What Do You Make of This HbA1c Data?

[Listlad]

I have just located and dusted down some older medical records of mine printed out for me in May 2017 to add to the more recent test results. There appears to be more test results than I was aware of. So have updated the additional records in my footer.

I draw attention to the first in 2014 at 49mmol/mol or 6.6% - the record is stamped up as "Normal - no action".

A1c Dec 2014 : 49
A1c Feb 2015 : 43
A1c Aug 2015 : 40
A1c Sept 2016 : 41
A1c Feb 2018 : 41 again

There is also a heap of other blood test statistics which is a bit bamboozling.

 

[HSSS]

I have just located and dusted down some older medical records of mine printed out for me in May 2017 to add to the more recent test results. There appears to be more test results than I was aware of.

I draw attention to the first in 2014 at 49mmol/mol or 6.6% - the record is stamped up as "Normal - no action".

A1c Dec 2014 : 49
A1c Feb 2015 : 43
A1c Aug 2015 : 40
A1c Sept 2016 : 41
A1c Feb 2018 : 41 again

There is also a heap of other blood test statistics which is a bit bamboozling.

Sadly not unusual.

 

[Listlad]

Also interestingly when I asked for all of my test results from my GP recently, they didn't go back that far though did overlap some of the older data.

( The two sources of my data are from different "jurisdictions" )

 

[Alison Campbell]

Although it was marked 'normal' you were tested again 3 months later which is not normal for normal.

By jurisdictions did you mean you changed GP?

I'm glad they kept an eye on you.

 

[Listlad]

Although it was marked 'normal' you were tested again 3 months later which is not normal for normal.

By jurisdictions did you mean you changed GP?

I'm glad they kept an eye on you.

Okay thanks. That makes a lot of sense.

I try to avoid mentioning the Isle of Man as it complicates everything but it (earlier tests) was in the Isle of Man, where things are the same but different in many ways.

You make a good point about the retest.

 

[Resurgam]

As you have had a test of 49 you are not exactly prediabetic - over 47 is diabetic and so you are 'reversed' or 'in remission' - even though you knew nothing about it.

 

[Listlad]

As you have had a test of 49 you are not exactly prediabetic - over 47 is diabetic and so you are 'reversed' or 'in remission' - even though you knew nothing about it.

But the NHS registered me as “Normal” at 49. And have never yet declared me as diabetic.

I pieced back the timeline today and the 49 was the reading just before my holiday in mid December 2014. I had been eating a lot of sweet foods in the run up to Christmas. I recall stopping the sugar intake over Christmas, in response to the result but not the carbs, once I found out the test results revealed high blood sugar levels. And they retested me in the New Year. Looking back I recall the GP threatening to put me down as diabetic but opted not to, to see if I could manage it with diet.

At no time since then have I dropped the carb intake. Nobody advised me to do that, only replace some with better forms. But ...... I recognise that probably needs to change. And it has, even though my carb intake might still be more than many, I have dropped my carb intake to a much lower level.

 

[Alison Campbell]

I think the NICE guideline recommend two HBA1C's to confirm diagnosis if you are bordeline

 

[HSSS]

As you have had a test of 49 you are not exactly prediabetic - over 47 is diabetic and so you are 'reversed' or 'in remission' - even though you knew nothing about it.

Or there was never the second positive confirmation test placing him as diabetic that’s why he’s not had the label.

 

[HSSS]

But the NHS registered me as “Normal” at 49. And have never yet declared me as diabetic.

I pieced back the timeline today and the 49 was the reading just before my holiday in mid December 2014. I had been eating a lot of sweet foods in the run up to Christmas. I recall stopping the sugar intake over Christmas, in response to the result but not the carbs, once I found out the test results revealed high blood sugar levels. And they retested me in the New Year. Looking back I recall the GP threatening to put me down as diabetic but opted not to, to see if I could manage it with diet.

At no time since then have I dropped the carb intake. Nobody advised me to do that, only replace some with better forms. But ...... I recognise that probably needs to change. And it has, even though my carb intake might still be more than many, I have dropped my carb intake to a much lower level.

If your carb response was totally normal it would have coped with the sugary pre Christmas, with your insulin rapidly lowering the levels. It was because you’re on the diabetic pathway with dodgy insulin response that it was raised for long enough to mess up the hb1ac. Cutting the sugars (even though not the carbs) probably dropped the levels the few points to take you back into the prediabetic range you have hovered in since, ie your level of insulin resistance was just about managing with the carbs but not carbs and sugars.

 

[Listlad]

If your carb response was totally normal it would have coped with the sugary pre Christmas, with your insulin rapidly lowering the levels. It was because you’re on the diabetic pathway with dodgy insulin response that it was raised for long enough to mess up the hb1ac. Cutting the sugars (even though not the carbs) probably dropped the levels the few points to take you back into the prediabetic range you have hovered in since, ie your level of insulin resistance was just about managing with the carbs but not carbs and sugars.

Okay. That is the kind of conclusion I was beginning to draw. So you kind of confirm a line of thought that I had.

Thanks.

Since I was alerted by that reading I have made a more concerted effort to cut out added sugar and sugary products, though at times not totally consistently. But I can honestly say that I never attempted to cut out carbs or reduce them dramatically. As I said before, porridge for breakfast became the norm for example, often with honey or stewed or dried fruit, but may well have been part of the reason I was still bubbling under the prediabetic threshold still. (There was a lot of ignorance in my dietary thinking).

Thanks for helping out on that one.

 

[HSSS]

Okay. That is the kind of conclusion I was beginning to draw. So you kind of confirm a line of thought that I had.

Thanks.

Since I was alerted by that reading I have made a more concerted effort to cut out added sugar and sugary products, though at times not totally consistently. But I can honestly say that I never attempted to cut out carbs or reduce them dramatically. As I said before, porridge for breakfast became the norm for example, often with honey or stewed or dried fruit, but may well have been part of the reason I was still bubbling under the prediabetic threshold still. (There was a lot of ignorance in my dietary thinking).

Thanks for helping out on that one.

Well it’s just my opinion but glad it helps. You seem to be getting a good handle on it now so onwards and upwards (well downwards hopefully). The ignorance was there in many of us and most of the public because that’s what we’ve been taught for decades. Hardly our fault so don’t beat yourself up about it

 

[Resurgam]

Ah - yes, if there are rules about testing again then possibly no formal diagnosis was made.
I do despair about the advice not given to people though - honey and fruit are as much sugary as sucrose and high fructose corn syrup but they are somehow 'healthy' options. Bread and potatoes or rice are going to result in glucose in the bloodstream. Such information must be the foundation of dealing with type two diabetes - any diabetes really, so why is it not given?

 

[Listlad]

Ah - yes, if there are rules about testing again then possibly no formal diagnosis was made.
I do despair about the advice not given to people though - honey and fruit are as much sugary as sucrose and high fructose corn syrup but they are somehow 'healthy' options. Bread and potatoes or rice are going to result in glucose in the bloodstream. Such information must be the foundation of dealing with type two diabetes - any diabetes really, so why is it not given?

I wasnt instructed to take honey. It was my ignorant interpretation of what would be a more healthy approach. In hindsight I was wrong but trying to make sense of what is supposed to be the correct or most appropriate dietary approach is difficult at the outset.