Year on Year HbA1c 'trend'

[Cricket_Balls]

Hi

if this has already been covered elsewhere, apologies; please point me in the right direction

background: I don't monitor my bg with a meter - found it a bit stressful & not cheap. So I rely on my annual HbA1c.

have just had my blood test, results soon but 1 thing I don't understand - & can't find on the forum - is whether the year-on-year trend for HbA1c is important, or not

brief background: I've always been slim & fit (train hard) but went low carb when I was diagnosed - suspect am not as low carb as many of you but I avoid pasta/rice/have little amounts of root veg/ very little bread/etc

any info much appreciated
Thanks
David aka Cricket_Balls (due injury only played 1 game last season so am now a (professional) umpire)

 

[bulkbiker]

Well its better to get a level below 42mmol/m (pre diabetes) than over and if there is a significant rise say from 30 to 38mmol/m then there maybe be cause for concern re diet If they wobble around the same level you are probably doing ok.
Is that the kind of thing you were asking? What were your last year's results?

 

[LittleGreyCat]

The year on year trend is important, obviously, because it shows if your control in the 3 months prior to your test each year is improving, same, or getting worse.

This doesn't really say much about your control over the other 9 months.

For example I am on 6 monthly tests, autumn and spring, and my control in the summer is better than my control in the winter.

Possibly due to more exercise in the summer and more hunkering down and comfort eating in the winter.

If I was only tested once a year then I would miss this trend.

Finger pricking is boring, but I find it useful to run a short campaign of testing every now and then just to get an idea of how I am doing between HbA1c tests.

 

[Bluetit1802]

I agree that trends are very important, more so if you are increasing year on year. Also, annual testing is unreliable for the reasons stated above by @LittleGreyCat unless you do some self testing in between tests. I appreciate it can be stressful for some people, and can be expensive. However, there are meters with very reasonably priced strips (the Codefree and the Tee2) The ideal aim is to reduce year on year until under 42, and then either reduce further or stay stable.

It would help us formulate better replies if you could tell us more about your results - are they increasing/staying stable/reducing and by how much. Can you tell us what your HbA1cs are and why you are concerned?

Are you taking diabetes medication?

 

[Guzzler]

The reason for having the HbA1c is to spot trends so, yes, it is important. The fact that yours are annual suggest that it has been low-ish on the Diabetes scale but a year in terms of Diabetes is a long time to go without having a clue as to what your bg is doing in the meantime. It has been a year since my last A1c but I test at home with a glucometer which will spot trends far more quickly than that and gives me peace of mind, yes there are times when I'm frustrated by the results and the cost gets on my wick but in my opinion the results are well worth it.

 

[porl69]

The reason for having the HbA1c is to spot trends so, yes, it is important. The fact that yours are annual suggest that it has been low-ish on the Diabetes scale but a year in terms of Diabetes is a long time to go without having a clue as to what your bg is doing in the meantime. It has been a year since my last A1c but I test at home with a glucometer which will spot trends far more quickly than that and gives me peace of mind, yes there are times when I'm frustrated by the results and the cost gets on my wick but in my opinion the results are well worth it.

Hi @Guzzler Surely your HBA1c will not show you trends!? Ver regular finger pricking or CGMs will show you the trends or am I missing something?

 

[Brunneria]

I have done intensive testing (in bursts), and had very sporadic HbA1cs, mainly because my doc surgery is stunningly disinterested in anyone who doesn't have a high HbA1c.

And I can categorically state that relying on just HbA1cs, and staying fairly low carb would not give me good enough control, and would in fact probably lull me into a false sense of security.

The only reason I have dropped my blood glucose numbers below pre-diabetes, and into the 'normal' range is because I test, experiment with different foods and portions, and stay very low carb/keto. Nowadays, I invest in a Libre sensor, rather than finger pricking daily I wear one for 2 weeks every couple of months. It works out at around £5 a week, so not a big investment!
The rest of the time I implement what I have learned from the sensor.

It must be working, because I don't change anything prior to an HbA1c test (which I now pay for privately, since my surgery doesn't think I need them more than every couple of years). Frankly, an annual HbA1c, expecially if people suddenly come over all strict and clamp down on their eating just beforehand, is IMHO rather like pinning the tail on a fidgeting donkey.

 

[Guzzler]

Hi @Guzzler Surely your HBA1c will not show you trends!? Ver regular finger pricking or CGMs will show you the trends or am I missing something?

It would show an annual trend which as I said is a poor measure considering. Let's say I have the A1c blood draw today, I have been unwell for the past three weeks and as we know the A1c shows best the previous 4-6 weeks levels which would (if I was unaware of my levels over the past year) suggest a trend upwards and may prompt a DN to prescribe drugs or increase in dosage but it takes no notice of the remaining 40 odd weeks which may have been absolutely spiffing so you are quite right, daily testing will flag up trends much sooner. It is still important to have the A1c done, though, if nowt else it comes with the other tests that we need to keep an eye on such as liver and kidney function and tickle tests etc.

 

[Cricket_Balls]

Firstly, many thanks to bulkbiker, LittleGreyCat, Bluetit1802, Guzzler, porl69 & Brunneria (what an interesting collection of noms de plume!)
Firstly, it's got me thinking I ought to test more frequently so will check-out the monitors - the Libre sounds interesting; must look into it
Went to get my file of previous HbA1cs & am still trying to think where the h*ll did I put it - does having T2 make you forgetful? Might tell everyone it does - sounds like a great excuse even if it's not true
Get this year's results tomorrow - have no idea what they'll show; another reason to do some testing on my own - it's a fair cop!
David
PS 'tickle tests' Guzzler? sounds like fun. What are they?

 

[Robbity]

I also rely on regular finger prick testing to show me "routine" trends and patterns. Muy HbA1c (generally 6 monthly) is what my GP uses to keep tabs on me, but it's also shown me long term how I'm doing, and this has been more or less stable for the past five years. If I had problems though, that six months delay would be too long when I could have been taking action much earlier to (hopefully) fix things.

Robbity

 

[Guzzler]

Firstly, many thanks to bulkbiker, LittleGreyCat, Bluetit1802, Guzzler, porl69 & Brunneria (what an interesting collection of noms de plume!)
Firstly, it's got me thinking I ought to test more frequently so will check-out the monitors - the Libre sounds interesting; must look into it
Went to get my file of previous HbA1cs & am still trying to think where the h*ll did I put it - does having T2 make you forgetful? Might tell everyone it does - sounds like a great excuse even if it's not true
Get this year's results tomorrow - have no idea what they'll show; another reason to do some testing on my own - it's a fair cop!
David
PS 'tickle tests' Guzzler? sounds like fun. What are they?

The tickle test is part of the annual foot checks, the check includes sensitivity tests and ultrasound to check blood flows etc..

 

[Cricket_Balls]

The tickle test is part of the annual foot checks, the check includes sensitivity tests and ultrasound to check blood flows etc..

Thanks Guzzler
had forgotten about the feet test - further proof that T2 makes you very forgetful
don't think I've ever had the ultrasound test tho. Is this something everyone has or is it subject to the postcode lottery?
Cricket_Balls aka David

 

[Guzzler]

Thanks Guzzler
had forgotten about the feet test - further proof that T2 makes you very forgetful
don't think I've ever had the ultrasound test tho. Is this something everyone has or is it subject to the postcode lottery?
Cricket_Balls aka David

I had the ultrasound (handheld device) at my second review but not at my first so I'm not sure how often everyone else gets them. I did mention at my first review my freezing cold feet so that may have prompted my DN to put that down in my notes. NB the freezing cold disappeared after just a few weeks after lowering my A1c. And yes, both my feet were pregnant and my twins, Consumpta and Concepta are doing well