Fifth Blood Test Results- Would you be worried or not?

[Admiral Benbow]

So I got back my fifth blood test results for myself as a 43 year old man, and here are the results:

Height Measured: 171.7 (Wrong should have used a tape measure not machine as I am 174cm)
Waist: 78 cm (less than 90cm before flagged)
Weight (KG) : 59.30
Vision Correction: Left: 0.6 Right 0.8
Blood Pressure: 131 Systolic (Range before flagged 90-139) Diastolic 65 (Range before flagged 60-89)
Protein in Urine: Negative
Occult blood in Urine: Negative
Blood pigment: 14.7 (13.0-180.0 g/dL before flagged)
White blood count: 5.8 (3.5-9.6 10^3/uL before flagged)
ALT and SGPT: 17 (7-52 IU/L)
Fasting Blood Glucose: 108 (Flagged because range 70-99mg/dL)
Creatinine: 1.00 (0.7-1.3 mg/dL)
Cholesterol: 204 (Flagged because range 0-200 mg/dL)
Triglycerides: 59 (Range 0-150 mg/dL)
HDL Cholesterol: 55 (Range >40 mg/dL)
LDL Cholesterol: 112.10 (0-129 mg/dL)
Chest X ray- No abnormalities

Well I'm generally happy with this, as my fasting glucose before has been higher at the technical diabetic level of 126 mg/dL or higher and after 5 blood tests now, it seems they are all over the map as I've had 130, 93, 134, 128, and now108. The last two A1C's I've had have been 4.8% and 5.1%. This appears to be random fluctuations to my untrained eye and I don't think I will go see the old Doc for another A1C as a fasting glucose of 108 mg/dL is just barely into the 'prediabetic' range. I might need to drink more water and eat more veggies to keep cholesterol in range, but I have heard that people on low carb diets who eat more healthy saturated fats can have slightly elevated cholesterol levels. Really happy with Trigs and HDL. Those are more predictive of whether I will have a heart attack and die I think. I'd like one test, just one, to not be flagged for something, but I'm heading in the right direction I think. What do you guys think? Here were my prior results:

	Fasting Glucose	Triglycerides	Blood Pressure	Weight /173 cm h	BMI	Waist	A1C	HDL
January 2023	130 mg/Dl	210	150/83	75.1 kG	25.1	92cm	n/A	45
May 2023	93 mg/Dl	73	120/80	59.6 kG	19.9	84-85 cm	4.8	55
August 2023	134 mg/Dl	45	115/71	60.25 kG	20.25	75 cm	n/A	50.25
Sept 1 2023	128 mg/Dl	N/A	N/A	n/A	n/A	n/A	5.1	n/A

 

[harbottle]

From what I have read, 'fasting' glucose can vary even in people without diabetes, and sometimes be in the pre-diabetic range, and can be especially variable in the mornings. One reason why it isn't used for diagnosis.

 

[Leadinglights]

HbA1C result looks fantastic. Too much natural variation in fasting blood glucose to base a opinion on 1 result on 1 day.

 

[everydayupsanddowns]

I think this natural variation in fingerstick results is why the UK has moved to HbA1c for diagnostic purposes.

Fasting glucose levels can be a helpful flag, or at least raise the question, but an HbA1c removes that daily (hourly!) fluctuation, and while not a perfect measure, does at least give a slightly more stable measurement on which to base decisions.

108mg/dl = 6.0mmol/L

4.8% = 29mmol/mol
5.1% = 32mmol/mol

Both HbA1cs are well below the ‘at risk of diabetes’ range 42-47mmol/mol

 

[harbottle]

I read an interesting paper recently that was looking at the effects of the circadian rhythm on the metabolism. It covered glucose, and was quite interesting in that at different points of the day the body's response to blood glucose is different - insulin resistance changes, insulin secretion levels change and beta cell sensitivity is different. (It pointed out that at some times during the day a non-diabetic may see pre-diabetic levels.)