Exactly same HBA1C test result over 4 months

[silver minion]

Thanks for that. My GPs seem to be reluctant to go back to the testing lab. They've agreed to do another test next week so we'll see what that comes back with and take it from there. The medics seem to be wedded to the 3 month interval which is ok if you've got to a stable HbA1c but if not then a test to make sure you're going in the right direction is good. I've talked to people who like me had very high blood sugar who were refused a test before 3 months only to find the HbA1c hadn't changed and they'd wasted 3 months and had more nerve damage etc for their pains.

I started with an HbA1c of 165 and was put on medication immediately. I have had regular checks but they have been spaced out to approx 3 month intervals with one exception. I find this acceptable in addition to FP checks myself as I take gliclazide. Now moved to annual checks as HbA1c under 50.

 

[JITR]

I've talked to people who like me had very high blood sugar who were refused a test before 3 months only to find the HbA1c hadn't changed and they'd wasted 3 months and had more nerve damage etc for their pains.

In general such people should be advised, at the time of diagnosis, to monitor their blood glucose (and/or their weight) while they improve their diet and exercise themselves as much as they can. This does not seem to be the norm.

It would not be that difficult or expensive to commission a group of experts to come up with comprehensive guidance for all newly diagnosed T2Ds and prediabetics; it would ensure all GPs/DNs and their patients had the same basic information.

 

[Lucyr]

I've had exactly the same HBA1C result of 55.2 mmol/mol for the last 3 tests over a 4 month period. This seems unlikely has anyone had this happen to them. Particularly as I stopped taking Gliclazide in this period

Why have you had 3 hba1cs in a 4 month period anyway, it gives a 3 month average so would expect about the same result. Are you sure you’re reading the result correctly too? Normally if a hba1c is given in mmol/mol it’s given as a whole number

 

[JITR]

Why have you had 3 hba1cs in a 4 month period anyway, it gives a 3 month average so would expect about the same result. Are you sure you’re reading the result correctly too? Normally if a hba1c is given in mmol/mol it’s given as a whole number

See post #9 of this thread.

 

[Lucyr]

See post #9 of this thread.

It doesn’t answer my question. A hba1c won’t significantly reduce in one month between the last two tests

 

[paul.a.thompson]

It doesn’t answer my question. A hba1c won’t significantly reduce in one month between the last two tests

Hi, in answer to your question the surgery suggested reducing my Gliclazide from 80mg to 40mg. I said before making the chance an HbA1c test should be done to establish a base value before any change. This was the 55.2 on March 7th. To see whether the reduction had made any difference a tests was done in May. This gave the second 55.2. The gliclazide was then reduced to zero. I then noticed a rise in my daily finger prick test % so I asked for another test which although only a month later would not give a stable value but would show if my blood sugar level was rising. It came back with the 3rd 55.2. The same 3 values over a 4 month period is extremely unlikely so I was asking if this had ever happen to any one else. To answer your other question I can read a test result as can the GP and the practice nurse who I’ve discussed this with.

 

[Lucyr]

Hi, in answer to your question the surgery suggested reducing my Gliclazide from 80mg to 40mg. I said before making the chance an HbA1c test should be done to establish a base value before any change. This was the 55.2 on March 7th. To see whether the reduction had made any difference a tests was done in May. This gave the second 55.2. The gliclazide was then reduced to zero. I then noticed a rise in my daily finger prick test % so I asked for another test which although only a month later would not give a stable value but would show if my blood sugar level was rising. It came back with the 3rd 55.2. The same 3 values over a 4 month period is extremely unlikely so I was asking if this had ever happen to any one else. To answer your other question I can read a test result as can the GP and the practice nurse who I’ve discussed this with.

The third one was pointless then? If May test had one month on lower dose and two months on higher dose. Then June one had three months on higher dose of which one month with higher bgs. Then both those last 2 a1cs had one month of higher bgs in them.

 

[JITR]

The third one was pointless then? If May test had one month on lower dose and two months on higher dose. Then June one had three months on higher dose of which one month with higher bgs. Then both those last 2 a1cs had one month of higher bgs in them.

@paul.a.thompson
One rule of thumb for interpreting HbA1c results is 50% of the glycated blood cells come from previous month 1, 25% from month 2, and 25% from months 3-4. On that basis you should be able to estimate the effects of withdrawing Gliclazide from your HbA1c results and your finger pricks.

 

[paul.a.thompson]

@paul.a.thompson
One rule of thumb for interpreting HbA1c results is 50% of the glycated blood cells come from previous month 1, 25% from month 2, and 25% from months 3-4. On that basis you should be able to estimate the effects of withdrawing Gliclazide from your HbA1c results and your finger pricks.

Exactly right. This rule of thumb is what I’ve been using all along. It’s basic Maths that not everyone seems to get particularly the NHS. If blood cells last 4 months then 25% will be replaced in a month and you should see a consequential change in HbA1c for any change in medication. There’s no point in waiting 3 months to find out your sugar levels are raised and you’ve got more nerve damage.

 

[helli]

@paul.a.thompson while I understand your confusion about identical HBA1c results and the very low probability of this happening, given you mention that you take finger pricks. I am not sure why you need to repeat your HBA1c so often.
Many of us are lucky to get the test once a year and judge how well we are managing our diabetes by finger pricks and/or CGM. For many of us finger pricks provide the baseline as it is able to tell us changes throughout the day in response to different "stimuli". I have used this to change my diabetes management and consider my HBA1c more of a box ticking exercise for the NHS.
As you are seeing your finger prick tests increase, it is very likely your HBa1C has increased since you stopped Gliclazide. Are you able to do anything to reverse this such as adjust your diet? Or are you wanting to return to the Gliclazide?

 

[Docb]

Another couple of points. The graph shows the variation in my waking blood glucose over the years.

I stopped gliclazide at the start of 2022 and the general rise in my waking result can be seen. After that there is a trend upwards and at the start of 2024 I began dapagliflozin to correct it and my waking BG slowly declined close to the levels seen after stopping gliclazide.

The couple of points are first, that the effects of my medication changes can be seen in my waking results, and second that it is necessary to make quite a lot of observations over quite long periods to see it.

Usual caveat... my data, collected my way and looked at my way so not necessarily universally useful. As usual would be interested if anybody with a similar data set can see a similar pattern

 

[paul.a.thompson]

@paul.a.thompson while I understand your confusion about identical HBA1c results and the very low probability of this happening, given you mention that you take finger pricks. I am not sure why you need to repeat your HBA1c so often.
Many of us are lucky to get the test once a year and judge how well we are managing our diabetes by finger pricks and/or CGM. For many of us finger pricks provide the baseline as it is able to tell us changes throughout the day in response to different "stimuli". I have used this to change my diabetes management and consider my HBA1c more of a box ticking exercise for the NHS.
As you are seeing your finger prick tests increase, it is very likely your HBa1C has increased since you stopped Gliclazide. Are you able to do anything to reverse this such as adjust your diet? Or are you wanting to return to the Gliclazide?

@paul.a.thompson while I understand your confusion about identical HBA1c results and the very low probability of this happening, given you mention that you take finger pricks. I am not sure why you need to repeat your HBA1c so often.
Many of us are lucky to get the test once a year and judge how well we are managing our diabetes by finger pricks and/or CGM. For many of us finger pricks provide the baseline as it is able to tell us changes throughout the day in response to different "stimuli". I have used this to change my diabetes management and consider my HBA1c more of a box ticking exercise for the NHS.
As you are seeing your finger prick tests increase, it is very likely your HBa1C has increased since you stopped Gliclazide. Are you able to do anything to reverse this such as adjust your diet? Or are you wanting to return to the Gliclazide?

I saw my daily finger prick tests increase so I asked for another HbA1c and it came back exactly the same as the previous 2. So in my eyes the numbers don't add up. So either Gliclazide has no effect on me or HbA1c tests are faulty.

 

[paul.a.thompson]

Another couple of points. The graph shows the variation in my waking blood glucose over the years.
View attachment 35755
I stopped gliclazide at the start of 2022 and the general rise in my waking result can be seen. After that there is a trend upwards and at the start of 2024 I began dapagliflozin to correct it and my waking BG slowly declined close to the levels seen after stopping gliclazide.

The couple of points are first, that the effects of my medication changes can be seen in my waking results, and second that it is necessary to make quite a lot of observations over quite long periods to see it.

Usual caveat... my data, collected my way and looked at my way so not necessarily universally useful. As usual would be interested if anybody with a similar data set can see a similar pattern

Have you tried putting a trendline on your data graph this will help spot any directional change early. I've downloaded all my finger prick test into Excel to do this.

 

[paul.a.thompson]

@paul.a.thompson while I understand your confusion about identical HBA1c results and the very low probability of this happening, given you mention that you take finger pricks. I am not sure why you need to repeat your HBA1c so often.
Many of us are lucky to get the test once a year and judge how well we are managing our diabetes by finger pricks and/or CGM. For many of us finger pricks provide the baseline as it is able to tell us changes throughout the day in response to different "stimuli". I have used this to change my diabetes management and consider my HBA1c more of a box ticking exercise for the NHS.
As you are seeing your finger prick tests increase, it is very likely your HBa1C has increased since you stopped Gliclazide. Are you able to do anything to reverse this such as adjust your diet? Or are you wanting to return to the Gliclazide?

This is the dilemma I saw my finger prick tests increase but there was no increase in HbA1c the values were exactly the same 2 readings are 4 months apart with one in the middle. At the 1st I was taking 80mg Gliclazide between the 1st and second 40mg and after the second none. So if the HBA1C tests are right then I don't need the Gliclazide. If the finger prick tests are right then ...

 

[JITR]

I saw my daily finger prick tests increase so I asked for another HbA1c and it came back exactly the same as the previous 2. So in my eyes the numbers don't add up. So either Gliclazide has no effect on me or HbA1c tests are faulty.

No. Taking your HbA1c results at face value, my back of the envelope estimates show Glicazide did have an effect. So did whatever dietary and exercise measures you are taking to lower your blood glucose. By chance these must have cancelled each other out so HbA1c remained the same.

Looks like you are on the way to remission either by continuing whatever you are doing and/or by tweaking your diet.

When I have moment I will check my figures and put them up.

 

[Docb]

Have you tried putting a trendline on your data graph this will help spot any directional change early. I've downloaded all my finger prick test into Excel to do this.

I have all my data in an Excel spreadsheet and am in the middle of writing a Python based application to do all the same things. The graph above is from that application and I have not yet worked out how to put a trend line on it.



This is the same data plotted in Excel with a moving average. I have not been able to see anything more looking at the trendline. Any thoughts?

 

[JITR]

I have not been able to see anything more looking at the trendline. Any thoughts?

Yes, I'd say the plot tells the story.

Have you tried putting a trendline on your data graph this will help spot any directional change early. I've downloaded all my finger prick test into Excel to do this.

@paul.a.thompson
Any chance of a similar plot of your finger prick data for comparison?