HbA1c testing - help!? New to this

Fergie72

Member
Relationship to Diabetes
At risk of diabetes
Pronouns
She/Her
Hello folks, just diagnosed as pre diabetic/ almost diabetic but next test from the doctor is going to be in 12 months (Scotland). Started the lower carb 5/2 and general healthier approach, bit more exercise, hoping it’ll help. Can anyone recommend a hba1c (is that even right?) home test so I can do some quarterly monitoring in the hope I can improve my score? It’ll all a bit of a shock right enough. I don’t know what’s good or bad to be honest. Any help much appreciated. Thanks x
 
Welcome to the forum @Fergie72.
You can finger prick test as often as you like. The BG monitors which have cheaper strips and lancets are the Gluco Navii and the Spirit Tee 2, though other makes are available. It won't give you your hba1c which is an accumulated test over the last 3 months, but it will indicate your fasting bloods, and how much it increases after eating. So test first thing in the morning, then just before a meal and 2 hours after. You should be looking at no more than 2-3mmol increase 2 hours after eating.
I may be wrong here (and please someone put me right if so) but a reasonable mmol would be, say, 5 in the morning, 5 before eating and no more than 7-8 after a meal. I'm using 5 as that's generally my fasting level though it drops below that later in the day.
 
Hello folks, just diagnosed as pre diabetic/ almost diabetic but next test from the doctor is going to be in 12 months (Scotland). Started the lower carb 5/2 and general healthier approach, bit more exercise, hoping it’ll help. Can anyone recommend a hba1c (is that even right?) home test so I can do some quarterly monitoring in the hope I can improve my score? It’ll all a bit of a shock right enough. I don’t know what’s good or bad to be honest. Any help much appreciated. Thanks x
uk here medichecks nurse visit
 
Welcome to the forum @Fergie72.
You can finger prick test as often as you like. The BG monitors which have cheaper strips and lancets are the Gluco Navii and the Spirit Tee 2, though other makes are available. It won't give you your hba1c which is an accumulated test over the last 3 months, but it will indicate your fasting bloods, and how much it increases after eating. So test first thing in the morning, then just before a meal and 2 hours after. You should be looking at no more than 2-3mmol increase 2 hours after eating.
I may be wrong here (and please someone put me right if so) but a reasonable mmol would be, say, 5 in the morning, 5 before eating and no more than 7-8 after a meal. I'm using 5 as that's generally my fasting level though it drops below that later in the day.
Thanks Vonny that’s really helpful. You sound like you’ve had a really big change in stats from diagnosis to now?!
 
Thanks Vonny that’s really helpful. You sound like you’ve had a really big change in stats from diagnosis to now?!
Mostly thanks to my trusty Gluco Navii monitor! You don't have to monitor, but it really helps you to see what you can and can't eat. TBH I hardly use mine now, but it's handy to have if I'm trying some new food to see if I can tolerate it or not. Best of luck!
 
Thanks Vonny that’s really helpful. You sound like you’ve had a really big change in stats from diagnosis to now?!
being checked my finger prick waking 6.2 6.6 7.2. too much chocolate
 
ate loads prunee after dinner going to bed finger prick 20
 
ate loads prunee after dinner going to bed finger prick 20
No wonder, one of the highest carb fruits. Lesson learned I would thing. Whether your other readings were good or bad depends on when you took them.
 
@Fergie - the HbA1c test is one using a sample of blood drawn out of a decently sized vein then tested in a pathology laboratory - NOT a test we can do ourselves at home usually. But we always say that only doing any blood test once a year would be like driving the length of the M1 and not bothering to glance at the speedo - ie damn stupid - hence why we're great fans of fingerprick testing in the meantime!
 
@Fergie - the HbA1c test is one using a sample of blood drawn out of a decently sized vein then tested in a pathology laboratory - NOT a test we can do ourselves at home usually. But we always say that only doing any blood test once a year would be like driving the length of the M1 and not bothering to glance at the speedo - ie damn stupid - hence why we're great fans of fingerprick testing in the meantime!
Thank you. It turns out I am anaemic too, so trying to get to bottom of that. In the meantime finger pricking in the morning and levels have begun to drop after six weeks (hurrah!) It is very heartening that the low carb / low calorie approach seems to be working (despite the odd blip). Thanks for your response, much appreciated.
 
Thank you. It turns out I am anaemic too, so trying to get to bottom of that. In the meantime finger pricking in the morning and levels have begun to drop after six weeks (hurrah!) It is very heartening that the low carb / low calorie approach seems to be working (despite the odd blip). Thanks for your response, much appreciated.
Just be aware too that an hba1c is less accurate if you have anaemia. The test literature actually says it shouldn't be used to diagnose diabetes (or pre-diabetes in your case) in someone with anaemia.
I would have thought that that in itself would be a reason to be retested sooner than a year. If you are able to resolve the anaemia, it would be reasonable to ask for your hba1c to be rechecked then (as long as its at 3 months since your last hba1c).
 
Just be aware too that an hba1c is less accurate if you have anaemia.

Out of interest, I looked to see what Google AI had to say. This paper describes an analysis of HbA1c results of anaemic and non-anaemic patients at The Brooklyn Hospital Center.

Their conclusion was HbA1c normal reference ranges calculated for the anaemia and non-anaemic groups corresponded 3.8%-6.9% and 4.5%-7.0% (48 mmol/L) respectively.
 
Last edited:
I may be wrong here (and please someone put me right if so) but a reasonable mmol would be, say, 5 in the morning, 5 before eating and no more than 7-8 after a meal.

The general advice for T2s used to be 4-7 before meals, and no higher than 8.5 by 2hrs after a meal (by which time your 'second phase insulin' should have kicked-in and started working).

Interesting to note that if you keep your meals down to a 2-3mmol/L rise, and more or less hit the 4-7 premeal target, then by and larg you'd be below 8.5 at 2hrs more often than not.

In the early days when levels are gradually drifting downwards the 2-3 rise aim that T2 forum members generally go for can be especially helpful in menu tweaking when pre-meal levels are yet to drop to 4-7. eg a 9.8 before a meal, with 11.1 after 2hrs would still be an encouragingly low 'meal rise' of only 1.3, even though both readings might look a little on the high side.

Keeping the meal rises low allows your overall levels to drift down gradually over weeks and months, which is kinder on the eyes and nerve endings 🙂

Good luck with it @Fergie72
 
Thanks all for your very helpful responses. Lots of food for thought there, much appreciated. God it’s a learning curve isn’t it!
 
Thanks all for your very helpful responses. Lots of food for thought there, much appreciated. God it’s a learning curve isn’t it!
food for thought 🙄
hope that’s reasonably low carb food your think about @Fergie72
 
Out of interest, I looked to see what Google AI had to say. This paper describes an analysis of HbA1c results of anaemic and non-anaemic patients at The Brooklyn Hospital Center.

Their conclusion was HbA1c normal reference ranges calculated for the anaemia and non-anaemic groups corresponded 3.8%-6.9% and 4.5%-7.0% (42 mmol/L) respectively.
There are plenty of papers discussing the inaccuracies of hba1c in some forms of anemia. Often suggesting using a fructosamine test instead or an OGTT, as often used in pregnancy, thus bypassing the potential for misdiagnosis as a result of rbc inconsistencies and using established testing rather than theoretical redefined parameters not yet in existence as proposed in that paper.
 
There are plenty of papers discussing the inaccuracies of hba1c in some forms of anemia. Often suggesting using a fructosamine test instead or an OGTT, as often used in pregnancy, thus bypassing the potential for misdiagnosis as a result of rbc inconsistencies and using established testing rather than theoretical redefined parameters not yet in existence as proposed in that paper.
@Dragonheart,

Did you have a look at the paper?

Its final conclusions were:

The realized reduced lower limits of reference range in this population will lead to appropriate clinical tolerance for lower HbA1c levels, with avoidance of inappropriate intervention for erroneous perception of over-enthusiastic control of diabetic hyperglycemia. [whatever that means!]

and, as you say:

We recommend that, absent risks factors for and symptoms relatable to diabetes, marginal elevations in HbA1c levels (i.e. HbA1c >6%) in anaemic patients should warrant confirmation of diagnosis using fasting blood glucose and 2HPPG or OGTT. The use of other surrogates of glycemic control, immune to the blur associated with haemoglobin type and concentration, may circumvent the problem associated with use of HbA1c in this special population. To this end, fructosamine and glycated albumin assays are currently being examined.
 
Back
Top