A1C a higher threshold for diagnosis than fasting glucose?

[Admiral Benbow]

Hi everyone,

Just a question. I got my bloods tested on saturday. It had been 82 days that day since I found out I had Trigs of 210 and a fasting glucose of 130 on Jan 30. The Doc I saw said he will redo the tests but this time is also doing an A1C. He took my BP and it was exactly 120/80, higher than my 4 readings I took at home which were below 110, but I'll take it.
I read that an average blood glucose reading of 140mg/dl is an A1C of 6.5 which is a diagnosis for diabetes.
So my question is, do you think that the worst case scenario is my A1C indictates prediabetes (< 6.5) if I've spent the last two months intermitting fasting, sprinting and watching my carbs and the day before my test had a body weight of 59.6 kg on a 173cm height for a BMI of 19.9?
My last bloods were taken Jan 30, and I worry what I ate then, and the first two weeks of Feb might give a high A1C. After the 13 Feb I started to really watch things and take things seriously. I really don't believe I have diabetes or a risk of it anymore than the average person, as my gut is completely gone, and I am thinner than the average bloke now, and can feel the bones in my collar and back. What do you think? I find out tomorrow.

 

[CatsFive]

mmol/mol is the usual measure in the UK and 48 is taken as the threshold for diabetes, 42 for prediabetes.

I think it will come out in the wash tomorrow, and no point in stressing over it. I'm not sure what caused them to test your HbA1c in the first place, and it sounds like you might well have significant other health issues.

You might want to vary your exercise - walking longer distances, cycling, swimming, weights are all good. So are yoga & Pilates which has more or less fixed my bad back.

Find a unit converter on this page - it's below the video, which I found very irritating: https://www.diabetes.co.uk/hba1c-units-converter.html

 

[Lucyr]

You can’t decide in advance what the results will be, you can develop diabetes even if you have a lower bmi than your 19.9, even if you exercise and intermittently fast etc. Hopefully the result will be good but if it’s not then you’ll deal with it.

 

[Admiral Benbow]

mmol/mol is the usual measure in the UK and 48 is taken as the threshold for diabetes, 42 for prediabetes.

I think it will come out in the wash tomorrow, and no point in stressing over it. I'm not sure what caused them to test your HbA1c in the first place, and it sounds like you might well have significant other health issues.

You might want to vary your exercise - walking longer distances, cycling, swimming, weights are all good. So are yoga & Pilates which has more or less fixed my bad back.

Find a unit converter on this page - it's below the video, which I found very irritating: https://www.diabetes.co.uk/hba1c-units-converter.html

Yeah, I don't feel I have any significant health challenges. In fact, I feel healthier than I've ever been in the last 5-10 years. Other than the numbers in January which were high, I have no indication externally anything is wrong with me. I now have low BMI, low normal weight, good or ideal blood pressure below 120/80 repeatedly when I self test and the doc said it was 120/80. That is why I am really wondering what will happen tomorrow.

 

[Dragonheart]

A fasting test such as your first one is a moment in time. And various things could have made that high as well as diabetes. Even though you can anticipate what your hba1c might be using conversions it’s never going to be accurate based on a single blood glucose reading. You are never going to be at that level all the time. You need a lot of readings across the days to get even a half decent estimate. Your single reading might have been much higher than usual (lack of sleep, infection, stress, preceding days food and energy expenditure and even the weather!) or lower than usual or typical. You simply don’t know. That’s one reason they stopped using fbg to diagnose and went for the hba1, particularly at such a borderline level, and in most cases a confirmation test repeated soon after the first (unless there are other clear confirmatory symptoms)

Your hba1c back then could have been almost anything and tomorrow it still could, although with the changes you’ve made likely better than before. If nothing else it sounds like you’ve improved your overall health and that a bonus. I’m assuming you’ve not been testing bgl at home to get a clue. Hang tight and you’ll know soon. I suspect you’ll be quite relieved if I look into my crystal ball.