While I'm waiting...

[Mel108]

Hi, I haven't been officially given the diagnosis yet but 3 weeks ago the G.P receptionist told me my hbca1 tests were 51 and 52 and I that she'd book me in to see the diabetes nurse at the end of April!
Since that call, I have reduced my carb intake significantly and lost 11lb. I have a bg monitor and have been doing readings in the morning and 2 hrs after eating. All my readings have been in the 4s and 5s so the past 2 days I've upped my carb intake to 80g per day and have eaten a hot cross bun with thick butter which sent my bg to 6.7 and half a slice of toast on my dinner which sent it to 6.2. These are still very much in the normal range.
Anyway. What I really wonder is, could my hbca1 test be inaccurate in showing as diabetes as my diet preciously consisted of eating high carb food constantly throughout the day so it never really had time to get low enough to balance out the highs?

I guess the test would be eat some real carby food and see what happens???

Also, is the nurse likely to put me on medication?

And... are there any test strips that work in accu check performa nano but are cheaper?

 

[catinahat]

Of course it's always possible that any test result could be wrong, that's why they usually do two hba1c 's
The second is to confirm the first before diagnosis, with both of yours virtually the same it's extremely unlikely that any mistakes have been made you can be pretty certain that you are T2.

The point you make about your previous high carb diet somehow affecting the HbA1c, well of course you are right, the more carbs in your diet the higher your HbA1c will be, if you are diabetic.
If you were not diabetic you would be able to eat as many carbs as you wanted, without it giving a HbA1c results in the diabetic range
The HbA1c measures how much glucose has stuck to your blood cells, the cells live for around 12 weeks, so it's a sort of 12 week average.

The tests you do at home are just a snapshot of the range your blood sugar is in at that moment.
I say range, because the meters are accurate to +/-15%, which means that whatever number you see, your actual level could be higher or lower by 15%. For example, a result of 6 means that your true level
is any where between 5.1 and 7. That's why they don't use a finger prick test to diagnose us

Even with their limitations the meters are a useful tool for understanding how our food is affecting us,
For example you were 6.7 2hrs after the hot cross bun, but what was your level just before your first bite?
the difference between the two readings is more important than the actual level.
The other thing to take into account with your bun is the thick butter, fat slows the digestion of carbs so at 2hrs it's possible that your blood sugar was still rising.

When testing you have to think about what you are testing and what you want to learn from the test.
If you want to know how you react to fruit juice for example, testing at 2hrs would be a waste of a test strip, fruit juice will hit your blood almost immediately, so your blood sugar will have spiked and come back down long before you do your 2hr test, giving you a false impression that the juice had no effect.
Pizza is another classic example, high carb & high fat, again a 2hr test might have you thinking that by some miracle pizza has no effect, but a test at 3,4 and even 5hr's will prove otherwise.

 

[ajbod]

Theoretically if you had been on any medication which could raise your levels, or carrying an infection for a large part of the 3 months previous to your Hba1c, then it could be possible that the results are skewed slightly.
However even if this had by some very slim chance have happened, then the real figure would still have been pre diabetic, as they couldn't have that big an impact.
The DN might want you to take Metformin, but at the end of the day she cannot make you take them if you don't want to. You'll probably have Statins pushed at you as well, a good earner for the practice.

 

[Mel108]

Of course it's always possible that any test result could be wrong, that's why they usually do two hba1c 's
The second is to confirm the first before diagnosis, with both of yours virtually the same it's extremely unlikely that any mistakes have been made you can be pretty certain that you are T2.

The point you make about your previous high carb diet somehow affecting the HbA1c, well of course you are right, the more carbs in your diet the higher your HbA1c will be, if you are diabetic.
If you were not diabetic you would be able to eat as many carbs as you wanted, without it giving a HbA1c results in the diabetic range
The HbA1c measures how much glucose has stuck to your blood cells, the cells live for around 12 weeks, so it's a sort of 12 week average.

The tests you do at home are just a snapshot of the range your blood sugar is in at that moment.
I say range, because the meters are accurate to +/-15%, which means that whatever number you see, your actual level could be higher or lower by 15%. For example, a result of 6 means that your true level
is any where between 5.1 and 7. That's why they don't use a finger prick test to diagnose us

Even with their limitations the meters are a useful tool for understanding how our food is affecting us,
For example you were 6.7 2hrs after the hot cross bun, but what was your level just before your first bite?
the difference between the two readings is more important than the actual level.
The other thing to take into account with your bun is the thick butter, fat slows the digestion of carbs so at 2hrs it's possible that your blood sugar was still rising.

When testing you have to think about what you are testing and what you want to learn from the test.
If you want to know how you react to fruit juice for example, testing at 2hrs would be a waste of a test strip, fruit juice will hit your blood almost immediately, so your blood sugar will have spiked and come back down long before you do your 2hr test, giving you a false impression that the juice had no effect.
Pizza is another classic example, high carb & high fat, again a 2hr test might have you thinking that by some miracle pizza has no effect, but a test at 3,4 and even 5hr's will prove otherwise.

Thanks for the detailed reply. I hadn't really thought about how long the spike in blood sugars varies according to what I've eaten. So much to learn at the moment!

 

[catinahat]

So much to learn at the moment

There's no rush, it takes time to get your head round it all, I'm ten years in and still learning, still getting puzzled by the occasional test result.
The more you can learn about what T2 is, the easier it is to control
Have a look here, it explains T2, and our real problem, insulin resistance
https://www.endocrineweb.com/conditions/type-2-diabetes