Which readings do I use?

[RM51]

Hello

I am fairly recently diagnosed with HbA1c reading of 44 and have been monitoring my levels for the past few months with Accu-chek instant but I can't work out which readings are most accurate or important.

My typical readings first thing in the morning (before eating or drinking) are around 6.6 to 7.2 but 2-4 hours after eating, they are typically between 5 and 5.6 which would be just about ok as far as I can understand.

So my question is, do I ignore the morning reading and just focus on the other readings during the day?

Thanks

 

[jonathan183]

Suggest you monitor just before eating and then 2 hours after eating, check you do not have too much of a blood glucose rise caused by the meal (less than 2mmol/l increase). Sort out the food first ... then you can look at bringing down fasting blood glucose levels (which may be the last to respond to changes you make).

 

[ianf0ster]

Hi @RM51 and welcome to the forum
There are 2 different things going on here, but only one that you can directly do something about, so I suggest you concentrate on that - i.e. your meals

A HbA1C level of 44 only just puts you in the pre-diabetic range, so it should only take a small change to get you back in the normal range again.
All carbohydrates when digested turn into glucose, and Type 2 diabetics are unable to handle the large amounts of carbs in the modern diet as well as the average person, so they get persistently higher blood glucose which can cause health problems.

The simplest and most direct way of fixing the problem is to reduce the amount of carbohydrates (particularly refined carbs) that we eat.
So take a BG measurement just before a meal and then 2hrs later (2 hrs after first reading, not 2hrs after finishing the meal). If the 2nd Blood glucose reading is more that 2.0 mmol higher than the 1st, then it is likely that the meal has too many carbs or too much refined carb for your body to easily handle. Thus it's a good idea to reduce the portion of carbs or substitute with something containing less carbs or less refined carbs.

If you do this a few times for each Breakfast , Lunch and Dinner you will soon know the best foods for your body and also the ones you most need to avoid. Breakfast Cereals and Fruit Juices are the ones that catch most people out at first.

The first thing in the morning ( a Fasting Blood Glucose) level Is affected by the liver. It is known as Dawn Phenomenon ( DP) or Foot On The Floor Syndrome (FOTF). You can't directly control this. Your liver thinks you are living like a cave dweller and so need extra energy to go and hunt/gather your breakfast. Once your body gets used to a lower Blood Glucose, then this DP slowly get weaker, but this can take a very long time.
Mine is still quite strong even having been in remission for over 2yrs already.

 

[In Response]

The question is, "why are you testing?"
If you are testing to find out if your body can cope with a meal, the 2 hours afterwards tells you.
If you are testing to track your progress, the fasting test is a good indicator.

 

[KennyA]

Hello

I am fairly recently diagnosed with HbA1c reading of 44 and have been monitoring my levels for the past few months with Accu-chek instant but I can't work out which readings are most accurate or important.

My typical readings first thing in the morning (before eating or drinking) are around 6.6 to 7.2 but 2-4 hours after eating, they are typically between 5 and 5.6 which would be just about ok as far as I can understand.

So my question is, do I ignore the morning reading and just focus on the other readings during the day?

Thanks

Agree with what others have said. I wouldn't ignore any reading just because it's higher than you might like. It all gives potentially useful information. None of the readings are any more accurate of themselves than the others - assuming you're using the same meter, test strips etc.

It's possible that what you're seeing is your liver doing either or both of two things. One is the dawn phenomenon effect where the liver manufactures some glucose and adds it to the bloodstream to give you a start: the other is the liver trying to raise and maintain your BG to/at what it thinks your "normal" level is. It took my liver about a year to accept that the new lower level (achieved via 20g/day) was now "normal".

 

[RM51]

Thanks for all your replies, very helpful. I will continue to monitor and record blood sugars. Food for the last 3 months isn't too much of an issue as I am on the lower carb side with lots of fish and salads etc and small amounts of pasta/bread/potatoes etc on occasions so my readings are typically the same or sometimes slightly less 2 hours later (not sure why). In the past I have eaten much higher levels of carbs and I found the idea of the dawn phenomenon effect really interesting as it takes a while for my morning readings to drop so maybe this has pushed my average HbAc1 into the prediabetes range and my body hasn't accepted this new lower level as KennyA mentioned.