Hello, I’m new & I have questions about my HbA1c test results.

[Welsh mum]

I have been using Medichecks postal blood tests since 2019 to monitor my thyroid hormones as I’m hypothyroid & medicated. I’m always interested in my blood sugar results as both my parents were diabetic, T2 in old age. My results have varied over the years but last year it was 38, in Jan 2024 it jumped to 42 & last week it’s 43. The puzzling thing is that last November I started eating strictly low carb, I’d like to reach Keto but have had no luck yet. The January result would include Christmas with a few brownies, nut clusters etc but I was always careful to eat them after protein. The January to February month I’ve been much stricter low carb but my result is worse. Any ideas why please? Many thanks for any guidance.

 

[Inka]

I don’t know how accurate the tests are @Welsh mum but very low carb can cause a form of insulin resistance so maybe that pushed your result up? Or have you gained any weight, particularly abdominal or reduced your exercise? If you’re concerned, I’d speak to your GP and get a repeat HbA1C there.

 

[trophywench]

Meaningless, frankly, to only test your HbA1c, or TSH for that matter - only once a year!

Diabetes blood test results do vary whatever we do and whoever we happen to be and there are over 40 different things that might affect it.

 

[trophywench]

Plus of course we all have hormonal changes. And what's insulin? A hormone .......

 

[Welsh mum]

I don’t know how accurate the tests are @Welsh mum but very low carb can cause a form of insulin resistance so maybe that pushed your result up? Or have you gained any weight, particularly abdominal or reduced your exercise? If you’re concerned, I’d speak to your GP and get a repeat HbA1C there.

I don’t know how accurate the tests are @Welsh mum but very low carb can cause a form of insulin resistance so maybe that pushed your result up? Or have you gained any weight, particularly abdominal or reduced your exercise? If you’re concerned, I’d speak to your GP and get a repeat HbA1C there.

It is interesting to hear that low carb can cause insulin resistance. I had an NHS HbA1c done last week at the same time so I would expect it’ll be 42 also unless NHS tests vary much from private lab tests. So maybe low carb or Keto is not really suitable for me?
I’m thinking of trying a Freestyle Libre sensor to see if I’m suffering hypoglycaemia at about 3am as I mostly wake then with a racing heart & sweating. Would insulin resistance explain that too?
I’m also finding that during the day, whilst following the low carb diet, I’m back to having hot flushes. I’m 7 years past menopause so it’s a surprise to be experiencing them again & it’s definitely the change in diet. All else is stable.
I’m impressed to find that my ferritin reading which has been far above range for several years
has halved in the last month of low carb, much reduced inflammation I presume. Thank you for any thoughts.

 

[Lucyr]

I’m thinking of trying a Freestyle Libre sensor to see if I’m suffering hypoglycaemia at about 3am as I mostly wake then with a racing heart & sweating.

A libre sensor wouldn’t tell you this as you could have low readings from lying on it. You would need to fingerprick to get confirmation of whether your blood sugar is low. So may as well save the £50+ (you’d have to pay VAT as not diagnosed diabetic), and if you’re keen to test then invest in a cheap fingerprick meter instead.

Still not sure it’s worth testing though as everyone’s blood sugar dips overnight and it’s perfectly normal for non diabetics to have blood sugars below 4

 

[Welsh mum]

Meaningless, frankly, to only test your HbA1c, or TSH for that matter - only once a year!

Diabetes blood test results do vary whatever we do and whoever we happen to be and there are over 40 different things that might affect it.

I’d like to point out that my annual Medichecks test was to check my thyroid hormones, TSH, Free T4 & Free T3 as I’ve been on a stable dose of hormone for many years & don’t need more frequent tests. I choose to do a fuller test to keep an eye on other readings so it’s definitely not meaningless at all. I can track many test results back to 2019.
My post today refers to the results of 3 blood sugar tests. Again far from meaningless, especially as I have followed advice & reduced my carb intake greatly yet it has caused the opposite effect from that expected.
I think your critical reply to a newcomer looking for advice is unkind and funnily enough meaningless.

 

[Welsh mum]

A libre sensor wouldn’t tell you this as you could have low readings from lying on it. You would need to fingerprick to get confirmation of whether your blood sugar is low. So may as well save the £50+ (you’d have to pay VAT as not diagnosed diabetic), and if you’re keen to test then invest in a cheap fingerprick meter instead.

Still not sure it’s worth testing though as everyone’s blood sugar dips overnight and it’s perfectly normal for non diabetics to have blood sugars below 4

Do they wake with a racing heart & sweating every night though?

 

[Docb]

Hi @Welsh mum and welcome to the forum. My thought for you is that if you are at all concerned about your blood glucose levels then go to your GP and get your HbA1c measured. That way you can be sure that proper samples have been taken, they have been handled properly and tested to established protocols. I personally would not rely on tests done commercially, especially when carried out as part of a block of tests done on what will be a small sample sent through the post.

To me the results you quote are unlikely to be statistically different and are in any case are what might be expected from people without diabetes. I would suggest you take great care in using them to point to causes of things like your night sweating.

PS... I think that is what @trophywench was trying to say but she can be a bit direct as I found out years ago when she replied to my first post on the forum!!

 

[Welsh mum]

Hi @Welsh mum and welcome to the forum. My thought for you is that if you are at all concerned about your blood glucose levels then go to your GP and get your HbA1c measured. That way you can be sure that proper samples have been taken, they have been handled properly and tested to established protocols. I personally would not rely on tests done commercially, especially when carried out as part of a block of tests done on what will be a small sample sent through the post.

To me the results you quote are unlikely to be statistically different and are in any case are what might be expected from people without diabetes. I would suggest you take great care in using them to point to causes of things like your night sweating.

PS... I think that is what @trophywench was trying to say but she can be a bit direct as I found out years ago when she replied to my first post on the forum!!

Yes, I have been to the GP but not received a result yet. I just thought that I needed to check before continuing with my diet change, which was insisted upon by a doctor, since it’s now having the opposite effect to the expected one. I have found some medical research papers which do support the idea that low carb can increase insulin resistance. I feel I’m between a rock & a hard place! Not sure what to do now. I realise that my readings are low & only just pre diabetes levels but genetically I’m vulnerable especially being hypothyroid & I’m trying to stave off T2.

 

[Lucyr]

Do they wake with a racing heart & sweating every night though?

Since neither libre sensors nor fingerprick tests can be used to diagnose anything at all, you’d need to speak to your GP about night time symptoms regardless

 

[Docb]

OK... Many of us have GP practices that use things like Patient Access to access their services and one of the great things about it is that you can look up your test results within a day or two of the sample being taken. Does your practice have this?

I would be intrigued to see what Hba1c result you get from tests done via your GP to compare it with the Medicheck results. I spent most of my working life measuring stuff and then trying to make sense of the answers and one thing that experience leaves you with is the knowledge that every measurement has an error associated with it. Some of those errors can be a lot bigger than you might expect - unless you are a bit of an old lab rat like me.

 

[Inka]

Do they wake with a racing heart & sweating every night though?

Sometimes if someone has slightly higher than usual blood sugar, the body can overcompensate and release a little too much insulin pushing blood sugar to the low end of normal. This sudden change from high to low can cause symptoms.

However, other things can cause this too, eg thyroid issues and hormonal changes (I know you said you were post-menopause but maybe things have gone a bit erratic again. I do know that some ladies get hot flushes when they’re a little older despite their periods having ended). As you’re already on thyroid medication, I’d mention this to your doctor and see if it’s connected at all.

 

[trophywench]

I know you're Welsh and I'm English but my Hypothyroid is routinely dealt with by my GP and only if the results go too far up or down, does the diabetes consultant get involved since the consultants we see in Diabetes Clinics are all fully qualified Endocrinologists in the first place, before they decided to specialise in diabetes. I have HbA1c and TSH tests done twice a year by hospital clinic and once a year by GP surgery. Is not all Hypothyroidism checked at least once a year by UK GPs?

 

[Welsh mum]

I know you're Welsh and I'm English but my Hypothyroid is routinely dealt with by my GP and only if the results go too far up or down, does the diabetes consultant get involved since the consultants we see in Diabetes Clinics are all fully qualified Endocrinologists in the first place, before they decided to specialise in diabetes. I have HbA1c and TSH tests done twice a year by hospital clinic and once a year by GP surgery. Is not all Hypothyroidism checked at least once a year by UK GPs?

I have my thyroid hormones prescribed privately with an annual blood test before. Most hypothyroid people treated by the NHS have an annual TSH test which isn’t adequate for good treatment at all but it’s the standard NHS approach.

 

[Deb_l]

Do they wake with a racing heart & sweating every night though?

My hot flushes are like this - I wake up scared to death sometimes

Hormones (or lack of) are horrible. I was 48 when I started the menopause, I'm 54 now and only just having horrid hot flushes.

 

[trophywench]

True. But as mine only appeared once I'd had T1D for 2 or 3 decades and it's never made me ill to speak of eg losing a lot of body hair or weight probs etc, just sometimes felt very very tired more time than usual, it's always just been treated as Hey Ho, just another auto immune condition to get on with. Such a common extra ai condition for anyone who already has any other ai history it simply doesn't raise any comment whatever when I need to visit a medical profession who doesn't know me or my story. I just make sure I take the tablets and get the results of the blood tests.

Here's a subsidiary general question (so to anyone reading this) that's just occurred to me though - I take 125mg Levothyroxine a day. I discovered this morning that I'd run out of the 25mg. Ooops, so ordered some more (and most other things on my repeat list) straight away. Is the TSH test a test of what's happened over the last however long (slightly akin to how the HbA1c test measures) or does it 'only' show the measurement of TSH on that particular day?

 

[Leadinglights]

Don't forget the HbA1C is an average blood glucose level over the previous 3 months prior to the test so unless you have been doing a low carb regime for the whole of that time it will not fully reflect the impact of that.
Also you mention ferritin levels and that is also something that can affect the HbA1C test result and certainly the difference between 42 and 43 is not significant.

 

[Docb]

Don't forget the HbA1C is an average blood glucose level over the previous 3 months prior to the test so unless you have been doing a low carb regime for the whole of that time it will not fully reflect the impact of that.
Also you mention ferritin levels and that is also something that can affect the HbA1C test result and certainly the difference between 42 and 43 is not significant.

!!PEDANT ALERT!!

HbA1c is not an average blood glucose level. It is a measurement of the proportion of haemoglobin that has been glycated. A better way of characterising it would be to say the HbA1c test reflects the average blood glucose level over the last three months or so.

A bit pedantic I know but people, especially newbies get confused over the various tests that are used and anything we can do to be technically accurate must help in keeping things clear.

 

[Martin.A]

!!PEDANT ALERT!!

HbA1c is not an average blood glucose level. It is a measurement of the proportion of haemoglobin that has been glycated. A better way of characterising it would be to say the HbA1c test reflects the average blood glucose level over the last three months or so.

A bit pedantic I know but people, especially newbies get confused over the various tests that are used and anything we can do to be technically accurate must help in keeping things clear.

Yet anyone looking up HbA1c on this very website sees this:-

HbA1c is your average blood glucose (sugar) levels for the last two to three months

??????