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Confused about different tests , can anyone explain please?

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Beebo

New Member
Relationship to Diabetes
At risk of diabetes
Hi

I have recently had a letter from my GP telling me I am at risk of diabetes with a score of 42. this test was apparently taken in Sept (I didn't know it was being taken, I am assuming it was when I got my thyroid tested).
However, the day I got that letter, I coincidentally did get my HBA1C checked and it was 36, which is more in line with previous years of 37. BUT, I also had a "random blood glucose (FL) test done, and that came out at 9.1, where the reference range is upper limit 7.9.

Can anyone explain why the HB1AC would seem to be normal and the random too high? What does it mean? I'm not sure if I am prediabetic, diabetic or something else

thank you

Beebo
 
It's not a big deal IMO for the random BG test to be 7.8+, particularly if it was done not long after you ate. From the benchmark data I look at, non-diabetics on average spend 4% of their time at 7.8+, so around an hour per day, mostly while awake.

HbA1c is much more important for working out where you are on the D-spectrum. FWIW, I've only ever heard of a random BG test as a secondary diagnostic for full diabetes, with a threshold of 11+, requiring confirmation by a second test on another day - not for an assessment of pre-diabetes.
 
Lots of factors can make your fingerstick (random) glucose wobble during the day - most noticeably food (carbohydrate) which tends to max out between 30 and 90 minutes after eating depending on what it is and what else you are eating. But also hormones, activity, illness even ambient temperature can have marked effects (up and down!)

The HbA1c is measuring the concentration of red blood cells affected by elevated glucose - the more elevated glucose and the longer it remains elevated the more red blood cells are affected. Red blood cells last up to 120 days, so HbA1c gives an indication of glucose profile over the last 3-4 months, but doesn’t actually tell you how even or widely distributed that profile was.

If you are regularly spending time in the 9s after eating it would be well worth reducing the carbohydrate load in meals to give your metabolism a better chance of coping with your food.
 
Thank you so much for replying.

It was a massive shock to get the pre diabetes letter from my GP, as I think I eat very healthily, I'm not overweight, and I excercise regularly. It made me wonder if I have some underlying disease.

The day I had the tests, I did have some avocado toast (white bread which is not my preference, but they gave it to me at the clinic where I was having all of the tests). That could have been about 90 mins or less before they took my blood.

I don't understand why it would be 42, then go back to 36?

I also had FBC, ESR, liver and kidney function which came out normal.

Thank you again

Beebi
 
The day I had the tests, I did have some avocado toast (white bread which is not my preference, but they gave it to me at the clinic where I was having all of the tests). That could have been about 90 mins or less before they took my blood.

That could easily do it. People's (including non-diabetics') responses to grains are very variable, often more so it appears than for other types of carbs. It's really not that uncommon for some non-diabetic to have levels of around 10 after eating even quite small amounts of grains. It's probably nothing to worry much about, but if you want to get some more insight, maybe invest in a cheap BG meter and do some before & after eating tests with different types of food.

Re 42 vs 36: no idea! There could just be some random squidginess involved. Did you have an infection or illness or any medication changes around the time of the 42? Any unusual stress?

Again, probably nothing to worry about bur maybe worth getting an HbA1c update every few months if you can, just to track.
 
Hi. The HBa1C is the right measure and I wonder why the surgery sent the letter when it was only 36? The random blood test is only ever a guide.
 
Hi

Thanks for the replies.

I don't think I was I'll, but I do suffer with anxiety.

I don't think I explained properly, so I'll give a chronological list

May 19. HbA1c was 37
Sept 19. HbA1c was 42 according to go
Dec 19. HbA1c was 36 at health screening, and at the same time my random glucose was 9.1

Hope that makes more sense, I just find the whole thing confusing.

Thank you

Beebo
 
36, 37 and 42 are all in a fairly close range, but 42 just (only just!) gets into the pre-diabetes category, which is why the surgery notified you of this. HbA1c tests will vary over time, nothing really unusual about these results.

I would not worry about the finger-prick reading of 9.1, as others have said non-diabetics could easily be as high within 2 hours of eating bread.
 
Thank you for your reply.

I'm not sure now if I am.prevfiabetic or not. Should I get a fasting blood test?
 
No, fasting blood tests are only of use for cholesterol (and even that is being questioned now). HbA1c is a long-term measurement that cannot be affected by a few hours fasting.
From what you've said, my entirely non-expert opinion is that you're not pre-diabetic and shouldn't do anything until you've had another test (in 3 months?).
 
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