HbA1c 5.8 %getting myself in a state!

[jacsgirl]

Good evening I realise I'm being a wimp - just had some standard blood tests, all good but this one which flagged that because I'm above 5.7% I'm in the 'pre-diabetes zone'. I am slightly underweight if anything, take loads of exercise and, mainly because I'm a coeliac, eat no sugars, no processed food, no juices or fizzy drinks etc. I'm stressing what I can give up to reduce the sugars in me! Am feeling worried and ignorant tonight

 

[Robin]

Hi jacsgirl.
I've never heard of someone being told they are at risk of Prediabetes at a level of 5.8. A diagnosis of Prediabetes only starts around 6.0. ( this is an old system, if you're in the Uk, btw, we now use mml/mol and 6.0 equates to 42 for a Prediabetes diagnosis. Diabetes is diagnosed if over 6.5, or 48 in the new system.)
.

 

[jacsgirl]

Hi jacsgirl.
I've never heard of someone being told they are at risk of Prediabetes at a level of 5.8. A diagnosis of Prediabetes only starts around 6.0. ( this is an old system, if you're in the Uk, btw, we now use mml/mol and 6.0 equates to 42 for a Prediabetes diagnosis. Diabetes is diagnosed if over 6.5, or 48 in the new system.)
.

 

[jacsgirl]

Thank you so much for such a quick reply you are kind. I appreciate the reality check and will do some research and ask some questions now. Do you think stress and v poor sleep can impact on blood sugar levels?

 

[Robin]

Thank you so much for such a quick reply you are kind. I appreciate the reality check and will do some research and ask some questions now. Do you think stress and v poor sleep can impact on blood sugar levels?

Most people with diabetes find that stress raises their blood glucose levels, but I think that's because we have impaired or lack of insulin response. I think in non diabetics, the body should match the increased glucose output with more insulin production. (Perhaps it can get out of kilter after a protracted period of stress, but I'm not sure whether any studies have ever been done in this field.)

 

[TheClockworkDodo]

Yes, stress definitely sends blood sugar up (unless it's the sort of stress when you're running round like a headless chicken trying to do too many things at once, then it might send it down). Poor sleep might too, if you're waking up early and your body is putting out a surge of glucose to give you energy ready for the day when you're not actually ready for it yet.

I'd be delighted if my blood sugar were 5.8 though, it sounds pretty low to me even for a pre-diabetic 🙂

 

[jacsgirl]

Yes, stress definitely sends blood sugar up (unless it's the sort of stress when you're running round like a headless chicken trying to do too many things at once, then it might send it down). Poor sleep might too, if you're waking up early and your body is putting out a surge of glucose to give you energy ready for the day when you're not actually ready for it yet.

I'd be delighted if my blood sugar were 5.8 though, it sounds pretty low to me even for a pre-diabetic 🙂

 

[jacsgirl]

What an amazing forum this is - I've never been on one before, you are all so well informed. It wasn't a fasting test and the report showed it was 5.8. Yes we are in the UK. It freaked me out as I couldn't think what I could to make it better. I will definitely go back to the doctors now and ask more questions. Do blood sugars get higher with age I wonder? Thank you all again - I hope you all have a happy, healthy day tomorrow.

 

[jacsgirl]

Sorry, me again. The other number was 40 mmol which apparently isn't great

 

[Eddy Edson]

I know some guidelines in the US at any rate use 5.7% as the pre-diabetes level, FWIW. Eg: https://www.mayoclinic.org/diseases-conditions/prediabetes/diagnosis-treatment/drc-20355284

But one thing which I don't think gets mentioned often enough is that the HbA1c just isn't precise enough to make a difference on a test result between say 5.7% and 5.8% (or an even wider range) meaningful.

The same test on the same person by the same lab on the same day will probably show more variabiltiy than that. And the only point of the test is to estimate yr average blood sugar over the previous 2-3 months, but it is only an estimate: pretty good but not precise. Again, there's not really any meaningful diff between test results of say 5.7% and 5.8% (or an even wider range).

Finally, the fact that different guidelines have different cut-offs should make it apparent that there isn't a crystal-clear separation between "non-diabetic" and "pre-diabetic".

I would say don't stress but keep an eye on it & have it checked every few months for a while. At those levels there's zero complication risk, as far as I can see. There'd only begin to be a possible issue if you saw levels definitely on the rise over time.

 

[Robin]

Sorry, me again. The other number was 40 mmol which apparently isn't great

40 in the new system, is equal to 5.8 in the old, so they are both the same reading. I'd be asking my doctors why they are setting a lower threshold than the NICE guidelines, which state that 42-47 is a diagnosis of prediabetes, they may have their reasons. Let us know how you get on.

 

[Eddy Edson]

Sorry, me again. The other number was 40 mmol which apparently isn't great

It's just two different scales for the same thing. 40 mmol = 5.8%. (Why they had to complicate things by introducing the 40 mmol one, dunno.)

I found this graphic useful for getting my head around things. 5.8% / 40 is down in the non-scary green part.

 

[TheClockworkDodo]

I would say don't stress but keep an eye on it & have it checked every few months for a while. At those levels there's zero complication risk, as far as I can see. There'd only begin to be a possible issue if you saw levels definitely on the rise over time.

I was just in the process of typing something along those lines, went off for a minute to look for a chart, and Robin's and Eddy's posts had appeared!

 

[Ljc]

Sorry, me again. The other number was 40 mmol which apparently isn't great

5.8 % is 40 in the newish measurement. So you’re are below pre diabetic range .
Did a doc tell you you were at risk of diabetes at this level ?
Pre diabetes or glucose intolerance as I believe it’s now often called , starts at 42 which is 6.0 % in the old measurement
Diabetes starts at 48 Which is 6.5 % in the old measurement
So yes you are at the higher end of normal but you are in normal range 🙂.

Stress and other factors can and do affect glucose levels of people with diabetes and I am assuming here, with non diabetics it will but probably with less effect and of shorter duration.

 

[Ljc]

I must learn to type faster lol

 

[jacsgirl]

This is fantastic information i really appreciate it. I feel calmer and will ask some questions now. I had no idea of the range and complexity of diabetes. Out of interest/nosiness is the substantial reduction in your levels down to medication or do you have to work hard to make that happen?

 

[Ljc]

I am glad you feel calmer now.
With pre diabetes it’s diet and exercise, with a good chance of reversing it but reversal is not guaranteed.
With type 2 diabetes , a few can control it by diet and exersize the rest of us need medication as well .

 

[TheClockworkDodo]

I wonder if it's possible if your doctor thinks that as you already have one autoimmune disease you might be at (very slight) risk of type 1 and that's why s/he has flagged up your HbA1c result? - that might be something to ask him or her. The same thing we've already said would still apply though - 40 is very low for anyone to think about that (my HbA1c was about 110 when I was diagnosed, over the far end of Eddy's chart!). There's certainly nothing to worry about at the moment, from the results you've told us.

 

[Eddy Edson]

This is fantastic information i really appreciate it. I feel calmer and will ask some questions now. I had no idea of the range and complexity of diabetes. Out of interest/nosiness is the substantial reduction in your levels down to medication or do you have to work hard to make that happen?

For me: A bunch of people around here have achieved faster reductions than I have. By now, I think I'm down around yr 5.7% / 40 level, maybe a bit higher or lower. HbA1c test next week!

Combination of standard meds, a bit better diet, small extra exercise. I've lost a bit of weight without really trying - wasn't really overweight to start with. Really can't disentangle what has had what impact, but I'm sure the diet has been biggest. The resulting weight loss might have been a big factor also. The meds I think have a good but more modest impact.

So a bit of work but nothing very heroic.

One thing: fibre, which is my hobby horse at the moment. Upping my fibre to recommended levels seems to have had a big effect for me recently, and there's various studies which point to some impact of fibre on insulin response, BG control etc. I don't really know anything about coeliac but do you get enough fibre? Might be worth thinking about.

 

[JMyrtle]

Hi there
I brought my levels down from 58 to 45 by drastically reducing my carbohydrate intake, exercise is not my thing! and also saw a weight loss of two and a half stone caused by the change in diet.
It means no cakes, sweets, biscuits, bread, rice potatoes or pasta although I am lucky and can eat fruit which many cannot.
If you are really worried buy a Codefree meter on eBay and test your blood glucose yourself, the meter costs about £20.00 and the test strips £7.00 for fifty ( it's up to you how often you test but most people test on rising, before their main meal, two hours afterwards and just before retiring.)