Guess my HbA1c level game

[helli]

The timing of results seems to be geographical. All those who say they should be back within a couple of days needs to move down to my neck I'd the woods where we are advised to schedule blood test at least two weeks before appointments.
Perhaps, it is a good idea to say "In my area, results come back In a couple of days". Otherwise, it can be misleading.

Fingers crossed for you @Jenny65 . I am sure you will see results from the great work you have been putting in and predict low 50s.
I hope you don't have long to wait.

 

[Jenny65]

The results would normally be back in a few days, but all the tests may not be at the same time and sometimes would not be released until the Doctor had looked at everything to get the overall picture as some may impact on others.
9 days though worth ringing them.

Hi, yes I agree, I just called but they have an automated message saying to call back after 2pm if its in regard to results so will call back later, wish me luck 🙂

 

[Jenny65]

I had my first HbA1c since diagnosis the day before you I think, on the 29th Sept and got my results last week, which I am still disappointed with, dropped from 50 to 44 whilst MySugr app has been saying 34. I mention it because I think my expectations were raised by seeing the estimation on MySugr.
I've lost just over 2.5 stone and dropped from a size 16 to a size 10 which is a good if expensive result as I need new clothes.
My cholesterol has dropped from 8.3 to 5.7 which means I've dropped my risk from heart disease from 50% to 33% 🙂retesting HbA1c week before Christmas!
Got fingers crossed for a great result for you @Jenny65 🙂

wow wonderful news on the cholesterol result, I will be happy if mine has come down, almost more than the HbA1c result as I am really keen to get my risks lower on that front. Brilliant to be a size 10, wow you will be able to get some lovely Christmas party clothes too, Your result is still in the right direction so well done.

I think there are a lot of delays with the results at my surgery as they made a point of telling me they can take up to 2 weeks now they have changed labs, does make me wonder why they have changed over though if they are slow although it may be out of their hands. 🙂

 

[Jenny65]

The timing of results seems to be geographical. All those who say they should be back within a couple of days needs to move down to my neck I'd the woods where we are advised to schedule blood test at least two weeks before appointments.
Perhaps, it is a good idea to say "In my area, results come back In a couple of days". Otherwise, it can be misleading.

Fingers crossed for you @Jenny65 . I am sure you will see results from the great work you have been putting in and predict low 50s.
I hope you don't have long to wait.

Thank you Helli, I am nervous the longer it goes on.

I am in the South East, near Gatwick so maybe its my area that has the delays only 🙂

 

[Wannie]

wow wonderful news on the cholesterol result, I will be happy if mine has come down, almost more than the HbA1c result as I am really keen to get my risks lower on that front. Brilliant to be a size 10, wow you will be able to get some lovely Christmas party clothes too, Your result is still in the right direction so well done.

I think there are a lot of delays with the results at my surgery as they made a point of telling me they can take up to 2 weeks now they have changed labs, does make me wonder why they have changed over though if they are slow although it may be out of their hands. 🙂

don't remember last time I bought Christmas party clothes, or went to a Christmas party tbh, though we did have big family get togethers before covid. Thank you for the thought though 🙂
I'm coming to terms with the HbA1c 😉 DSN was lovely though trying to make me feel better, reminding me that my diabetic HbA1c may have been affected by the glucosamine tablets I'd been taking on physio's recommendation, and that its often harder to reduce the lower end numbers .... I sincerely hope not because I might be a while getting under pre diabetic numbers 🙄
I'm sure you'll have a great result!!!

 

[rebrascora]

Hope and expectation are a really big issue here and whilst I know this is supposed to be a bit of fun, people can end up pinning their hopes too high and being disappointed, so whilst I think you have reason to be optimistic of a 42-47 result from the information you have given us, you simply may not get that result because other things can affect your HbA1c and there is no direct correlation. Those results are actually a much better reflection of your diabetes management than the HbA1c result because they demonstrate that you have significantly lowered your Blood Glucose levels and no doubt reduced the variability which are both now recognized as the important factors. HbA1c less so, even though it is the one medical professionals still use.
I think you should be extremely proud of yourself whatever the result because you have made HUGE positive changes, as has @Wannie. It is easy to lose sight of that or at least take the shine off it, if an HbA1c result doesn't live up to hope or expectation and that can have a significant mental impact on you as it sounds like it sadly has with @Wannie. There are things which can make an HbA1c result less of a reflection on your effort and good diabetes management, but it is easy to view it as the all important rubber stamp or pat on the back, so I would say, don't have so much faith in it as a measure of your success. You are doing brilliantly and you don't need an HbA1c result to tell you that or worse still doubt that you are doing as well as you are.

 

[42istheanswer]

I think from those BG results you have a good chance of a result in the "pre-diabetic" range too. 45 and 46 seem to have been taken, so I'll go for 47!

 

[Wannie]

Hope and expectation are a really big issue here and whilst I know this is supposed to be a bit of fun, people can end up pinning their hopes too high and being disappointed, so whilst I think you have reason to be optimistic of a 42-47 result from the information you have given us, you simply may not get that result because other things can affect your HbA1c and there is no direct correlation. Those results are actually a much better reflection of your diabetes management than the HbA1c result because they demonstrate that you have significantly lowered your Blood Glucose levels and no doubt reduced the variability which are both now recognized as the important factors. HbA1c less so, even though it is the one medical professionals still use.
I think you should be extremely proud of yourself whatever the result because you have made HUGE positive changes, as has @Wannie. It is easy to lose sight of that or at least take the shine off it, if an HbA1c result doesn't live up to hope or expectation and that can have a significant mental impact on you as it sounds like it sadly has with @Wannie. There are things which can make an HbA1c result less of a reflection on your effort and good diabetes management, but it is easy to view it as the all important rubber stamp or pat on the back, so I would say, don't have so much faith in it as a measure of your success. You are doing brilliantly and you don't need an HbA1c result to tell you that or worse still doubt that you are doing as well as you are.

Thank you @rebrascora this is what I was trying to say to @Jenny65 my expectations were raised by the estimated HbA1c on the MySugr app, and I was very disappointed last Thursday when I got my result, however I know if I hadn't been using the app I would have been happy with the result.

Everything else they tested is fine and my Cholesterol and Blood Pressure have gone down so there were positives as well and I'm a glass half full person anyway.
I haven't lost my resolve and will just have to wait a short while longer to go and get a Black Forest trifle 😉 which is to be my reward when I get to a HbA1c of 40 or under! (This is probably the true reason for my disappointment )
My current average BG for the last seven days is 5.2 but 5.7 for the last 90 days, it will be interesting to see if the app resembles my next HbA1c, but will not be pinning my expectations on it in December.

 

[Jenny65]

Hope and expectation are a really big issue here and whilst I know this is supposed to be a bit of fun, people can end up pinning their hopes too high and being disappointed, so whilst I think you have reason to be optimistic of a 42-47 result from the information you have given us, you simply may not get that result because other things can affect your HbA1c and there is no direct correlation. Those results are actually a much better reflection of your diabetes management than the HbA1c result because they demonstrate that you have significantly lowered your Blood Glucose levels and no doubt reduced the variability which are both now recognized as the important factors. HbA1c less so, even though it is the one medical professionals still use.
I think you should be extremely proud of yourself whatever the result because you have made HUGE positive changes, as has @Wannie. It is easy to lose sight of that or at least take the shine off it, if an HbA1c result doesn't live up to hope or expectation and that can have a significant mental impact on you as it sounds like it sadly has with @Wannie. There are things which can make an HbA1c result less of a reflection on your effort and good diabetes management, but it is easy to view it as the all important rubber stamp or pat on the back, so I would say, don't have so much faith in it as a measure of your success. You are doing brilliantly and you don't need an HbA1c result to tell you that or worse still doubt that you are doing as well as you are.

Thank you Barbara, that made me feel much better, whatever the result. I simply couldnt do anymore than I am doing to lower it (apart from take medication) so whatever the result I will take comfort in what you have written here as it makes a lot of sense.

I have spoken to the surgery to chase up the result and they said there is an issue with these particular results for all their patients and to call back tomorrow but it may be I need to redo the test!

This is annoying as I have to book time off work each time I have a test, Work are OK with it and in reality I could sneak off because I work from home, but would worry that someone needed me urgently when I was at the GP and away from my desk. I dont drive and its a 20 min walk there and then back so at least an hour away from my work. I work for an ambulance trust and whilst I am not a paramedic or call taker I sometimes have to deal with time critical work so to leave my post for an hour I need to book this in with my manager, so far I have taken quite a bit of time off for other appointments, DSN, Eye checks, Flu and Covid Vaccines, liver scan and several blood tests, I feel like I am taking the mickey as seem to need a few hours off each week to attend appointments, so when something like this happens it is really annoying

 

[Jenny65]

Thank you @rebrascora this is what I was trying to say to @Jenny65 my expectations were raised by the estimated HbA1c on the MySugr app, and I was very disappointed last Thursday when I got my result, however I know if I hadn't been using the app I would have been happy with the result.

Everything else they tested is fine and my Cholesterol and Blood Pressure have gone down so there were positives as well and I'm a glass half full person anyway.
I haven't lost my resolve and will just have to wait a short while longer to go and get a Black Forest trifle 😉 which is to be my reward when I get to a HbA1c of 40 or under! (This is probably the true reason for my disappointment )
My current average BG for the last seven days is 5.2 but 5.7 for the last 90 days, it will be interesting to see if the app resembles my next HbA1c, but will not be pinning my expectations on it in December.

I know its not quite the same as a black forrest trifle but have you tried greek yoghurt with frozen cherries and melted in some 85% dark chocolate? its not as naughty but tastes like it is xx

 

[Leadinglights]

Because the HbA1C is an average over an approximately 3 month period it perhaps does not well reflect what one might expect from current finger prick tests when people have taken active steps to alter their diet thus showing better than the average blood glucose. I know there is some sort of weighting that gives bias toward more recent weeks but there may well be quite few weeks of high readings from month one or so contributing to a higher reading for HbA1C.
So, after a second period of 3 months, the test then will be more representative.

 

[Wannie]

I know its not quite the same as a black forrest trifle but have you tried greek yoghurt with frozen cherries and melted in some 85% dark chocolate? its not as naughty but tastes like it is xx

Aww Thank you for the suggestion Jenny, but I discovered the black forest trifle when I moved here on the coast in the middle of the pandemic and if truth be told it was probably the trifle, the cream teas, fish and chips that pushed my weight and blood glucose up, I had started to behave as if I was permanently on holiday . Sad to say I probably wouldn't enjoy it now as I think it would be too sweet, but I like to think I would give it a good try 😉

 

[rayray119]

Firstly your results are taking a long time ! Usually no more than 48 hours or so however I can say with absolute certainty that your result will be better than the last one… I win !

Both times I've got my hb1ac done since diagnosis I've had to ask the nurse I was seeing at my next appointment.

 

[Jenny65]

Both times I've got my hb1ac done since diagnosis I've had to ask the nurse I was seeing at my next appointment.

Oh thats annoying, I just assumed as they just added them to my GP record last time on the App it would be the same this time, also my cholesterol test hasnt come back yet either, my surgery messed up last time by telling me my results were OK and then that they were anything but OK 2 weeks later, I did get a written apology and a promise they were going to change the way these results were passed on for future patients though.

Just really want a straight forward , take a test get a result situation 🙂

 

[Docb]

Because the HbA1C is an average over an approximately 3 month period it perhaps does not well reflect what one might expect from current finger prick tests when people have taken active steps to alter their diet thus showing better than the average blood glucose. I know there is some sort of weighting that gives bias toward more recent weeks but there may well be quite few weeks of high readings from month one or so contributing to a higher reading for HbA1C.
So, after a second period of 3 months, the test then will be more representative.

Can I be a bit pedantic? The HbA1c is really not an average of anything. It is a measure of the level of glycated haemoglobin in the blood relative to unglycated haemoglobin. Thats why it is expressed in units of mmol/mol or as a percentage. The complicating factor is that haemoglobin is has a life span of about three months and old haemoglobin, some of which might be glycated, is being continually replaced by new, unglycated haemoglobin. What you end up with is an equilibrium level of glycated haemoglobin, and it is that which is measured in your HbA1c result.

Finger prick test results and HbA1c test results are both measures of blood glucose control and if one is high then the other will be high. The neat thing about HbA1c is that it does not dodge about like finger prick results and so is very handy when it comes to setting diagnosis levels. The neat thing about finger prick test results is that they dodge about so you can get a handle on short term effects, especially the effect of different foodstuffs. The two measures need to be taken together to give a good picture of diabetes status.

 

[Leadinglights]

Can I be a bit pedantic? The HbA1c is really not an average of anything. It is a measure of the level of glycated haemoglobin in the blood relative to unglycated haemoglobin. Thats why it is expressed in units of mmol/mol or as a percentage. The complicating factor is that haemoglobin is has a life span of about three months and old haemoglobin, some of which might be glycated, is being continually replaced by new, unglycated haemoglobin. What you end up with is an equilibrium level of glycated haemoglobin, and it is that which is measured in your HbA1c result.

Finger prick test results and HbA1c test results are both measures of blood glucose control and if one is high then the other will be high. The neat thing about HbA1c is that it does not dodge about like finger prick results and so is very handy when it comes to setting diagnosis levels. The neat thing about finger prick test results is that they dodge about so you can get a handle on short term effects, especially the effect of different foodstuffs. The two measures need to be taken together to give a good picture of diabetes status.

Thank you for clarifying, I think the HbA1C is a hard concept to visualise though I understand the principal. I can see as a diagnostic tool when people have made no changes over the previous 3 months it will a fairly static percentage but once people make changes over the 3 month period, the percentage will be changing constantly and hopefully reducing so less easy to see how that works out.

 

[Finn]

I'll guess 49.

I have since reduced carbs to less than 100g a day and lost 3 stone, and given up smoking, plus taken up exercising regularly.

Whatever the result, you've had some amazing achievements in the last few months, Jenny. Well done!

 

[Proud to be erratic]

Can I be a bit pedantic? The HbA1c is really not an average of anything. It is a measure of the level of glycated haemoglobin in the blood relative to unglycated haemoglobin. Thats why it is expressed in units of mmol/mol or as a percentage. The complicating factor is that haemoglobin is has a life span of about three months and old haemoglobin, some of which might be glycated, is being continually replaced by new, unglycated haemoglobin. What you end up with is an equilibrium level of glycated haemoglobin, and it is that which is measured in your HbA1c result.

Finger prick test results and HbA1c test results are both measures of blood glucose control and if one is high then the other will be high. The neat thing about HbA1c is that it does not dodge about like finger prick results and so is very handy when it comes to setting diagnosis levels. The neat thing about finger prick test results is that they dodge about so you can get a handle on short term effects, especially the effect of different foodstuffs. The two measures need to be taken together to give a good picture of diabetes status.

Pedantic perhaps, but still very useful as a reminder that this game is comparing apples with oranges (pink apples with blood oranges?). I love the game and the associated chat that goes on.

I can see that before the arrival of CGMs, HbA1c was a valid and presumably only way of medical assessment of a person's BG state and certainly more reliable for diagnosis than one (or even a few) finger prick results. Does the glycated haemoglobin measure still have relevance when a sensor such as Libre provides an average of BG over a period of 90 days and thus a pretty good statistical measure of BG status, including variability? Is there more to checking glycated haemoglobin, ie perhaps an indicator of the bodies way of refreshing our blood - or something similar?

 

[gll]

I got so triggered with my GPs obsession with my a1c. It caused so many delays to getting me referred and onto the right treatment path.
It was more of an opposite issue for me, I was going up and up and the a1c wasn't reflecting the rapid changes quick enough.
I had an a1c of 77 at referral and by the time I saw a DSN 5 weeks later I was seeing 22+ on my meter as a baseline and sometimes too high to get a reading at all.
Even if DSN repeated the a1c it still wouldn't have been a true reflection to the crisis point I was at.

As @Leadinglights already mentioned, I would be more interested in the next one if they do one in 3 months time 😉

 

[Jenny65]

OMG, I need a rant! I rang the doctors about my results and they said, yes the results have been received and are with my doctor but there is a note not to add to my record or pass on until I have seen him, so I said Ok when can I see him, they said 8th November I can have a telephone appointment, so I said I have to wait nearly 4 weeks to know if something is up or I need medication. She said a reason that the doctor sometimes holds back the results is they think the patient then wont make an appointment. So I said "does this mean they are not bad then as otherwise I would google and realise I needed to see him" she said "oh that could be the case, I will email him and ask him if he can share the results so I can update the app!"...this is making me so stressed as I dont know if I need medication or if my diet is working at controlling my diabetes and cholesterol

Sad sorry just needed to let this out