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Hba1c test

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Chrissie Wa

Active Member
Relationship to Diabetes
hello all
Returning here after a while. My OH was diagnosed as T2 14 months ago. Since then he has had lots of tests for extreme pain in stomach/liver area including ct of pancreas, 2 X MRI scans etc. He originally was highly sensitive to Metformin and after a couple of months of vomiting and losing even more weight he stopped taking it and went on the X-pert course, in the meantime he had 5 days in hospital for malnutrition. Anyway, his bloods came down from 155 to I think 55 or thereabouts whilst we were on the Xpert course and the nurse was pleased. Now I don't think that he's changed much in his diet since then, he does have ice-cream, odd cakes etc but he was doing that before. So he's just had another test but tinware not fasting and he's come out at 111. He is in despair. The GP has given him Glucophage SR 500mg (which the instructions say take at night with food but GP said to take in the morning(?) He's taken 2 so far at night but he's terrified he's going to start throwing up again. He had a very bad bout of flu and a bad chest infection in February with 2 courses of antibiotics and steroids. Could this have affected his readings? I have no medical or dietary training apart from Weightwatchers, slimming world etc so would be grateful for any advice or help. Sorry for long post. TIA
 
The Metformin (Glucophage) slow release should be taken with/straight after food. You can take the tablet in the morning but your OH will still need to eat with it. This is mostly to try and combat the side effects you may get with the tablets, if you take it on an empty stomach then the side-effects are much more likely. 500mg is the lowest dose of that medicine. I take mine with breakfast (my dose is also contrary to the advice on the leaflet, I take 500mg in the morning and 1000mg in the evening), I don't get the side effects I did with the normal Metformin any more, but it's taken a bit of time to get used to it. To be honest, with a result that high, I'm surprised that he wasn't given more drugs.

Your HbA1c test measures the glucose in your blood stream over the previous three months, so it's a picture of his BG levels in that time not fasting that morning doesn't make a difference to the HbA1c. Being ill can certainly make his levels go higher, that happens to a lot, if not most people here I think so it could definitely contribute.

I've also done the X-Pert course, and found it very helpful. The main thing I took away from it was the importance of portion sizes and making sure I stick to them. It may be that he has to cut out more carbs, and the cake and ice cream for a bit to help get his levels down. Meat and veg for a while.
 
I’m wondering if the steroids and antibiotics contributed. I’ll cut out the oven chips and packet mash (is mashed swede ok)? The lunches are up to him.
I’ve just made him a sug Free jelly for tonight and we have cream and skyr
 
Hi. Does your husband have a meter & self test. This can tell you what affect any food has on your BG. You can then make changes based on that.
 
Hi Chrissie, certainly being unwell would impact his levels and raise them. Does your husband test his BG levels? If not it be helpful for him to do so, even for a shorter period, to understand a little better about when in the day his levels are increasing? As Beck mentioned, the HbA1c is just giving a broad average over 3 months and doesn't help you and your husband to understand what is happening throughout the day. Different food can have an affect on people in different ways so it can be really important to understand the smaller picture. However, may also be that he needs a review of his medication, with quite a high HbA1c, perhaps other medication needs to be considered?
 
Hi
He was testing all the time but he stopped because he got down to 55 and had sore fingers. I don’t think the GP is treating it properly. He has poor circulation, cold hands, cold feet, weight loss
 
Chrissie Wa said:
Hi
He was testing all the time but he stopped because he got down to 55 and had sore fingers. I don’t think the GP is treating it properly. He has poor circulation, cold hands, cold feet, weight loss
Click to expand...

I’d be asking (insisting) on a referral to a specialist/endocrinologist for him to be honest Chrissie. I don’t think you are convinced his GP has got a handle on this and greater expertise is required with his ongoing health issues. I’d even pay for one if I had to. Good luck.
 
Never been offered that option so worth asking. However we would not be able to pay, we've lost so much money through him being ill.
 
The standard release metformin is shorter acting, and usually needs to be taken with a meal.

I have also been told that it may be better to have something to act on if you suffer from the most common side effects.

The extended release version can be taken at almost any time - it takes a while to build up in your system and to have any (intended) effect anyway.

Meformin by itself does not dramatically reduce blood glucose, but it does:
Slow down the process of the liver "dumping" glucose into the blood stream.
Improve the effectiveness of insulin on peripheral cells.

It also apparently act to suppress appetite.
 
grovesy said:
Most Type 2 don't get referred to specialists at hospitals.
Click to expand...

Not many spend 5 days in hospital with malnutrition though grovesy. Sounds like he’s struggling to cope or get his levels anywhere near under control with the present treatment regime.
 
Well, this is our thoughts. Possibly HbA1c is is elevated due to antibiotics and steroids in Feb. So we're reviewing the diet but not going carb free ATM so mirroring diet which took him down to 55 last year. He's always hungry too. Then we will go back for another Hba1c at Gps in say a month or 2 and see if we've made any difference. Meanwhile...?
 
Hello again,
Just been with him to see diabetic nurse at surgery. She has invited us back tomorrow to see a specialist who is Holding a clinic for the more challenging diabetics in the surgery. I Said we are struggling with diet and keeping him full she said 150 g of carbs per day. I also said I'd been on the forums advocating as low carb as possible and she said no, that's wrong. He said he's always hungry, she said eat more Vegs and protein. I'm wondering what tomorrow will bring? Your comments would be appreciated, Tia
 
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