I'm very careful about what I eat, check everything containing sugar. Only eat 1 slice of bread a day and 1 pitta bread usually with a thin slice of ham & avocado. I mainly eat fish & veg. I do not eat chips/potatoes, no alcohol or fizzy drinks. Milky coffee once a day and several cups of tea. Go to a gym 3 times a week. Where I'm I going wrong?
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I'm completely flummoxed. About a month ago I had a finger prick test that resulted in 38. I had another test a week ago and it was 48.
- Thread starter Tilly6364
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Leadinglights
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Can you clarify what that particular finger prick test was and the units of the result as the numbers you mention don't quite make sense. Also when were they in relation to food.
Are you sure it was not 3.8 and 4.8 which would be mmol/l as that would be consistent with a fasting reading if you are as in your logo At risk of diabetes.
Have you ever had an HbA1C test to confirm in which case that is normally done from a blood sample from your arm and sent to the lab so those results could be 38mmol/mol and 48mmol/mol (at risk is 42-47mmol/mol, diabetes would be over that and below 42 normal)
John Gray
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> Where am I going wrong?
Probably nowhere, other than assuming that a single finger-prick gives a result which extends beyond the time you made it.
A quick analogy.
Consider a car journey. Assume you are allowed to read the speedometer only twice at random times throughout the journey. What could you tell an inquirer about how fast you were going during the journey?
Probably nowhere, other than assuming that a single finger-prick gives a result which extends beyond the time you made it.
A quick analogy.
Consider a car journey. Assume you are allowed to read the speedometer only twice at random times throughout the journey. What could you tell an inquirer about how fast you were going during the journey?
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Where was the fingerprick check carried out, and what machine was used @Tilly6364 ? Is it a machune at your gym?
Do you have units for the numbers you are quoting?
As others have said, it’s hard to interpret the numbers you are offering, because they seem more associated with HbA1c eg 38mmol/mol but that is more often a check done with blood taken from a vein in the arm.
There are fingerprick ‘instant’ HbA1c machines available, but I’m not sure I’d completely rely on them as it’s a relatively new technology. HbA1c values usually change slowly, because they reflect red blood cells which have a lifespan of 3-4 months, so checks a few weeks apart would have a significant overlap, and wouldn’t be expected to change very dramatically?
Do you have units for the numbers you are quoting?
As others have said, it’s hard to interpret the numbers you are offering, because they seem more associated with HbA1c eg 38mmol/mol but that is more often a check done with blood taken from a vein in the arm.
There are fingerprick ‘instant’ HbA1c machines available, but I’m not sure I’d completely rely on them as it’s a relatively new technology. HbA1c values usually change slowly, because they reflect red blood cells which have a lifespan of 3-4 months, so checks a few weeks apart would have a significant overlap, and wouldn’t be expected to change very dramatically?
Thanks for your replies. I just received a phone call that advised advising my blood test was 48. I'm seeing a diabetic nurse in about 2 weeks. My other test was at my gym so I will contact my personal trainer when he returns from holiday.
Inka
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That sounds like the gym test might not have been completely accurate @Tilly6364 An HbA1C of 48 puts you just in the diabetes zone, so hopefully with a few tweaks you can improve things a lot.
At least you know where you are now. I wonder what sort of machine was used at the gym. The reason I ask was that, a few years ago, I was pre-diabetic (42) back to normal for a few years now 42 again. I went on a diabetes prevention course which I felt at the time was telling me to eat too many high glycaemic carbs such as bread, potatoes, pasta etc. I ignored it and listened to people on here.
The prevention programme used a machine to take a blood test and got readings of 35 and 36. When the GP re-took a couple of months afterwards it was still 42. I told him what had happened with the machine and he did not comment but said he had to work on the hba1c test done at our local hospital. I mentioned it on here and one of the members told me that she had the same thing happen to her and when her GP tested he or she was on 47 and they had heard the machines could be faulty or inaccurate. This was probably why the GP did not seem interested in the readings I had from the other machine.
Leadinglights
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I would suspect that a machine at a gym will be using finger prick blood which is capillary blood and the result may then be an extrapolation to give an approximate HbA1C but the lab based tests are from venous blood which is slightly different in the red cell number and will therefore give a different more accurate HbA1C.
That makes sense as that is what they did with me at diabetes prevention. Most likely why it was incorrect then and GP was not interested in it.
Proud to be erratic
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Hello @Tilly6364,
I have read back into your earlier posts in late 2022 and 2023 under titles that include "pre-diabetic" and from those threads and now @John Gray's response earlier .... I also think you really are doing nothing wrong. Despite now having met the big 70, you sound fit, active and a great weight. Even with your most recent HBa1C possibly indicating that you are creeping (just) into a diabetic diagnosis you certainly are doing all that anyone can reasonably do to truly "look after yourself".
So my initial response would be relax and enjoy your good health.
However if (and I suspect my comments above won't fully satisfy you) if you still feel you must do even more then I would at least wait to see what your discussion with your diabetes nurse goes. I would certainly not take any major decision from the tests results you get from your gym; they are clearly misleadingly low and at risk of causing confusion and stress for you.
There has been some discussion in this forum around research results which suggest that there ought to be a sensible amount of relaxation from too zealously declaring a diagnosis of diabetes with an HbA1c at 48, for those of us who are older. The suggestion makes sense in the context of understanding how that blood sample is analysed in a laboratory to provide a number and the knowledge that as we get older our body's ability to repair or replace damaged blood cells is inevitably impaired.
I can see that you have been doing your utmost to reduce your carb intake. What I'm not clear about is whether you have your own finger pricker, test meter and test strips. If not, then that would be your best way of identifying if you are inadvertently eating something which your body is struggling to fully metabolise and causing this apparent very gradual increase in blood glucose. Do keep in mind that we are each different and can get different responses to any form of carbohydrate or food combination eaten - regardless of what the common consensus might be. If you do have a test meter then are you using it to conduct small but systematic testing both immediately before a meal and consistently at the 2 hr point after starting to eat.
So do you you already have a test meter and a systematic test regime? If you don't already have these do NOT feel that you must rush out and get them; you may simply not want to commit to the intrusion into your present lifestyle that regular testing can be. But it would be helpful to know if you are already familiar with this sort of approach to monitoring meals - food eaten and initial consequence.
I have read back into your earlier posts in late 2022 and 2023 under titles that include "pre-diabetic" and from those threads and now @John Gray's response earlier .... I also think you really are doing nothing wrong. Despite now having met the big 70, you sound fit, active and a great weight. Even with your most recent HBa1C possibly indicating that you are creeping (just) into a diabetic diagnosis you certainly are doing all that anyone can reasonably do to truly "look after yourself".
So my initial response would be relax and enjoy your good health.
However if (and I suspect my comments above won't fully satisfy you) if you still feel you must do even more then I would at least wait to see what your discussion with your diabetes nurse goes. I would certainly not take any major decision from the tests results you get from your gym; they are clearly misleadingly low and at risk of causing confusion and stress for you.
There has been some discussion in this forum around research results which suggest that there ought to be a sensible amount of relaxation from too zealously declaring a diagnosis of diabetes with an HbA1c at 48, for those of us who are older. The suggestion makes sense in the context of understanding how that blood sample is analysed in a laboratory to provide a number and the knowledge that as we get older our body's ability to repair or replace damaged blood cells is inevitably impaired.
I can see that you have been doing your utmost to reduce your carb intake. What I'm not clear about is whether you have your own finger pricker, test meter and test strips. If not, then that would be your best way of identifying if you are inadvertently eating something which your body is struggling to fully metabolise and causing this apparent very gradual increase in blood glucose. Do keep in mind that we are each different and can get different responses to any form of carbohydrate or food combination eaten - regardless of what the common consensus might be. If you do have a test meter then are you using it to conduct small but systematic testing both immediately before a meal and consistently at the 2 hr point after starting to eat.
So do you you already have a test meter and a systematic test regime? If you don't already have these do NOT feel that you must rush out and get them; you may simply not want to commit to the intrusion into your present lifestyle that regular testing can be. But it would be helpful to know if you are already familiar with this sort of approach to monitoring meals - food eaten and initial consequence.
I have read that research Proud to be Erratic. It is a very interesting read.
I recall when I first went pre-diabetic a few years ago at the age of 63 (hba1c 42) then got back to normal for a few years but could not get below 40 which disappointed me greatly as I had made a great deal of effort. This year they checked again and it is back at 42. GP just put retest next year and they expected it could possibly happen. I was upset so I called the surgery and they arranged for the Diabetic Nurse to see me last Monday.
I told the DN I wanted a reading of between 30 and 35 and I had not been satisfied with 40. I am 70 years old by the way and underweight. GP had previously told me he thought I was more insulin resistant getting older and I must stop losing weight. I was 7 stone 10 lbs and 5 feet 7 inches and he was horrified. DN felt I was being unrealistic at wanting the readings down to 30 to 35 and to just try and get back to a "normal" reading if I could. She did say as the GPs have previously said that I cannot expect my body to work as though I am half my age and I can only try my best to get it down.
I do test against foods but had stopped it recently. I have started again but cannot yet find anything that is causing any problems. GP and DN did not think it was a good idea as I would just get mostly normal results but it was up to me if I wanted to as I was funding the monitor and the strips. They are unable to fund it as I am not diabetic.
I recall when I first went pre-diabetic a few years ago at the age of 63 (hba1c 42) then got back to normal for a few years but could not get below 40 which disappointed me greatly as I had made a great deal of effort. This year they checked again and it is back at 42. GP just put retest next year and they expected it could possibly happen. I was upset so I called the surgery and they arranged for the Diabetic Nurse to see me last Monday.
I told the DN I wanted a reading of between 30 and 35 and I had not been satisfied with 40. I am 70 years old by the way and underweight. GP had previously told me he thought I was more insulin resistant getting older and I must stop losing weight. I was 7 stone 10 lbs and 5 feet 7 inches and he was horrified. DN felt I was being unrealistic at wanting the readings down to 30 to 35 and to just try and get back to a "normal" reading if I could. She did say as the GPs have previously said that I cannot expect my body to work as though I am half my age and I can only try my best to get it down.
I do test against foods but had stopped it recently. I have started again but cannot yet find anything that is causing any problems. GP and DN did not think it was a good idea as I would just get mostly normal results but it was up to me if I wanted to as I was funding the monitor and the strips. They are unable to fund it as I am not diabetic.
@Tilly6364 I wonder about your diet and hydration. You mention bread and a thin slice of ham. That looks like too much carb and not enough protein to me, relatively to each other. A thick slice of ham from the butcher, not the highly processed stuff, and some veg would be better for me. I used to drink many cups of tea a day but my blood became too viscous according to the nurse at the hospital who does venesections every day. I switched to half litre flasks of hot water with slices of lemon and/or various alternatives to builder's tea on the shelves these days. Drinking 2-3 litres per day made a big difference.
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Leadinglights
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I think you are being unrealistic about getting an HbA1C as low as 30 when recent guidelines from NICE are that for more mature people that a higher HbA1C is safer especially if people are being overmedicated to keep them at lower levels or get them to lower levels. This of course need to take other risk factors into consideration and there should be a personalised approach.
As you are below 48mmol/mol which is regarded as being the target once diagnosed as diabetic that is likely why your Nurse is dismissive of your concerns about not being as low as you want, even though you are at normal level now.
The links about diet I had in mind:
- David Unwin's Norwood Surgery low carb diet sheet
- Zoe Harcombe's 'What should we eat?'
Both of these are from the same stable, focusing on nutrient dense foods. They are inherently low carb to keep your glucose levels down.
I agree with your general point. On the other hand my diagnosis A1c was 104 just after my 80th birthday. It was down from 32 after 6 months on a diet of protein and vegetables. Mark you I had been seriously overweight and wanted to get back to normal.
As @Maz2 is underweight it's a different situation. Even so dietary changes may be possible. Maz2, why not compare your diet with the ones I just mentioned above:
- David Unwin's Norwood Surgery low carb diet sheet
- Zoe Harcombe's 'What should we eat?'
and Freshwell's advice, a model of clarity.
I find Cronometer (free version) invaluable to keep track of my nutrients.
Leadinglights
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That is why I said taking other risk factors into account.
You obviously managed to get as low as you have with a dietary regime that suits you and is one you are finding sustainable.
Thank you Leadinglights. I am very glad I had a meeting with the DN as I felt quite reassured about it all. I have been told before by GPs that I am being unrealistic about expecting my body to work as well now as it did 30 and 40 years ago.
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