third day of Xmas I started my new diet, LCHF not drugs, 85 a1c and its T2 diabetes for me.

· On the fourth day of Xmas I set my new macros, 60% fat, 20% Protein, 20% carbs, LCHF not drugs, 80 a1c and its T2 diabetes for me.

· On the 5th day of Xmas NO MORE SUGAR, I kept to my new diet, LCHF not drugs , 75 a1c and its T2 diabetes for me

· On the 6th day of Xmas, I got rid of refined carbs, NO MORE SUGAR, I kept to my new diet, LCHF not drugs , 70 a1c and its T2 diabetes for me

· On the 7th day of Xmas , found my keto foods, got rid of refined carbs, NO MORE SUGAR I kept to my new diet, LCHF not drugs , 65 a1c and its T2 diabetes for me

· On the 8th day of Xmas , I got rid of veggie oils, found my keto foods, got rid of refined carbs, NO MORE SUGAR, I kept to my new diet, LCHF not drugs , 60 a1c and its T2 diabetes for me

· On the 9th day of Xmas, I felt the urge to walk, I had no more veggie oils, enjoyed my keto foods , was done with refined carbs, NO MORE SUGAR , found my new diet easy, LCHF not drugs , 55 a1c and its T2 diabetes for me

· On the 10th day of Xmas , as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the keto foods, forgot the refined carbs , NO MORE SUGAR, found my new diet easy, LCHF not drugs, 50 a1c but its still T2 diabetes for me.

· On the 11th day of Xmas , I didn't eat all as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the meat & fish, forgot the refined carbs , NO MORE SUGAR, I found my new diet easy, LCHF not drugs, 45 a1c and its now pre-diabetes for me.

· On the 12th day of Xmas, I slept a whole lot better, as I didn't need to eat, as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the keto foods, forgot the refined carbs , NO MORE SUGAR, I found my new diet easy, LCHF not drugs, 40 a1c and NO MORE DIABETES FOR ME.

· On the 13th day of Xmas, I started telling others, I slept a whole lot better, as I didn't need to eat, as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the Keto foods, forgot the refined carbs, NO MORE SUGAR, I found my new diet easy, LCHF not drugs, 40 a1c and its STILL NO DIABETES FOR ME.

· On the 14- 99th day of Xmas, I am shouting from the rooftops, please, please change the guidelines, you don't need carbohydrates, junk foods will get you sometime, veggie oils cause damage, sugar is clearly toxic, diary , meat, and fish rock, EAT LCHF, improve your lipid profile, lose your diabetes symptoms , read the bloody research, forget the current guidelines and enjoy a HAPPY NEW YEAR.

· ( rinse and repeat ad nauseum ) I did it you can too.
 
CherryAA said:
Sorry to hear about the diagnosis. Fortunately the same treatment that is shown to improve fibrosis also improves diabetes. So making a start onyour diet as soon as possible is likely to be helpful for both conditions.
You will not be surprised to find that that is a low carb diet.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122212/

here is my xmas song on how to do this ! I followed this andI'm 25kg down which again would hep both your conditions.


12 days of Xmas for those with T2 diabetes

· On the first day of Xmas - I got the diagnosis - 90 A1C and T2 diabetes for you.

· On the second day of Xmas I did my own research - and refused the drugs, 90 a1c and its T2 diabetes for me.

· On the third day of Xmas I started my new diet, LCHF not drugs, 85 a1c and its T2 diabetes for me.

· On the fourth day of Xmas I set my new macros, 60% fat, 20% Protein, 20% carbs, LCHF not drugs, 80 a1c and its T2 diabetes for me.

· On the 5th day of Xmas NO MORE SUGAR, I kept to my new diet, LCHF not drugs , 75 a1c and its T2 diabetes for me

· On the 6th day of Xmas, I got rid of refined carbs, NO MORE SUGAR, I kept to my new diet, LCHF not drugs , 70 a1c and its T2 diabetes for me

· On the 7th day of Xmas , found my keto foods, got rid of refined carbs, NO MORE SUGAR I kept to my new diet, LCHF not drugs , 65 a1c and its T2 diabetes for me

· On the 8th day of Xmas , I got rid of veggie oils, found my keto foods, got rid of refined carbs, NO MORE SUGAR, I kept to my new diet, LCHF not drugs , 60 a1c and its T2 diabetes for me

· On the 9th day of Xmas, I felt the urge to walk, I had no more veggie oils, enjoyed my keto foods , was done with refined carbs, NO MORE SUGAR , found my new diet easy, LCHF not drugs , 55 a1c and its T2 diabetes for me

· On the 10th day of Xmas , as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the keto foods, forgot the refined carbs , NO MORE SUGAR, found my new diet easy, LCHF not drugs, 50 a1c but its still T2 diabetes for me.

· On the 11th day of Xmas , I didn't eat all as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the meat & fish, forgot the refined carbs , NO MORE SUGAR, I found my new diet easy, LCHF not drugs, 45 a1c and its now pre-diabetes for me.

· On the 12th day of Xmas, I slept a whole lot better, as I didn't need to eat, as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the keto foods, forgot the refined carbs , NO MORE SUGAR, I found my new diet easy, LCHF not drugs, 40 a1c and NO MORE DIABETES FOR ME.

· On the 13th day of Xmas, I started telling others, I slept a whole lot better, as I didn't need to eat, as I was no longer hungry, and I felt the urge to run, I had no more veggie oils, loved the Keto foods, forgot the refined carbs, NO MORE SUGAR, I found my new diet easy, LCHF not drugs, 40 a1c and its STILL NO DIABETES FOR ME.

· On the 14- 99th day of Xmas, I am shouting from the rooftops, please, please change the guidelines, you don't need carbohydrates, junk foods will get you sometime, veggie oils cause damage, sugar is clearly toxic, diary , meat, and fish rock, EAT LCHF, improve your lipid profile, lose your diabetes symptoms , read the bloody research, forget the current guidelines and enjoy a HAPPY NEW YEAR.

· ( rinse and repeat ad nauseum ) I did it you can too.
Click to expand...

Obviously I didn't need metformin, you may find that you can get there quicker if you use it, and it may be the faster the better in this case.
 
LaserMum said:
However, the DN ignored anything I gave her saying that there was no need to test as a T2.
Click to expand...

She's right. And there's no need to look both ways before crossing the road, either. I think people possibly live longer if they do, however. So I'd keep testing. If I hated testing, I'd at least spend a couple of weeks doing it so I could build up a log of 'allowable meals' which don't spike me for too high or too long, then stick to those meals. Also see what happens to my levels after various forms of exercise. Possibly do another round of (re-)testing a year later.

LaserMum said:
All they've kept saying for years is that I need to lose weight. I try but not very successfully.
Click to expand...

I'd say it's worth keeping at that if you feel you could be lighter. Not just from a diabetes perspective either; just in terms of general health and happiness. There's a good chance, if getting lighter also includes a bit of exercise, it will help your insulin resistance decrease, helping you to keep the numbers lower.

LaserMum said:
I have recently been diagnosed with severe liver fibrosis although it's not at the level for cirrhosis yet.
Click to expand...

Could this be related to alcohol? A blood test a few months ago showed a potential problem with my liver. I certainly was in the habit of hitting the bottle at the weekends. I haven't drunk for months and the results now suggest my liver is fine, but more than that, cutting out alcohol has helped reduce my appetite, lose weight and keep glucose levels lower. If you drink and you think you can muster up the discipline at least until your next blood test, why not try cutting it out and see if it gets you a better score next time?
 
One way to think of it.
  • High blood sugar results increased liver fat.
  • Alcohol adds fat to the liver, but without “insulin resistance “ (Type2) it takes a LOT of alcohol, as normally fat will continually be removed from the liver.

  • Low carb => don’t add sugar to your body (all carbs turn to sugar when we eat them)
  • Marformin => allows your muscle to use up more sugar and slows down the speed your liver converts protein into sugar.
  • SGLT2 Inhibitors => Make you **** out sugar whenever you go to the WC, hence the need to drink a lot of water when taking them.
  • Resistance training => your muscle will use more sugar for a few days after doing it even when you are sleeping.
  • HIIT => your muscle will use more sugar for a few days after doing it even when you are sleeping.
  • 10 minutes walk after a meal => your muscle will use more sugar for the next hour or two so helping with the post-meal BG peak.
  • Fasting => your body will use up some of the fat in your liver, even a 12 hour fast between the dinner and breakfast the next day help. A lot better if you can make the gap longer.
I am very much of the view its best to use diet and drugs, stopping the drugs (other then Metformin) as soon as you get great control. I consider taking say an SGLT2 Inhibitors short term to be a small price to pay for getting good control quicker. Remember the damage to your liver (and the rest of your body) will continue until you have got good BG control.
 
AdamJames said:
She's right. And there's no need to look both ways before crossing the road, either. I think people possibly live longer if they do, however. So I'd keep testing. If I hated testing, I'd at least spend a couple of weeks doing it so I could build up a log of 'allowable meals' which don't spike me for too high or too long, then stick to those meals. Also see what happens to my levels after various forms of exercise. Possibly do another round of (re-)testing a year later.



I'd say it's worth keeping at that if you feel you could be lighter. Not just from a diabetes perspective either; just in terms of general health and happiness. There's a good chance, if getting lighter also includes a bit of exercise, it will help your insulin resistance decrease, helping you to keep the numbers lower.



Could this be related to alcohol? A blood test a few months ago showed a potential problem with my liver. I certainly was in the habit of hitting the bottle at the weekends. I haven't drunk for months and the results now suggest my liver is fine, but more than that, cutting out alcohol has helped reduce my appetite, lose weight and keep glucose levels lower. If you drink and you think you can muster up the discipline at least until your next blood test, why not try cutting it out and see if it gets you a better score next time?
Click to expand...

Note. NAFLD looks exactly the same as alcohol induced liver problems and the outcomes can be the same. I have been teetotal for over 25 years but if I went on to develope chronic liver failure it would be due to T2/extremely poor management/poor diet or a completely different condition.
 
The OP has an unexplained jump in HbA1c and liver fibrosis both of which need to be investigated and treated by health care professionals not by a forum.
 
Guzzler said:
Note. NAFLD looks exactly the same as alcohol induced liver problems and the outcomes can be the same. I have been teetotal for over 25 years but if I went on to develope chronic liver failure it would be due to T2/extremely poor management/poor diet or a completely different condition.
Click to expand...

That's the impression I got when I was told I may have a problem with my liver. In all the research I did, I couldn't for the life of me find anywhere that mentioned how to distinguish between them. I just presumed that as a diabetic who liked to drink quite a bit at weekends, it was sensible to hedge my bets and tackle both the alcohol and the diabetes. It seems to have worked, and seems sensible to try to tackle both. For me there was a strong link anyhow - after a night of drinking, I would spend all the next day hoovering food up.
 
AdamJames said:
That's the impression I got when I was told I may have a problem with my liver. In all the research I did, I couldn't for the life of me find anywhere that mentioned how to distinguish between them. I just presumed that as a diabetic who liked to drink quite a bit at weekends, it was sensible to hedge my bets and tackle both the alcohol and the diabetes. It seems to have worked, and seems sensible to try to tackle both. For me there was a strong link anyhow - after a night of drinking, I would spend all the next day hoovering food up.
Click to expand...

I just thought I'd mention it. If there is one lesson that I have learned that has stood me in good stead over the years it is that one should always be aware that having been diagnosed with one condition does not give you immunity against developing a completely different condition. We should always report new symptoms to a HCP and not put everything down to the one or two conditions we know we have. We should never assume, therefore, that because we have Diabetes that every new symptom points directly to that. We may never develope symptoms so that is why, in a way, being offered regular blood tests/appointments to check our health is perhaps the only upside of being diagnosed with Diabetes. Perhaps a double edged sword.
 
Mr_Pot said:
The OP has an unexplained jump in HbA1c and liver fibrosis both of which need to be investigated and treated by health care professionals not by a forum.
Click to expand...

Remember this is the standard cycle with Type2, increased liver fat results in increased insulin resistance, that results in increase BG, that results in increased liver fat.

The healthcare professionals will say "lose weight" most likely with "low fat" that we know don't work, along with drugs that mostly force the sugar elsewhere in the body. The GP will hopefully also check for a few unlikely possibilities like Liver Cancer or hepatitis etc. Nothing in this thread will be harmful if the liver fibrosis is due to hepatitis etc, and no one is saying to ignore the GP, or not have the blood tests.

(There was a reason I asked if the liver fibrosis was due to "fatty liver" at the start of this thread, this tells us what the health care professionals think from their current investigations.)
 
Mr_Pot said:
The OP has an unexplained jump in HbA1c and liver fibrosis both of which need to be investigated and treated by health care professionals not by a forum.
Click to expand...

Thank you for your concern @Mr_Pot. I have been properly diagnosed with liver fibrosis by a consultant after a liver biopsy. The jump in HbA1c is being investigated by my GP and DN. Metformin has been doubled (to 2000g/day) on the advice of my DN. Tests are currently being done to investigate possible Exocrine Pancreatic Insufficiency. So healthcare professionals are very much involved in this process.
However, I also value the input of people living with these conditions and realise that they may have an insight that the professionals don't. For instance, I didn't realise (I don't know why because it's logical) that diabetes could possibly have had such an effect on my liver. That is something that I have learned from this thread.
Thank you all for your help. I will be spending some time on MyFitnessPal today to plan a low carb diet! I didn't have anything else so it was roast beef and cheese for breakfast :)
 
ringi said:
Remember this is the standard cycle with Type2, increased liver fat results in increased insulin resistance, that results in increase BG, that results in increased liver fat.

The healthcare professionals will say "lose weight" most likely with "low fat" that we know don't work, along with drugs that mostly force the sugar elsewhere in the body. The GP will hopefully also check for a few unlikely possibilities like Liver Cancer or hepatitis etc. Nothing in this thread will be harmful if the liver fibrosis is due to hepatitis etc, and no one is saying to ignore the GP, or not have the blood tests.

(There was a reason I asked if the liver fibrosis was due to "fatty liver" at the start of this thread, this tells us what the health care professionals think from their current investigations.)
Click to expand...

Thanks @ringi, it does help to know this. I hadn't made the connection between "fatty liver" and Type 2. I've had all the tests for liver cancer and hepatitis, etc. and all were negative. The only tests I'm waiting on now are for Exocrine pancreatic insufficiency.
I'm planning on using the next week to log my food, try to reduce carbs and plan a very low carb diet to start in the new year. I need some thinking time to take all this in before I dive in and possibly crack my skull on the first hurdle!
Thanks for your help.
 
There are two issues.
  • Why did everything get worse suddenly, normally the doctors expect people with Type2 to get worse liver test results each year but the decline to be steady, hence all the other checks they are doing on you. That what the doctors are the experts in.
  • Then their how to help your body control BG when your body can’t cope with a normal diet, and how to remove the fat from the liver. That is what people on this forum are 10 times better at than most doctors, as doctors have been trained to think that Type2 and Liver Fat always gets worse, and the best they can do is slow down the decline.
Low carb diets don’t have to be hard, for example, the “steak and egg” diet when you just eat rib-eye steak and eggs along with drinking lots of water does work. (Personally, I like green veg etc, therefore I eat them.)

“roast beef and cheese for breakfast” is not a bad option that will be a lot better for you then toast, cereal, or porridge.

As you need to lose weight, most of the fat in “Low Carb High Fat” will come from your own body. Low carb diets are easy while you wish to lose weight, they get hard if you need to keep doing them to control BG once you have lost all the weight you wish to lose.

Don’t stress about the perfect diet, for example on Christmas day I will have the normal food, other than the potatoes and Yorkshire pudding with additional meat if they will give it to me. Then skip the dessert and overload on the cheese board, skipping the grapes and biscuits. The gravy will have some carbs in it, but, I will still have it – when cooking myself I will make carb free gravy but when eating out I am happy if I removed three-quarters of the carbs from a standard meal.

The connection between Type2 and Liver Fat was proven by Professor Roy Taylor a few years ago, long after most doctors finished their training (but all GPs know from experience they must be linked). Google for “.Professor Roy Taylor's Twin Cycle” and you will find some videos where he explains it, expect to need to watch more them one of them, as it takes time to understand the science.
 
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