HBA1C test

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Juliecov

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Type 2
i was diagnosed T2 in 2021 & have had HBA1C measured annually . gone from 62 to 39 to 42 to 44 how often should it be checked ? nervous about creeping up
 
"Sympathetic smiley face".
Unless you and your doctors are really worried about your D2, stick to once a year.
Believe me, when they think you need medication/more medication they will tell you! If you're in the UK, micro-management is their forte!
At 42-44 you are pre-diabetic. Keep going with healthy eating and exercise - worrying will bring on stress, which pushes up insulin, so keep the stress out of your life.
My most recent check up was 42, and they told me they want to see it UP at 48 next time, ( ie they want me to present as D2 not pre-diabetic!), so go figure.
After being diagnosed for 27 years, I've come to the conclusion that my health and fitness does not necessarily coincide with the pigeon-hole the NHS wants to force me into.
 
Juliecov said:
i was diagnosed T2 in 2021 & have had HBA1C measured annually . gone from 62 to 39 to 42 to 44 how often should it be checked ? nervous about creeping up
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42 and 44 are really within the accuracy of the test and as people get older the turn over of their red blood cells on which the test is based will change, there is now some recommendations that in more mature people you parameters should be more lenient. That doesn't mean to say that people should not maintain a healthy lifestyle to keep their glucose level well managed.
If you want then tighten up a bit on your carb intake as things can drift.
 
As it's on a pattern of slow rises, it may make sense to purchase a meter to test yourself. You can use that extensively initially to find which foods you tolerate well & which might be better avoided or consumed in smaller portions. Test before eating & two hours after. Your looking to be "in range" of 4-7 mmol before eating & ideally no more than 8.5 mmol two hours after.

Or you can just use the meter to test your waking levels maybe once a week to guard against any significant rise not being detected until the next HbA1c.
 
RBZ5416 said:
As it's on a pattern of slow rises, it may make sense to purchase a meter to test yourself. You can use that extensively initially to find which foods you tolerate well & which might be better avoided or consumed in smaller portions. Test before eating & two hours after. Your looking to be "in range" of 4-7 mmol before eating & ideally no more than 8.5 mmol two hours after.

Or you can just use the meter to test your waking levels maybe once a week to guard against any significant rise not being detected until the next HbA1c.
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I find self testing using a meter provides reassurance and guidance between HbA1c tests. Your HbA1c results seem OK though.
 
Juliecov said:
i was diagnosed T2 in 2021 & have had HBA1C measured annually . gone from 62 to 39 to 42 to 44 how often should it be checked ? nervous about creeping up
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As HbA1c effectively measures your BG over the past 3 months, there’s no point in having more frequent tests than that. My DSN has said that if you are stable then they would only look at testing annually. As your figures are below the 48 where diabetes is diagnosed, I would say annual tests are reasonable. As others have said, doing BG tests yourself, fasting, 2 hours after meals, etc. is a good check as to whether you are still doing alright.
 
Radical cartoons said:
My most recent check up was 42, and they told me they want to see it UP at 48 next time, ( ie they want me to present as D2 not pre-diabetic!), so go figure.
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What you were told is actually in line with NICE guidelines, but even so I agree it makes no sense. Why would someone who's got their numbers down to pre-diabetes or normal be told to get them back up? As you say, go figure.

For adults whose type 2 diabetes is managed either by lifestyle and diet, or lifestyle and diet combined with a single drug not associated with hypoglycaemia, support them to aim for an HbA1c level of 48 mmol/mol (6.5%). For adults on a drug associated with hypoglycaemia, support them to aim for an HbA1c level of 53 mmol/mol (7.0%).
 
Martin.A said:
What you were told is actually in line with NICE guidelines
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Only if they don't read the whole document, which goes on to say:

If adults with type 2 diabetes reach an HbA1c level that is lower than their target and they are not experiencing hypoglycaemia, encourage them to maintain it.

Anyone encouraging an increase without good reason needs some serious retraining.
 
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Juliecov said:
i was diagnosed T2 in 2021 & have had HBA1C measured annually . gone from 62 to 39 to 42 to 44 how often should it be checked ? nervous about creeping up
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Well done on your initial drop in A1c @Juliecov

Have your checks been fairly evenly spaced? Or did you have some quicker together, and then have they settled into annual checks?

Annual or 6-monthly HbA1c seem to be common frequencies? Depending on roughly how stable things are and whether 6-monthly adds value.
 
I believe there is some research which concludes that the optimum range of HbA1c for type 2 diabetics should be between 6% and 8% , this decreases the risk of CVD, I think the CVD risk vs HbA1c graph is horse shoe shaped with 7% at the bottom with lowest risk.
 
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