Can someone explain blood test

[Helenp479]

I saw the diabetic nurse for the first time yesterday and all I can say is I hope I see other one next time she was flipping abrupt and I ended up too scared to ask any more questions but I did ask what my blood test result was that prompted them to tell me that I was diabetic she said it was Hba1c 55mmd/mol. Could someone please tell me in simple terms what this means and is this not really that high or do I have a lot of work ahead of me to bring it down.
She told me that I will get appointments through to see a dietician, podiatrist and an eye test and that I will get called back to see her in December to see how I have gone with my diet. I am not doing too bad I managed to lose 2 lb this week so its a start.
Hopefully someone can answer my question as a lot of you seem well up on what the blood tests mean and I haven't a clue I thought she was going to say that it was 10 or something and it should be 5 type of thing but this 55 has me stumped.

Thanks upfront

Helen

 

[Mark T]

According to http://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Blood_glucose/Glycated_haemoglobin_HbA1c_and_fructosamine/, 55 mmol/mol is equivalent to 7.2%

The "recommended" target is to have a HbA1c of less than 48 mmol/mol (6.5%) although to minimise long term risk of complications it is far better to be less than 6%

 

[will2016]

welcome Helen, my DN is a right miserable cow, and I felt the same, however I wrote down all the questions I could think of and sat there and asked them, ignored her heavy sighs and tutting and got all my answers eventually, so stick in there, she works for you! and this forum is excellent for info 🙂

 

[Helenp479]

Thank you Mark and Will looking at the figure when its converted mine doesn't seem too high then for me to get back to what it should be using diet and not medication. I really don't want to go down the medication route if I can help it.
Hopefully the dietician will give me more help as I get stuck with some veg because I have diviculitis and with fruit I have to be careful with acid fruit because of another health issue that I have. Why these nurses need to be such cows I don't know but I felt like a child being told off and looking at the figures you have given me mine is not really high blooming woman scared the heck out of me yesterday saying if you don't do this and don't do that then this will happen all she had to say is that mine wasn't that high now but left untreated by either diet or medication or both it would get serious.

Helen

 

[LeeLee]

Hello Helen, sorry you had such a nasty nurse - unfortunately they're all too common. Mark posted the link to what the figures mean while I was still looking up the page!

If weight is an issue for you (and it sounds like it might be), the best thing you can do is lose some lbs. With type 2, your pancreas does produce insulin to deal with the carbohydrates that you eat - but the T2 body can't use it properly. That's called insulin resistance. Carrying around excess weight increases this resistance.

It's not just sugar that you need to avoid. For a diabetic, all carbs can be problematic, particularly the refined ones like white bread, breakfast cereal, rice, pasta, potatoes. I'm sure Northerner will be along soon to post a link to the GI diet, which explains it far better than I can..

 

[Northerner]

The reason for the confusion Helen is that people used to be given their HbA1c result as a percentage e.g. 6.3%. However, in 2010 the powers that be decided that the result should be given in units of mmol/mol e.g. 48 mmol/mol. For some time after the change we were supposed to be given both a percentage and a mmol/mol result, but it seems that many healthcare professionals have stuck largely with what they know and still give only a percentage - those adhering to the new standard give it as a mmol/mol reading!

It's a bit like when we were all supposed to go metric in the 1970s - if you're over a certain age, you are still more likely to talk about pounds, not kilos, or yards, not meters!

The answer to your question is as Mark says - your result is not terrible, especially as you are newly diagnosed, but hopefully your efforts will be successful in bringing it down over the next few months 🙂

 

[Helenp479]

Hello Helen, sorry you had such a nasty nurse - unfortunately they're all too common. Mark posted the link to what the figures mean while I was still looking up the page!

If weight is an issue for you (and it sounds like it might be), the best thing you can do is lose some lbs. With type 2, your pancreas does produce insulin to deal with the carbohydrates that you eat - but the T2 body can't use it properly. That's called insulin resistance. Carrying around excess weight increases this resistance.

It's not just sugar that you need to avoid. For a diabetic, all carbs can be problematic, particularly the refined ones like white bread, breakfast cereal, rice, pasta, potatoes. I'm sure Northerner will be along soon to post a link to the GI diet, which explains it far better than I can..

thank you LeeLee yes I do need to lose weight and hopefully I will get mine right down again as I don't like being like I am at the moment.
I have tried brown rice and wholemeal pasta in the past but I really do not like them which is a problem as I do like pasta. I have heard of the GI Diet but have never seen just how it works will have to look it up and see what it says.
It is a lot to take in at once and I know everyone on here has been here before me and hopefully with the help of this group I will get both my weight and my levels down.

Helen

 

[Helenp479]

The reason for the confusion Helen is that people used to be given their HbA1c result as a percentage e.g. 6.3%. However, in 2010 the powers that be decided that the result should be given in units of mmol/mol e.g. 48 mmol/mol. For some time after the change we were supposed to be given both a percentage and a mmol/mol result, but it seems that many healthcare professionals have stuck largely with what they know and still give only a percentage - those adhering to the new standard give it as a mmol/mol reading!

It's a bit like when we were all supposed to go metric in the 1970s - if you're over a certain age, you are still more likely to talk about pounds, not kilos, or yards, not meters!

The answer to your question is as Mark says - your result is not terrible, especially as you are newly diagnosed, but hopefully your efforts will be successful in bringing it down over the next few months 🙂

Hi Northerner yes I am from that era and still see things in pounds and ounces getting better with grams, do still weight myself in stones so that then I go omg when I see it if I weighed myself in kilos it wouldn't seem as much. I am glad that my reading is not that high now that I know that then it makes me even more determined to do it on diet alone and not have to have medication.

Helen

 

[Northerner]

thank you LeeLee yes I do need to lose weight and hopefully I will get mine right down again as I don't like being like I am at the moment.
I have tried brown rice and wholemeal pasta in the past but I really do not like them which is a problem as I do like pasta. I have heard of the GI Diet but have never seen just how it works will have to look it up and see what it says.
It is a lot to take in at once and I know everyone on here has been here before me and hopefully with the help of this group I will get both my weight and my levels down.

Helen

Hi Helen, I would recommend getting a copy of The GL Diet for Dummies as a good introduction to the GI/GL diet 🙂 If you still have a library where you live then they might have a copy! 🙂

 

[Mark T]

I guess you have to decide what is more important to you.

Going down the diet and exercise route (or even the diet, exercise and metformin route) means that you have to constrain your diet. You are already having to do this for other health reasons so it just further constrains your diet.

If I do a quick wiki on diviculitis it says that generally a low residue diet is recommended. The wiki link for that gives the following recommendations:
White bread, refined pastas and cereals, and white rice
Limited servings of canned or well-cooked vegetables that do not include skins
Moderate fresh fruits without peels or seeds, certain canned or well-cooked fruits
Tender, ground, and well cooked meat, fish, eggs, and poultry
Milk and yogurt (usually limited to two cups per day), mild cheese, ricotta, cottage cheese
Butter, mayonnaise, vegetable oils, margarine, plain gravies and dressings
Broth and strained soups from allowed foods
Pulp-free, strained, or clear juices

White bread, pasta, rice and cereals will put up your blood glucose - so you have to moderate them (only a blood glucose meter will tell you how much you can tolerate)
Fruit and especially fruit juices have to be moderated too.

So that leaves you on a diet of chicken and cheese, with perhaps a glass of milk and yogurt! 😱 OK, maybe I'm being overly dramatic there! 😛

Medication (and especially insulin) does give you some options since on MDI you can carb count and inject for a meal to attempt to keep your blood glucose in range. Therefore it opens back up some of the constraints (not all of them). So although it might not be what you want - I personally wouldn't completely block it out and say "never!".

Diabetes treatment is supposed to be tailored around what is right for the patient (I'm fairly sure the NICE guidelines do say that) not a one size fits all - "your doomed to loose you legs and kidneys and go blind" type approach that some nurses seem to favour.

 

[Vicsetter]

Hi Helen. I think the problem with your nurse is that she is probably old school and thinks that all patients are idiots to be bullied into doing what they want. You should have been advised that you have diabetes, it's a progressive disease (it gets worse over time). Unless you take action to control your diabetes it will get worse sooner rather than later. Whilst your a1c is not too bad it does mean you should take action (which is what you are doing). Unless you do your a1c will get worse and they will put you on pills and then injections of some kind.

Do your research (as you are) and take control. A reduction in weight might see your diabetes come into the normal range which should be your aim with the side benefit of not having to visit the nurse.

If your nurse is getting you to see a dietician and podiatrist etc then she at least is looking after you properly, so maybe just a misunderstanding between you.
Good luck and ask all you want - try the weight loss section of this forum and the food/recipes for ideas.

 

[yorksman]

Hi Helen, First things first. 55 ain't half bad. I was 87. 8 weeks later I was 48. When I told my DN that it was a good result, she still sneered, 'OK for a diabetic'. Some of these people seem to live on another planet. All I can say is that I am glad that I don't have to live there.

For you to get down to 40, which is where you start to be in comfortable territory, will probably be no more than watching the carbs that you eat. Cut out white bread, white rice in additional to all the sugary stuff. Look for foods that are 'low GI', be a bit more active and continue to lose a few pounds and you will get there.

I bought a meter and tested before and 2 hours after every meal. That way I learned what I should eat and what I should avoid. I started with 5 mins exercise per day and worked my way upto 15 mins, then 2 x 10 mins and then 2 x 15 mins.

HBA1c readings are different from your normal blood glucose reading which go up and down all the time. HBA1c is a sort of average level, not exactly, but near enough. If your finger prick meter readings come down, so will your HBA1c.

Exercise is very good for helping the way you digest food. It's not just for burning off calories. A combination of watching what you eat and doing a decent walk ever day is a powerful weapon against high gucose levels. It also helps you to lose weight which in turn is also another powerful weapon in fighting glucose levels.

Unless you get a good DN who is keen to be helpful, forget what they say. They can sap your will power. Some are proper miserable. Good ones are like gold.

 

[Davids]

Hi Helen
Like you - I am new to all this. I am lucky in that the nurse here is lovely - but even so time is tight and most of the knowledge I have found for myself - much of it on here.

That reading doesn't seem too bad to me - mine was over 80 when I was told that I am type 2 about a month ago.
I am testing at least twice a day and at different times. I am being fairly sensible about food (and there is loads of advice) but the thing I find has the greatest effect is exercise - my best readings have been after cycling, swimming or a short run. A month ago, I could hardly run to the end of the street. Now I can run just one mile and do that say three times a week. I can tell the difference it is making.
I have also joined a gym and didn't like it at first but, having got used to it, it is fine. I find early in the morning there are quite a few older people like me trying to get fitter - the muscle people and athletes tend to come out in the evening!

Best wishes to you - I have found it all mind boggling - but slowly, things are starting to make sense.