Why the rigid cut off points in HbA1c for diagnosis of type 2.

[Gardengnome]

I umderstand an HbA1c result of 6.5 mmol/mol is a diagnosis of T2 and once you reach that point there is no going back: it affects insurance and all sorts of other things and you are permanently on the register at the GP. I had a result of 5.9 a year ago and made many lifestyle changes including losing weight - [high fat and low carb] - and exercise and am now slim with a BMI of <19. I went from weighing 72 kilos to 55 kilos in 12 months. Certainly not your average type-2-diabetic-waiting -to-happen. I actually didn't know the HbA1c result at that point and did these changes for hypertension and arthritis. I also have borderline high cholesterol.. Now I've had the HbA1c done again and it is exactly the same. My dr says this is prediabetes and only the lifestyle changes I made have prevented it rising over the past year. He now says it will rise as there is nothing more I can do diet wise, and when it reaches the 50 mark he will have the metformin waiting for me!! Maybe it's his idea of humour ?? He also says thin people develop T2 as well. Perhaps I should add that I am 71 yrs.

 

[Andy12345]

hi, i suppose there needs to be a line, if there isn't any other lifestyle changes to make i suppose medication is the next step, metformin is a good drug (in my opinion) so i wouldn't worry too much about going onto them, i think 20% of type 2 diabetics are thin, its just a stereotype that we are all fat (and lazy) i believe it is more genetically related and i also like the theory that people genetically more likely to develop t2 are genetically more likely to be over weight (or over fat for MID) but it definitely isn't always the case

hope you get the answers your looking for great job with the weight loss!

best of luck

 

[sally and james]

The purpose of a line, or cut off point, is so that boxes can be ticked and people categorised. The aim of a line is, or at least should be, the point at which a significant proportion of people begin to get some sort of problem starting to occur. In different countries and at different times, the line has been in different places - it's a matter of opinion, not a god given truth.
Concerning your GP's witty suggestion of having the Metformin waiting for you, remember, many people do not manage to sustain weight loss or exercise regimes and doctors and diabetic nurses have a mind set, perhaps not surprisingly, that diabetes is a progressive condition.
Don't lose heart, keep up the good work and, like many others, whose stories I've read on this and other sites, prove them wrong!
Sally.

 

[Daibell]

Your GP obviously isn't that knowledgeable as many thin people diagnosed with T2 are in fact T1.5 (LADA). This is particularly true if they were never overweight and lost weight just before diagnosis.