HbA1c levl - IFCC Standardised Query

[Collar]

Hi

I was tested on Wednesday and told that my HbA1c level was slightly raised - 46mmol/mol. I have been a diagnosed type 2 diabetic for over 20 years now and the GP has referred me to the diabetic nurse. Am I correct in thinking that the level was not drastic and what could the nurse possibly suggest? All my other blood tests as well as normal diabetic checks and warfarin checks were fine.

Thank you for any help!

 

[Martin.A]

Hi

I was tested on Wednesday and told that my HbA1c level was slightly raised - 46mmol/mol. I have been a diagnosed type 2 diabetic for over 20 years now and the GP has referred me to the diabetic nurse. Am I correct in thinking that the level was not drastic and what could the nurse possibly suggest? All my other blood tests as well as normal diabetic checks and warfarin checks were fine.

Thank you for any help!

That's seems a little odd to me as 46 isn't diabetes, it's in the pre-diabetes range (42-47).

 

[Inka]

Welcome @Collar 🙂 I think a lot of surgeries try to see as many people with diabetes or pre-diabetes as they can (do they get some kind of payment for us??). My surgery keeps trying to get me to see their diabetes nurse even though she knows nothing about my insulin pump, very little about Type 1, and I’m already under the care of a hospital team.

So, if you don’t want to see the nurse, just politely refuse. As @Martin.A says, your HbA1C is only in the pre-diabetic range so not very high. It sounds like you’re doing well 🙂

 

[Martin.A]

Welcome @Collar 🙂 I think a lot of surgeries try to see as many people with diabetes or pre-diabetes as they can (do they get some kind of payment for us??). My surgery keeps trying to get me to see their diabetes nurse even though she knows nothing about my insulin pump, very little about Type 1, and I’m already under the care of a hospital team.

So, if you don’t want to see the nurse, just politely refuse. As @Martin.A says, your HbA1C is only in the pre-diabetic range so not very high. It sounds like you’re doing well 🙂

Just had a thought, though - maybe @Collar has been in remission and their BG has started to edge up?

 

[Collar]

Hello both!

Thank you for replies - I am very grateful.

I have never been told that I am in remission and unable to see my own history on the Patient Access website as my medical record has only been available for a short time :-( All that I recall is that when I was originally diagnosed the guidelines had only just changed and I think I was borderline? (It was the same with warfarin as my GP was unsure about putting me on it!)

Thank you for such a speedy response!

 

[Inka]

Just had a thought, though - maybe @Collar has been in remission and their BG has started to edge up?

Possibly, but someone here said that slightly higher HbA1C levels were ok as you got older. I can’t remember the figures though. Was it 45?

 

[Leadinglights]

I notice your age and as someone of more mature years then there is some recent NICE guidelines that say that the HbA1C that is used for diagnosis and for what is a good level to be stable at should be more lenient. This came from some research that suggested that the more mature people were being over medicated so a personalised approach was advised taking into account other risk factors.
So if your HbA1C is 46mmol/mol then that would be at the lower end of what would be fine given your age.

 

[everydayupsanddowns]

I think it would be helpful for you to get access to your diabetes results over the previous 20 years, so that you can understand what has been going on, and how things have been changing more recently?

 

[Lucyr]

Hi

I was tested on Wednesday and told that my HbA1c level was slightly raised - 46mmol/mol. I have been a diagnosed type 2 diabetic for over 20 years now and the GP has referred me to the diabetic nurse. Am I correct in thinking that the level was not drastic and what could the nurse possibly suggest? All my other blood tests as well as normal diabetic checks and warfarin checks were fine.

Thank you for any help!

The diabetes nurse can show you your previous results on the computer to explain how they compare. I don’t mean to offend but if you don’t even know what your hba1c values have been previously, then it would sound like you’ve not been taking that much of an active role in managing your diabetes and so it would be well worth a chat with the diabetes nurse if you’re now trying to manage it more closely

 

[childofthesea43]

The rise of HbA1c with age generally arises because of the change in red cell turnover. HbA1c is not a measure of how much glucose is in the blood, it is the percentage of red cells that are glycosylated at the moment of measurement. For a given level of serum glucose this percentage is bound to rise if the red cells decline. It has nothing to do with diabetes but is instead just a trivial consequence of arithmetic. Large scale study established some time ago that non-diabetics aged over 65 have an average A1c of 47.5. The standard 42-48 thresholds are pure nonsense for the elderly. The recognition by NICE of higher thresholds being appropriate for such people has nothing to do with being “lenient” with them, it is to do with the arithmetic of red cell turnover and glycosability of aging cells.