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When to go for my HBA1C?

Discussion in 'Blood Glucose Monitoring' started by Gryph, Jun 20, 2019.

  1. Gryph

    Gryph Type 2 · Active Member

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    Pondering when to go for my next HBA1C?

    A week on friday I go on holiday for 14 days, and while I'll be doing my absolute best to follow LCHF and keep the BG low and level, there are invariably going to be slip ups as I experiment.

    Do I go for the test before holiday, or after? Before holiday is 9 weeks of LCHF, after will be 12 by the time I've got back to work and managed to get to the phleb department.

    From all that I've read concerning the lifecycle of the red blood cells, etc, I understand that the HBA1C is an average over the 12 weeks, but that it is also fairly skewed to the most recent 2 weeks. Have I got the right end of the stick here please?

    Following the disastrous DN appointment earlier this week, I did manage to get a HBA1C test slip from it; so perhaps not so bad, after all I was looking to obtain this.

    My test was end of March this year, with the results supplied to me at the end of April.

    The result was HBA1C = 74 = 8.9%

    I immediately purchased an ACCU-CHEK Mobile and have been rigorously testing and following LCHF ever since.

    Over the last 8 weeks since the result I have collected 635 data points, all taken throughout the day and pre/post consuming anything, with the Accu suggestion that a 90 day average of 6.2mmol/L with no estimated HBA1C for the full duration (as only 8 weeks of data). I do appreciate that there is an accuracy factor with the meter.

    On a week by week basis, my results are as follows, with an estimated HBA1C of 4.8% / 29 / 5.1 mmol/L BG for the last two weeks:

    upload_2019-6-20_14-45-56.png


    I'm torn between wanting to know the most accurate reading of my progress now Vs waiting it out for the full 12. I do have the delightful DN threat of "shouting at me" if my results are not good enough :nailbiting::nailbiting: o_O:angelic::p

    thoughts welcome and appreciated :)
     
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  2. helensaramay

    helensaramay Type 1 · Expert

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    We are all different and only you know what is best for you.
    A few things which are true regardless
    - Hb1AC is an average over the last 3 months at all times
    - there is a slight weighting towards more recent readings
    - no Finger prick meter can accurately measure your Hb1AC - it has no idea what your BG was doing between the 635 readings

    Personally, I would wait until returned from my holiday so I had a better representation of real life rather than 2 months of trying really hard.
    My expectation would be for something better than last time but I would not expect anywhere near as low as the readings the meter is estimating.
    I would be ready with a description of everything I have done to improve my BG including the average BG shown in the graph above in case my DN shouted at me. If she did, I would report her.

    Congratulations on what is obviously a fantastic improvement in your BG.
    You deserve a good holiday - have fun!
     
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  3. Gryph

    Gryph Type 2 · Active Member

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    Thank you - makes perfect sense. I understand that the finger prick meter can't really predict HBA1C due to effectively only covering a 14-16 hour period, and then that only reflects what happened at the individual points of taking.

    What I can take away is that it is improving, just a question of how much - and holding out for the full 12 weeks should be my best bet.

    I think I just had a slight confidence wobble when the DN immediately dismissed the My Sugr printouts and readings, and then I was getting impatient for an official reading to check I really was heading in the correct direction. Patience I guess; one step after the other. :happy:
     
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  4. Listlad

    Listlad Prediabetes · Well-Known Member

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    I posed the question a few months back on the idea of delaying the test to eliminate the effect of Christmas. I got a bit of a roasting from a couple of posters which was a little out of order really, pretty much suggesting I was avoiding reality. In actual fact at the time I had organised the appointment proactively myself and was merely posing the question.

    It is up to you whichever you choose. I have another test lined up tomorrow, again pushed through by me. I don’t know what the end result will be, hopefully it will be good if not better than the last.
     
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  5. Veryanxious

    Veryanxious Prediabetes · Well-Known Member

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    As per my experience my HBA1c has never been effected by recent high carbing. I have this trend twice with my previous and current A1c. But everyone is different.
     
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  6. DCUKMod

    DCUKMod I reversed my Type 2 · Expert
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    @Gryph - It's entirely up to you when you go. If you go before, you'll know how well your plan is playing out. If you wait until after your holiday, you'll have a bit longer low carbing, and you can see how your plan is playing out.

    The thing about managing A1cs around "big" events, like birthdays, holidays and so on is they keep happening, and relating to our blood tests, they're never at convenient times.

    Personally, I just have them when they come around. It is what it is.
     
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    #6 DCUKMod, Jun 20, 2019 at 8:24 PM
    Last edited: Jun 21, 2019
  7. Gryph

    Gryph Type 2 · Active Member

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    Thank you - I appreciate your thoughts :)
     
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  8. Gryph

    Gryph Type 2 · Active Member

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    Cheers - another viewpoint is always good. I think the spike from 5 to 10.4 (or 10 something, I've not got it to hand) after an hour on a wholemeal bread sandwich after an hour, and back to a high 6 after 2 hours shocked me... but not as much as the DN dismissing it. All indication are that I'm heading in the correct direction - I just need patience.
     
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  9. Gryph

    Gryph Type 2 · Active Member

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    Thank you.

    I think I'll stick it out to the full 12 weeks :)watching:).

    I believe that the direction that I'm heading is good - and it's not a one off to hit a particular score; I feel quite happy that this lifestyle change is sustainable. I don't have cravings, I have alternatives and I can enjoy a cold (low carb) beer and a whisky when I fancy with no real discernible impact on BG from the meter (it just slows weight losss :p). Actually, I feel great! Best I have in memory :cat:

    We're off to Thailand where we utterly love the food. My understanding of the recipes (cooked many ourselves) is that 14g or so of palm sugar can go into a dish (in addition to the rice/noodles etc). From my testing, sharing a dish or 3, this should be fine - but you never know what might throw it out. But I guess, that's the joy of averages - a couple of bad readings while I educate myself and adjust, will be offset by the lower readings after.

    The attitude of my DN has me concerned - the advice if followed would kill me sooner than natural. I'll see if I can educate and disseminate :)
     
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  10. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    You can choose when to have a test done?
    My surgery only allows testing when they think it is appropriate, in my case once a year.
    I did have three tests in the six months after diagnosis, the second two authorised by the people doing the 'education' course, so you are lucky to be able to pick your date.
     
  11. DCUKMod

    DCUKMod I reversed my Type 2 · Expert
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    I know that question wasn't addressed to me, but if I request a test (for whatever), I will usually be granted it, maybe because I will add my rationale when requesting it. From there, I pick up the lab sheet, and it's then in my hands to book the appointment, whether in-house (long wait, and very, very long wait for fasting tests, which most of mine need to be), at the local cottage hospital - similar, but slightly better wait times, or I can trundle to the nearest main hospitals, who have walk-in phlebotomy clinics, where folks from all manner of departments have their bloods done. They don't do many GP requests, but wuillingly do them. If I rock up for them opening at 08:00, I'm usually first or second in the queue, which is very acceptable to me.

    I find it useful to be able to decide to go on a morning when I might already be either at the hospital already, or nearby for business meetings. In any interim period, I'd just go for a coffee somewhere. Saves multiple 30 mile round trips, and very relaxed from my perspective.

    I did have to "train" my GP to me preferred methods, but now she never considers I'll wait weeks, when I go at my leisure and the results are usually available to view within 24 hours. For one of my thyroid panels the results were in before I got home from my following morning meeting.
     
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  12. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    To set your expectations estimates tend not to correlate with the actual lab HbA1cs. Meter readings are useful for gauging progress from the start of use, ongoing. I have had Libres estimate 22, with labs at mid 30's.

    As to control, the only judge is yourself. If you want to low carb it is possible anywhere, if you want to relax your regime that's fine by you - personally I travel alot (just getting on a plane now), I spend time to quiz the servers, as sugar or similar is snuck in everywhere. Don't assume sauces or even meat is without a hidden hit, ask about every element to be sure - you are paying.
     
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  13. Gryph

    Gryph Type 2 · Active Member

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    As @DCUKMod has mentioned - I'm pretty much the same: lab sheet printed by GP/DN, then a trip to the main hospital near by and to their phlebotomy department. So once I've got the sheet and as they have no expiry date, when I go for the test is entirely up to me. :)

    When I was being treated by Nephrology 5 years back I had a wonderful consultant, and when discharged he advised if I ever wanted a blood test, I should ask my GP for the lab sheet and head to phleb at the hospital (and if no luck there, contact his department).
     
  14. Smallbrit

    Smallbrit Type 2 · Well-Known Member

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    I just had the same dilemma - but had no choice in the matter. My doctor's surgery scheduled my test for yesterday, one week after I;d come back from a two-week holiday in Texas. I was hoping that they'd do it before I went.

    Texas portions are Texas sized and with a lot of carbs. But I used to live there, and so I went out to eat a lot and while I made good choices where I could (there was actually quite a lot of choice - one Tex-Mex restaurant had something called a "Low Carb Platter" which was on a plate that could feed 10 people but hey... it was actually properly low carb), I was also back 'home' and was enjoying that too.

    So, yes, the results from this should be interesting. I do know from monitoring closely in the last six months that I've had much better control this year than last year (if we ignore the holiday :bag:) so I'm pleased with myself from that. But I've got about 4 years of HBA1C tests under my belt, and it's probably taken that long to get used to what I'm happy with personally, and that's something you know by trial, error, and deciding what works for you.

    You are heading in a great direction, and the results from lowering carbs, in a way that you are comfortable with and able to maintain, do pay off, health-wise, mentally and physically.
     
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  15. DCUKMod

    DCUKMod I reversed my Type 2 · Expert
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    I hope you were offered the doggy bag for your leftovers. I still find that a little amusing for some things.
     
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